Causes of Paget's disease

Paget's disease of bone is a condition in which the normal cycle of bone breakdown and rebuilding becomes disordered in one or more bones. Affected bone is renewed too fast and grows larger but weaker and more irregular. The exact cause is not known.

What is thought to contribute

• Genetic factors: about 1 in 7 people with the disease have a close relative with it. Changes in genes such as SQSTM1 raise risk.
• Possible environmental triggers: a slow viral infection of bone cells (osteoclasts) has been suggested, but this is not proven.
• Age: it rarely starts before age 50 and becomes more frequent with age
• Ancestry and region: more common in people of European descent and in some regions, and less common in parts of Asia and Africa
• Sex: slightly more common in men

What it is not

It is not caused by diet, lifestyle, injury or calcium supplements. It is not contagious and it is not cancer, though rarely a bone tumour can develop in a badly affected bone.

How it develops

Overactive bone-resorbing cells make pits in the bone. The body then lays down new bone quickly and in a disorganised pattern. The result is thicker, softer bone that can bend, ache or break.

Ayurvedic view

Ayurveda would discuss bone disorders under Asthi dhatu disturbances and Vata imbalance. This is an interpretive framework and does not explain this specific condition.

See a doctor if you have persistent bone pain, a bowing leg, a growing skull or hearing loss, particularly with a family history.