There's currently no cure for Paget's disease of bone, but treatment can help relieve the symptoms.
If you don't have any symptoms, your doctor may suggest keeping an eye on your condition and delaying treatment until any problems occur.
The main treatments are:
Good diet and nutrition is also important to keep your bones healthy.
Bisphosphonates are medicines that help regulate bone growth. They work by affecting the cells that absorb old bone (osteoclasts).
There are several bisphosphonates available, including:
- risedronate – a tablet taken once a day for two months
- zoledronate – a one-off injection
- pamidronate – six weekly injections or three fortnightly injections
These can help regulate bone growth and reduce pain for several years at a time. Treatment can be repeated when the effect starts to wear off.
The most common side effect of risedronate is an upset stomach. The main side effects of zoledronate and pamidronate are flu-like symptoms that last a day or two.
If you're unable to have bisphosphonates, you may need daily injections of another medicine that prevents bone loss called calcitonin.
Over-the-counter painkillers such as paracetamol and ibuprofen can help relieve pain caused by Paget's disease of bone.
Make sure you read the packet or leaflet before taking painkillers, to check whether they're suitable for you and to find out how much to take.
If these don't help reduce your pain, your GP can prescribe more powerful painkillers.
Some people with Paget's disease benefit from supportive therapies such as physiotherapy or occupational therapy.
These therapies involve exercises and techniques that can help reduce pain, improve movement and make everyday tasks easier.
Devices that reduce the weight placed on the affected bones may also help, such as:
- a walking stick or frame
- orthotics – insoles made of plastic that fit inside your shoe to help support your feet
- braces that support the spine in the correct position
Some therapists also use treatments such as transcutaneous electrical nerve stimulation (TENS) – a method of pain relief involving the use of a mild electrical current. The scientific evidence for TENS isn't strong, but some people find it helpful.
Surgery is usually only needed if further problems develop, such as fractures, deformities or severe osteoarthritis.
Operations that may be done include procedures to:
- realign the bones after a fracture so that they heal correctly
- remove and replace a damaged joint with an artificial one, such as a hip replacement or knee replacement
- cut and straighten deformed bones
- move bone away from a squashed (compressed) nerve
These operations are usually done under general anaesthetic, so you'll be asleep and won't experience any pain while they're carried out.
Diet and nutrition
Calcium and vitamin D help keep your bones healthy. If you have Paget's disease of bone, it's important to ensure you get enough of these.
You get calcium from your diet. It's found in foods such as:
- dairy foods – such as milk and cheese
- green leafy vegetables – such as broccoli and cabbage
- soya beans, soya drinks with added calcium and tofu
You get most of your vitamin D from sunlight, although it's also found in some foods such as oily fish.
Sometimes your GP may suggest taking extra calcium and/or vitamin D supplements to ensure you're getting enough.