Pain and Paget’s Disease of Bone

Types of Pain

Paget’s disease can cause several different kinds of pain, as described below.

Bone pain: Small breaks called microfractures can occur in pagetic bone. These breaks can cause pain, especially in weight-bearing bone such as the spine, pelvis, or leg.

Joint pain: Cartilage (a hard but slippery tissue that cushions the joints) can be damaged when Paget’s disease reaches the end of a long bone or changes the shape of bones located near joints. This can result in osteoarthritis and joint pain.

Muscle pain: When bone is changed by Paget’s disease, the muscles that support the bone may have to work harder and at different angles, causing muscle pain.

Nervous system pain: Bones enlarged by Paget’s disease can put pressure on the brain, spinal cord, or nerves. This can cause headache; pain in the neck, back, and legs; and sciatica, a "shooting" pain that travels down the sciatic nerve from the lower back to the leg.

Available Treatments

It is important for most people with Paget’s disease to receive medical treatment as soon as possible. Today’s treatments can help reduce pain and possibly prevent the development of further complications.

Several types of medicines are used to address the pain caused by Paget’s disease. A doctor may recommend drugs designed to control the Paget’s disease or to relieve pain. The doctor also may recommend drugs to address painful complications of Paget’s disease, such as arthritis.

When severe pain cannot be controlled with medicine, surgery on the affected bone or joint may be needed.

An appropriate program of regular exercise also can help people with Paget’s disease reduce or eliminate pain.

Medicines used to treat Paget’s disease help slow the rate at which affected bone is changed, thereby reducing pain. The Food and Drug Administration (FDA) has approved several bisphosphonates and calcitonin for the treatment of Paget’s disease.

Several over-the-counter (nonprescription) drugs can be used to reduce the pain associated with Paget’s disease. Each of these medicines is taken orally (by mouth), usually in tablet form. Although there are many brand names for these drugs, they can be purchased on the basis of their key ingredient, which is:

  • ibuprofen
  • naproxen
  • aspirin
  • acetaminophen.

In some cases physicians will recommend the use of pain-relieving medicine that requires a prescription.

Surgery to Manage Pain

Although surgery is rarely required for Paget’s disease, it should be considered in certain circumstances. Hip or knee replacement surgery may help people with severe pain from Paget’s disease-related arthritis. Surgery can also realign affected leg bones to reduce the stress and pain at knee and ankle joints or help broken bones heal in a better position.

The Value of Exercise

Physical exercise is an important tool for persons with Paget’s disease. Regular exercise can help patients:

  • maintain bone strength
  • avoid weight gain (and the pressure added weight puts on weakened bone)
  • keep weight-bearing joints mobile and free of pain.

To make sure that pagetic bone is not harmed, patients should discuss their plans with a doctor before beginning any exercise program.

There Is No Need to Be in Pain

Although there is no cure for Paget’s disease, people with the disorder do not have to live with constant pain. As this fact sheet describes, available therapies—especially when started early—can greatly reduce or, in some cases, eliminate the pain associated with the disease.

The National Institutes of Health Osteoporosis and Related Bone Diseases ~ 
National Resource Center acknowledges the assistance of the Paget Foundation for Paget’s Disease of Bone and Related Disorders in the preparation of this publication.

For Your Information

This publication contains information about medications used to treat the health condition discussed here. When this publication was developed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.

For updates and for any questions about any medications you are taking, please contact

U.S. Food and Drug Administration
Toll Free: 888–INFO–FDA (888–463–6332)

For additional information on specific medications, visit Drugs@FDA at Drugs@FDA is a searchable catalog of FDA-approved drug products.

NIH Pub. No. 15-7918

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