Paget’s Disease: Treating with Physical Therapy

A slow-progressing bone disease that typically afflicts older adults, Paget’s disease involves excessive and abnormal remodeling of bone. Throughout our lives, bone continuously breaks down and “re-forms” new bone; cells called osteoclasts absorb this broken-down bone matter, and osteoblas ts create new bone. Paget’s disease creates an imbalance in the way these cells interact, resulting in the production of excess, deformed bone. Over time, the aected bones may become fragile and misshapen, resulting in pain, fractures and bone deformities. Because Paget’s disease triggers only mild symptoms, the condition is usually diagnosed when an x-ray shows abnormal bone growth or a routine blood test nds increased levels of serum alkaline phosphatase, an enzyme that reects the abnormal bone turnover of actively remodeling bone. The physician will then order a noninvasive bone scan to ascertain how far the disease has progressed and determine the best treatment plan to follow.

While there is no “cure” for Paget’s disease, we can apply superficial heat, transcutaneous electrical nerve stimulation (TENS) and massage to alleviate Paget’s-related pain, tenderness and tightness and slow the progression of the disease. To address leg-length discrepancies from a Paget’s disease-induced bone fracture or deformity, we can suggest appropriate shoe modifications and provide prosthetic bracing, which would improve the patient’s ability to walk. Thus, effects related to immobility, such as muscle atrophy, bone loss and cardiovascular deconditioning, would be reduced. In addition, we can design a home exercise program to

• maintain skeletal health and strength
• avoid weight gain
• increase joint range of motion and flexibility
• prevent complications such as osteoarthritis and fractures from occurring

We can design a gentle aerobic exercise program or an aquatic therapy program that can support bone health and maintain overall physical condition. Early treatment can address specific issues caused by Paget’s disease, thereby making the disease more manageable and avoiding further, and future, problems.