What Causes Paget’s Disease?

What Causes Pagets Disease

Paget’s disease is a rare bone disorder that interferes with the bone formation process and, over time, can cause significant deformities. This condition affects the body’s normal recycling processes and new bone tissues are not formed properly. [1]

It is a chronic progressive condition. However, being aware of what causes pagets disease may help to inhibit the development of this disease. 

What causes pagets disease?

Paget’s disease is a rare disorder affecting the bones. It occurs due to the dysregulation of the bone remodeling processes. Paget’s disease usually affects the bones of the pelvis, spine, skull, and legs. [2]

It occurs when the process of formation of new bone aimed at regulating and replenishing the lost bones cells becomes less efficient. New bone tissue needed to replace the old and damaged bone cells is not formed properly. [3]

Over time, this disease can cause the bones to become fragile, weak, and misshapen. 

Pathogenesis of Paget’s disease

The bone is an active and living tissue that needs to be repaired and renewed constantly. The old and damaged bone cells are removed by cells called osteoclasts. These cells help to break down the old, dead cells so that they can be easily eliminated from healthy tissues. [4]

At the same time, new bone cells are produced by cells known as osteoblasts. The activity of osteoblasts is essential for bone formation processes. Improperly functioning osteoblasts can affect the formation of new bone cells and bones may continue to lose the existing cells without any healthy cells to replace them. [5]

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The functions of osteoblasts and osteoclasts are interdependent. These cells receive signals from the body telling them when and how many cells need to be removed or newly formed. 

This means the functions of osteoblasts are dependent on the activities of the osteoclasts and vice versa. These processes are carried out by the body in a balanced and orderly way to ensure your bones stay healthy and strong.

Lack of coordination between these cells or the improper signaling can affect bone loss and bone formation processes. This can trigger the development of Paget’s disease. 

In Paget’s disease, the processes of bone formation and bone loss are disrupted. As a result, the following abnormal changes may occur in the bones:

  • The repair and renewal of the bones are uncontrolled. The rate of turnover of bone tissues increases by nearly 40 times.
  • The bone cells become larger and increase in number. They also tend to be more active.
  • The new bone cells are abnormal in structure and shape. 
  • The new cells are immature and weaker than usual.
  • The increased activities of the bone cells may also increase the blood flow through the bone. 
  • The weakness of the bones prevents them from holding the weight of the body. As a result, the bones bend or become deformed. 
  • Bent bones exert more pressure on the joints resulting in joint pain, swelling, and inflammation. [6]

What are the risk factors of Paget’s disease?

1. Age

The risk of Paget’s disease increases with age. It is more common in men than in women. 

As we age, there is a reduced rate of cell regeneration. This is a natural process that occurs in all tissues and organs. At the same time, the rate of degeneration increases. This can contribute to bone loss and make a person prone to complications of Paget’s disease. [7]

2. Family history

Your risk of Paget’s disease could be higher if you have a family history of this condition. This means patients who have a close family member suffering from Paget’s disease are more likely to develop it. This suggests the possibility of this disease being genetically linked. 

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Clinical research has also revealed that the complications of Paget’s disease such as bone deformities and fractures are more common in patients having a family history of this disease. [8]

3. Smoking

The incidence of Paget’s disease has been found to be higher in smokers than in non-smokers. Quit smoking in order to help prevent the development of this disease. [9]

4. Reduced calcium intake

The lack of adequate amounts of calcium in the diet affects bone formation processes. Calcium is an essential nutrient needed for forming new cells. Patients are advised to increase their calcium intake to reduce the complications of Paget’s disease and improve bone health. [10]


Bone changes caused by Paget’s disease progress slowly over time and can result in permanent deformities.

Some risk factors of Paget’s disease, such as aging, are unavoidable but you can take steps to avoid complications from this rare disease. Improving your calcium intake and following healthy lifestyle habits could play a role in protecting your bones and reducing the complications of Paget’s disease.  


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953635/
  2. https://www.medicinenet.com/pagets_disease/article.htm#who_discovered_paget#39s_disease
  3. https://www.medicalnewstoday.com/articles/177668#treatment
  4. https://rarediseases.org/rare-diseases/pagets-disease/
  5. https://pubmed.ncbi.nlm.nih.gov/29752905/
  6. https://www.versusarthritis.org/about-arthritis/conditions/pagets-disease-of-bone/
  7. https://www.mayoclinic.org/diseases-conditions/pagets-disease-of-bone/symptoms-causes/syc-20350811#
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309316/
  9. https://rarediseases.org/rare-diseases/pagets-disease/
  10. https://orthoinfo.aaos.org/en/diseases–conditions/pagets-disease-of-bone

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