Causes and risk factors
The exact cause of paget’s diseases is not known. But is believed to arise due to some abnormality in the bone cells (osteoclasts and osteoblasts) Osteoblasts are a type of bone cells which synthesis bone while osteolclasts absorbs bone tissue thus the recycling of bone is altered where synthesis outgrows the absorption.A person suffering from Paget’s diseases posses’ imbalance between the two. An infection by virus can also trigger the disease. Metabolic diseases can predispose pagets disease.
Clinical presentation:
Most of the patients are asymptomatic. Bone pain is the commonest symptom. Symptoms develop gradually and they are often mild. Pain in joint, swelling and stiffness are the prominent features depending upon the location of the pagets. The patient experience dull aching pain and it is mostly aggravated at night. Difficulty in movement like walking, standing, sitting is experienced. The bones become enlarged, bending of the bones occurs. Affection of the skull can lead to large head size and headaches. Muscle weakness, malaise and tenderness are also present. Pagets disease can lead to various complications like hearing loss, vision loss, arthritis, loose teeth and even bone cancer.
Investigations:
Diagnosis is done of the basis of the symptoms narrated by the patient and the physical examination carried out by the doctor. Certain investigations which can be done are X-ray, MRI or CT scan of the affected joint. Routine blood test, Elevated serum alkaline phosphates test is diagnostic of pagets. A profile of specialized blood test is done to rule out other bone diseases.
Treatment:
Non steroidal anti inflammatory drugs (NSAID), steroids, DMARDS (Diseases modifying anti rheumatic drugs) and pain relieving drugs are prescribed .Drugs like biphosphonates and calcitonin are helpful. Symptomatic treatment is adopted for treating other conditions like hearing loss, headache, vision affection etc. Surgical intervention is required for treating enlarged or broken bones. Weight reduction in obese, adequate rest, correction of wrong postures and regular exercises needs to be adopted for muscle strengthening. Wearing of braces and supports to hold the joint in alignment during movement, cold and hot compressions along with medications can be advised. Intake of food rich in Vitamin D in diet is recommended.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up the symptom. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Acupuncture which is the science of insertion of fine needles on the certain stimulating spots on the body has proved to be effective. Certain yoga exercises can also be helpful in relieving the pain and strengthening the muscles.
