Massage therapy · Kitchener–WaterlooPaget's Disease

Often people are unaware that they have the disease, and joint pains may be put down to "arthritis" or "wear and tear" (NIAMS, 2022).

If you or your medical professional suspects this condition, a blood test can check the level of a substance called alkaline phosphatase (ALP). People with Paget's disease often have raised levels of ALP, but some people with the condition have a normal level, and a high level can also be caused by other conditions, so an X-ray or bone scan is also needed to confirm the diagnosis (NHS, 2023c). Normal ranges vary between laboratories; one example range is 40 to 129 IU/L (MedlinePlus, 2025a).

Paget's disease symptoms may include bone or joint pain (often a dull, deep ache that is worse at night), the skin feeling warm over the affected bone, bowing of a limb, and nerve problems such as shooting pain, numbness or tingling. If the skull is affected, it can cause headaches, hearing loss and an increased head size (NHS, 2023b; NIAMS, 2022). Paget's disease can also lead to broken bones, osteoarthritis and, rarely, bone cancer (NHS, 2023e).

Warning signs: call 911 or go to the emergency room at your nearest hospital if you have partial loss of movement in your limbs, or loss of bowel or bladder control (NHS, 2023b).

New blood cells are made by the red bone marrow inside the bones. The bones also act as the body's main store of calcium. The skeleton grows throughout childhood and serves as a framework for the rest of the body to grow along with it.

There is currently no cure for Paget's disease, but treatment can help relieve the symptoms (NHS, 2023d).

1. Pain Relief

MedlinePlus says that paracetamol (called acetaminophen in the US) or non-steroidal anti-inflammatory drugs (NSAIDs) may be given for pain (MedlinePlus, 2025b). (This medicine information comes from MedlinePlus (US National Library of Medicine), not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Monitoring

If you are not having any symptoms, your doctor may suggest keeping an eye on your condition and delaying treatment until any problems occur (NHS, 2023d).

3. Physio

Some people with Paget's disease benefit from supportive therapies such as physiotherapy or occupational therapy. These involve exercises and techniques that can help reduce pain, improve movement and make everyday tasks easier (NHS, 2023d). They can help people who are in long-term pain, but they will not cure the problem. I can also help with exercises and gentle hands-on techniques to ease pain and keep you moving.

4. Walking Stick

Devices that reduce the weight placed on the affected bones, such as a walking stick or frame, may help when the leg or pelvis is involved (NHS, 2023d). A stick can also help with balance and confidence when walking.

Options outside my scope

• Bisphosphonates: the main medicines used for Paget's disease. They work on the cells that absorb old bone, and one called zoledronate, given through a drip, can help reduce pain for several years at a time (NHS, 2023d).
• Calcitonin: injections of a medicine that prevents bone loss, sometimes used if you cannot have bisphosphonates (NHS, 2023d).

(This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

• Surgery: usually only needed if problems develop, such as fractures, deformities, severe osteoarthritis or a squashed nerve; operations include joint replacement and straightening deformed bones (NHS, 2023d).

How I can help (see the My Approach tab)

If a limb has become bowed, massage won't change the shape of the bone, but it can ease the aches and tired muscles that come with it. If numbness or weakness gets worse, see your doctor; partial loss of movement in your limbs or loss of bowel or bladder control needs emergency help (see Warning signs).