Paget's Disease of Bone - Treatment Overview
Many people do not need any treatment for
Paget's disease. But the disease should be monitored
for the rest of your life because of increased risk of
complications such as inflammation of joints (arthritis), broken bones (fractures), and nerve problems. If your disease is
active, you should see your doctor every 3 months. See your doctor or nurse
every 6 to 12 months if Paget's disease is inactive.
Doctors generally recommend treatment if you have symptoms or if
you have no symptoms but are at risk of
complications. You may be at risk if:
- Your lab tests suggest that your
bone tissue is breaking down faster than
- The disease is in long bones or bones that hold up the
weight of the body (such as the
thighbones or the
spine ). You may need treatment to prevent the affected
bones from becoming brittle and breaking.
- The disease affects your
skull or spine. You may need treatment for nerve problems such as
hearing loss, headaches, and numbness or tingling in
the body. Paget's disease in these areas may also cause deformities (such as a
bowed spine) that may make walking difficult. After bowing of bones has
occurred, it cannot be reversed with medicine.
- You are having
bone or joint surgery. If you have Paget's disease, you need treatment with
medicines to slow bone growth before surgery to reduce the risk of problems
such as bleeding after surgery.
- The disease requires you to stay in
bed for a long time. You may need treatment to prevent levels of
calcium in the blood from getting too high.
Doctors aim treatment at slowing the breakdown of bone tissue,
which may help Paget's disease to become
inactive. Treatment may also reduce pain and may help
If you have symptoms of complications from Paget's disease, such as
painful joints, you may also need treatment for these conditions.
For the initial treatment of
Paget's disease, doctors usually prescribe a medicine
bisphosphonate, which reduces the breakdown of bone
tissue and helps control symptoms such as bone pain. This medicine may also help prevent
complications such as
osteoarthritis or nervous system problems. If you
cannot tolerate bisphosphonate, your doctor may prescribe another medicine,
Bisphosphonates nearly always make Paget's disease
inactive, sometimes for years or decades. In some
people, though, Paget's disease becomes
active again. So you may need to take medicine off and
on for the rest of your life.
If your bone pain does not go away while you are taking medicine
to slow the breakdown of bone tissue, you may need acetaminophen, or aspirin,
ibuprofen, or other
nonsteroidal anti-inflammatory drugs (NSAIDs).
Other treatments may include the following:
- Splints or braces to support bones and joints
can help prevent weakened bones from breaking. If your doctor prescribes a
splint or brace, be sure it fits properly. Splints or braces that do not fit
properly can cause skin irritation.
- Canes or walkers may help you
walk with less risk of falling. Ask for training in how to use these devices
properly. You can also use these reminders to help you use a cane or walker
- Physical therapy can help strengthen muscles, increase
endurance, and improve balance.
- Home health nursing may be right
for you if you are taking a medicine that must be given
intravenously. Home health nurses can also help make
your home safe to prevent you from falling.
- Acupuncture and relaxation techniques (such as
guided imagery and
biofeedback techniques) may help reduce pain in some