Paget’s disease of bone is a chronic condition that interferes with the body’s natural bone remodelling process. Normally, bone tissue undergoes continuous renewal — old bone is broken down and replaced with strong, healthy bone. In Paget’s disease, this process becomes abnormally accelerated and disorganized, resulting in bones that are larger, weaker, and more prone to fractures and deformities.

Bone Remodelling and Structural Changes

In a healthy skeleton, remodelling ensures bone strength and shape through a balanced activity between bone-resorbing cells (osteoclasts) and bone-forming cells (osteoblasts). In Paget’s disease, osteoclasts become overactive, breaking down bone at a rapid rate. The body responds by producing new bone too quickly, but the resulting structure is often soft, deformed, and less resilient. This can cause affected bones to enlarge, bend, or weaken, increasing the risk of complications.

Commonly Affected Areas and Symptoms

Paget’s disease typically affects one or more specific bones — most commonly the pelvis, spine, skull, and leg bones. While many individuals remain symptom-free, others may develop symptoms depending on the bones involved. These may include:

• Dull, aching bone or joint pain
• Headaches or hearing loss if the skull is involved
• Numbness or tingling due to nerve compression in the spine
• Bowed legs or joint stiffness, especially in weight-bearing bones

Diagnosis and Monitoring

Paget’s disease is often discovered incidentally during X-rays for unrelated issues. To confirm the diagnosis, healthcare providers may order a bone scan or blood tests, particularly checking for elevated alkaline phosphatase levels, which indicate increased bone activity.

Treatment and Management

Though there is no cure for Paget’s disease, it can be managed effectively. Medications such as bisphosphonates are commonly prescribed to slow down the bone remodelling process, reduce bone pain, and help prevent further damage. Pain relievers and physical therapy may also be recommended in some cases. Surgical intervention is rare but may be necessary for severe complications like fractures or joint damage.

With timely diagnosis and appropriate treatment, individuals with Paget’s disease can lead active lives and minimize the risk of serious complications.