Paget’s disease, aka osteitis deformans, is the second most common bone disorder in the United States right behind osteoporosis.
Paget’s disease happens when bone cells don’t function properly and result in:
- Fragile bones
The bones of the spine (vertebrae) are susceptible to this condition.
Paget’s Disease and The Spine
Paget’s disease begins with a malfunction of two bone cell types: osteoblasts and osteoclasts.
Bones are constantly going through a regenerative process where osteoclasts break down old bone, and osteoblasts build new bone.
When the cells work together in a balanced way, the bones stay strong.
With Paget’s disease, the osteoclasts break down old bone faster than normal. This forces osteoblasts to work harder and longer.
When this happens, the new bone is placed improperly and leads to deformity.
The newly built bone tends to be more fragile than healthy bone and has a greater risk of fracturing.
Paget’s most commonly affects the spinal bones, specifically the:
- Low back
Paget’s disease can involve a single bone meaning it is monostotic or multiple bones or polyostotic.
Monostotic cases make up about 10- to 35-percent of total occurrences.
Paget’s typically affects people over the age of 55, and 3% of that population develop the disease.
Many have Paget’s in their spine don’t know it.
The most common symptom is bone pain in the neck and/or back.
The pain can feel:
- Worse at night
It can cause spinal cord compression, neurologic symptoms like:
- Difficulty walking
- Bladder problems
The cause of Paget’s disease is still unknown but research scientists believe genetics and viral infection contribute to the condition.
The telltale of Paget’s is the bone deformities that can result in painful spine conditions, which include:
- Spinal stenosis
The disease makes the spine prone to fractures because of the weakened new bone.
Also, vertebral body compression fractures can occur and cause spinal cord compression and nerve pain.
Types of spinal arthritis that can coexist with Paget’s include:
- Rheumatoid arthritis
- Spondylosis or spinal osteoarthritis
- Ankylosing spondylitis
It has also been linked to spinal tumors that include osteosarcoma.
Diagnosing and Treatment
If symptoms are obvious, like hunchback brought on from kyphosis then a physical exam could help determine the diagnosis.
Most cases require imaging tests to get a closer look at the bones.
- A doctor/chiropractor may order an x-ray of the spine to confirm a diagnosis and illuminate any bone problems.
- For early stages, a bone scan will pick up initial deformities better than an x-ray.
- CT scans or magnetic resonance imaging (MRI) can also be used.
Blood testing can be important in the diagnosis
Known as a bone-specific alkaline phosphatase test it can detect when the bones are regenerating too fast.
It’s not only used during diagnosis but also during the treatment in helping to monitor patients as they go through the therapy.
It is treated with medications called bisphosphonates.
These medications help return normal function to the osteoclasts and osteoblasts.
Bisphosphonates can manage the disease and reduce symptoms, but do not cure the disease.
Living with Paget’s
Advanced cases can cause spine problems, which includes spinal fractures.
Most with Paget’s disease have preferable outcomes.
When Paget’s disease is managed with medication, regular doctor visits, chiropractic care, and proper diet, then there shouldn’t be a problem in achieving a healthy quality of life.
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David Garcia, maintenance facility worker and proud Dad in El Paso, TX in the Region 19 Education Services Center. However, Mr. Garcia’s everyday life is often influenced by his chronic lower back pain. After experiencing worsening symptoms for some time, David Garcia was advocated to seek chiropractic care with Dr. Alex Jimenez by his sister, a former patient of Dr. Jimenez. Mr. Garcia has experienced enormous relief out of his lower back pain, and he is thankful to Dr. Alex Jimenez and his team for supplying him with schooling regarding his health problems as well as adequately caring for him. David Garcia urges Dr. Alex Jimenez as the non-invasive surgical selection for lower back pain.
Several studies show that chiropractic care is a very effective treatment for back pain. The chiropractor will perform spinal manipulation to bring the spine (and body) into proper alignment. He may also offer advice on exercises, stretching, and ways to improve posture as well as recommending lifestyle changes and what to look for in supportive shoes. Chiropractic’s whole-body approach not only helps relieve back pain, but it also helps prevent it as well.
This allows the patient to gain whole body benefits from chiropractic.
- Improved mental clarity and cognitive function.
- A healthier posture.
- Improved quality of sleep.
- Stronger immune system.
- Fewer migraines and headaches.
- A healthier spine.