Paget's Disease of Bone: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Paget's Disease of Bone?
A rheumatologist (a doctor who treats bone and joint diseases) or an endocrinologist (a doctor who treats hormone and bone problems) usually treats Paget's disease of bone. An orthopedic surgeon (a bone and joint surgeon) may help if surgery is needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is Paget's disease of bone?
Paget's disease of bone is a chronic bone disorder, which means it lasts a long time. Normally, your bones break down and then regrow. In Paget's disease, this process is abnormal, and the bones regrow too quickly. The bones become bigger and softer than normal. They may be misshapen and easily broken. Paget's usually affects just one or a few bones. It does not spread to normal bones.
Symptoms
Many people do not know that they have Paget's, because it often has no symptoms. When there are symptoms, they are similar to those of arthritis and other disorders. They can include:
- Pain, which may be due to the disease or to arthritis (joint swelling and pain), which can be a complication of Paget's.
- Headaches and hearing loss, which can happen when Paget's disease affects the skull.
- Pressure on the nerves, which can happen when the disease affects the skull or spine.
- Hip pain, if the disease affects the pelvis or thighbone.
- Increased head size, bowing of a limb, or a curved spine, which can happen in advanced cases.
Paget's disease can lead to other problems. These include arthritis, heart failure, kidney stones, nerve problems, and loose teeth if the face bones are affected. Bone cancer, called osteosarcoma, is a rare complication, affecting less than 1 percent of people with this condition.
Causes and who gets it
Researchers do not know for sure what causes Paget's disease. Environmental factors may play a role. In some cases, the disease runs in families, and several genes have been linked to it. It is more common in older people and those of northern European heritage. If you have a close relative who has Paget's, you are much more likely to have it.
How doctors diagnose it
Your health care provider may use many tools to make a diagnosis. These include:
- A medical history, which includes questions about your symptoms.
- A physical exam.
- An x-ray of the affected bones. Paget's disease is almost always diagnosed using x-rays.
- An alkaline phosphatase blood test.
- A bone scan, a test that takes pictures of the bones.
Sometimes the disease is found by accident when one of these tests is done for another reason.
Treatment
Not all people with Paget's disease need treatment. People who may not need treatment include those with no symptoms and no sign of active disease. Treatment is common when weight-bearing bones are involved, when bone changes are getting worse quickly, or when a person has pain or other symptoms. Treatment is also common when the skull is affected, to prevent hearing loss. It is important to find and treat Paget's disease early to avoid complications.
Bisphosphonates are the most common type of medicine, and they are the first treatment. They help reduce bone pain and stop or slow down the progress of the disease. Other medicines that may be used include calcitonin, a hormone, and denosumab. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) may also be given for pain.
Surgery is sometimes needed for certain complications. Surgery can help broken bones heal in a better position. Surgery can replace joints such as the knee and hip when there is severe arthritis. Surgery can also realign a deformed bone to reduce pain in weight-bearing joints. Diet and exercise do not treat Paget's, but they can help keep your skeleton healthy. Talk with your health care provider before you start a new exercise program.
When to see a doctor
Contact your health care provider if you develop symptoms of Paget's disease. Tell your provider if you have bone pain, because it can be a symptom of Paget's disease. Call 911 or go to the emergency room if you have trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, or sudden dizziness, weakness, or change in vision.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can look at your symptoms, order first tests, and help you see the right specialist. They can also help with follow-up care over time.
Common questions
Does Paget's disease of bone always cause symptoms?
No, many people with it have no symptoms. When symptoms do happen, they are similar to those of arthritis and other disorders.
Does Paget's disease spread to other bones?
No, it does not spread to normal bones. It usually gets worse slowly over time.
Is Paget's disease of bone inherited?
Sometimes, because in some cases the disease runs in families. If you have a close relative who has Paget's, you are much more likely to have it.
Can Paget's disease of bone be treated?
Yes, most of the time the condition can be managed with medicines. Bisphosphonates help reduce bone pain and stop or slow down the progress of the disease.
Does Paget's disease of bone turn into cancer?
Rarely, because bone cancer, called osteosarcoma, is a rare complication. It affects less than 1 percent of people with this condition.
Sources
- MedlinePlus - Paget's Disease of Bone
- MedlinePlus - Paget disease of the bone
- MedlinePlus Genetics - Paget disease of bone
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
