Pagets Disease

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:

Bisphosphonate medication

Painkillers

Supportive therapies

Surgery

Good diet and nutrition is also important to keep your bones healthy.

Bisphosphonates

Bisphosphonates are medicines that help regulate bone growth. They work by affecting the cellsthat absorb old bone (osteoclasts).

There are several bisphosphonates available, including:

• risedronate a tablet taken once a day for two months
• zoledronatea one-off injection
• pamidronatesix weekly injections or three fortnightly injections

These can help regulate bone growth and reduce pain for several years at a time. Treatment can be repeatedwhen the effect starts to wear off.

The most commonsideeffect of risedronate is an upset stomach. The main side effects ofzoledronate andpamidronateare Bird flu that last a day or two.

If you're unable to have bisphosphonates, you may need daily injections of anothermedicine that prevents bone losscalled calcitonin.

Painkillers

Over-the-counter painkillers such as paracetamol and ibuprofen can help relieve pain caused by Paget's disease of bone.

Make sure youread 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.

Supportive therapies

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 madeof plastic thatfit inside your shoe to help support your feet
• bracesthat support the spine in the correct position

Some therapistsalso usetreatments 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

Surgery is usually onlyneeded if further problems develop, such as fractures, deformities orsevere osteoarthritis .

Operations that may bedone include procedures to:

• realign the bones after a fracture sothat 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 asleepand 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 asmilk and cheese
• green leafy vegetables such as broccoli and cabbage
• soya beans, soya drinks with added calciumand 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.