Paget's disease of bone
If you don't have symptoms, you may not need treatment. However, if the
disease is active — indicated by elevated alkaline phosphatase levels —
and is affecting high-risk sites in your body, your physician may
recommend treatment even if you don't have symptoms because treatment
may prevent complications.
Treatment for Paget's disease can help alleviate pain and may halt the
damage done to your bones. In many cases, treatment can cause remission
of the disease, which may be prolonged in some people.
Doctors generally recommend treatment when:
bone pain, headaches, or neurologic symptoms related to Paget's
You're planning to
have surgery to repair damage related to Paget's disease. In this
case, your physician will prescribe medications to minimize blood
loss during the operation.
at risk of serious, long-term complications due to the
aggressiveness of your disease and the location of your affected
bones. Involvement of the backbone, skull, bones near major joints,
and the long bones of the arms and legs is more likely to result in
Your heart is
overworked because of widespread Paget's disease.
If any of the above criteria applies to you, your doctor may recommend
one or more of the following treatments.
Paget's disease may require treatment to reduce pain or treat the
inflammation associated with arthritis. Treatment options may include:
anti-inflammatory drugs (NSAIDs).
NSAIDs alleviate pain and reduce the inflammation that's often the
source of pain in arthritis related to Paget's disease. They work by
inhibiting your body's production of two forms — COX-1 and COX-2 —
of the enzyme cyclooxygenase, which is
responsible for the production of hormone-like substances involved
in pain and inflammation. Nonprescription NSAIDs used to relieve
pain associated with Paget's disease include aspirin and ibuprofen
(Advil, Motrin, others). NSAIDs available by prescription include
diclofenac sodium (Voltaren), indomethacin (Indocin), nabumetone
(Relafen), piroxicam (Feldene) and sulindac (Clinoril).
You may need to
try more than one NSAID before finding the one that's most effective
for you. Long-term use of NSAIDs or use of more than one NSAID can
cause side effects such as ulcers, heartburn, nausea and stomach
bleeding. Large doses of NSAIDs can lead to kidney problems.
(Tylenol, others). Acetaminophen may provide some relief of your
pain, but it doesn't improve inflammation. It's generally safe if
you take it for a short period of time and adhere to the daily
dosage guidelines. If taken at the maximum dose for extended periods
of time — especially when combined with regular alcohol intake —
acetaminophen may cause liver damage.
Your physician may recommend bone-regulating medications if you have
Paget's-related pain or if you're at risk of serious complications. Two
kinds of medications are used to treat Paget's disease of bone:
Doctors commonly use these medications to treat osteoporosis,
increase bone density and reduce the activity of Paget's disease.
They're currently the treatment of choice for Paget's disease.
these agents helps restore more normal-appearing bone and may
produce long-term remission of Paget's disease. Your doctor may
prescribe one of four biphosphonate drugs: pamidronate (Aredia),
alendronate (Fosamax), risedronate (Actonel) or etidronate (Didronel).
biphosphonates are generally well tolerated but may cause irritation
of the esophagus, diarrhea and nausea. Pamidronate isn't available
as an oral medication, and you must receive it through a vein
(intravenous infusion). Intravenous administration offers a more
rapid response than oral medications and provides an option when you
can't tolerate or are not a candidate for oral bisphosphonates.
prescribe biphosphonates for 2 to 6 months, depending on the drug
used. You may need to switch to another brand if you take these
medications long-term because resistance to one biphosphonate may
build over time. You should not take etidronate — the least
effective of the bisphosphonates — for longer than 6 months at a
If you can't tolerate biphosphonates, your physician may prescribe
calcitonin (Miacalcin), a naturally occurring hormone involved in calcium regulation and bone metabolism. Calcitonin is given by
Side effects may
include loss of appetite, nausea, facial flushing, frequent
urination and irritation at the injection site. Stopping treatment
with calcitonin usually results in a rapid reactivation of the
disease and recurrence of symptoms.
Your physician may use blood tests measuring your alkaline phosphatase
level to monitor your response to these medications. If therapy is
effective, your alkaline phosphatase level will decrease and may return
In rare cases, you may require surgery to help fractures heal, to
replace joints damaged by severe arthritis or to realign deformed bones.
If Paget's disease affects your spine or your skull, you may need
surgery to reduce pressure on nerves and prevent serious complications.
Paget's disease often causes the body to produce an excessive number of
blood vessels (hypervascularity) in the affected bones. This change
increases the risk of serious blood loss during an operation. If you're
scheduled for surgery that involves bones affected by Paget's disease,
your physician may prescribe medications to reduce the activity of the
disease, a step that tends to reduce blood loss during surgery.
disease of bone
2 > 3 >
Complementary and Alternative medicine
and mind-body-spirit approaches to health and
Live Blood Analysis
of blood under a specialized high powered ultra-dark
field microscope, reveals anomalies in the blood.
unique tool for prevention.
is recognized by most as
the most powerful and versatile therapy known in
alternative health because it plays a vital role in
maintaining the well-being of the body.
Check it out why.
contact the doctor
This information is
provided for general medical education purposes only and
is not meant to substitute for the independent medical
judgment of a physician relative to diagnostic and
treatment options of a specific patient's medical
In no event will The DrEddyClinic.com be liable for any
decision made or action taken in reliance upon the
information provided through this web site.
Chiang Mai 50230,