Paget's disease of bone
A condition that disrupts the normal renewal of bone, which can lead to bone pain or changes in shape, and which is very treatable
Paget's disease of bone is a condition in which the normal process of bone renewal becomes disrupted, so that affected bones are remodelled in a disorganised way. This can make them weaker, larger or change their shape. It often causes no symptoms and is found by chance, but in some people it leads to bone pain or other problems. It is very treatable.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928). Last clinically reviewed: June 2026.
Common symptoms
Many people with Paget's disease have no symptoms at all. Where it does cause them, features may include:
- Bone pain in the affected area, such as the pelvis, spine, skull or long bones of the leg
- Changes in the shape of a bone, or bowing of a limb
- Joint pain if a nearby joint is affected
- In some cases, complications related to the affected bone
How it is diagnosed
Paget's disease is often first suspected from a blood test showing a raised level of a bone enzyme, or found incidentally on an X-ray done for another reason. The diagnosis is confirmed with imaging, and sometimes a bone scan to show which bones are involved. Assessment also looks at whether the affected bone is causing or likely to cause problems.
How it is treated
Not everyone needs treatment, particularly if there are no symptoms and no bone at risk. Where treatment is needed, the main medicines are bisphosphonates, which control the overactive bone turnover; this is most often a single infusion of zoledronic acid, given under specialist supervision. Calcium and vitamin D are checked first and corrected if needed, because vitamin D should be adequate before an infusion to avoid the calcium level dropping afterwards. The bone enzyme on the blood test (alkaline phosphatase) is then monitored to judge the response. Pain relief and management of any complications are addressed alongside this. Bone health more generally, including osteoporosis, is considered as part of the assessment. The plan is agreed with you.
Why assessment helps
Paget's disease is very manageable, and assessment determines whether treatment is needed and monitors the affected bone. If you have unexplained bone pain, a raised bone enzyme on a blood test, or a bone change found on a scan, a specialist review can clarify it.
Unexplained bone pain or a raised bone enzyme?
A specialist assessment can establish whether Paget's disease is present and agree whether treatment is needed
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