Paget’s Disease and Spine Health

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:

• Deformed
• Enlarged
• Fragile bones

The bones of the spine (vertebrae) are susceptible to this condition.

Paget’s Disease and The Spine

Paget’s disease begins with two bone cell types malfunctioning: osteoblasts and osteoclasts. Bones constantly undergo a regenerative process where osteoclasts break down old bone, and osteoblasts build new bone. The bones stay strong when the cells work together in a balanced way.

 

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, leading 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
• Sacrum
• Pelvis

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 55, and 3% of that population develops the disease.

Spinal Symptoms

Many have Paget’s in their spine but don’t know it. The most common symptom is bone pain in the neck and/or back. The pain can feel:

• Dull
• Persistent
• Worse at night

It can cause spinal cord compression and neurologic symptoms like:

• Tingling
• Numbness
• Difficulty walking
• Bowel
• Bladder problems

Causes

The cause of Paget’s disease is still unknown, but research scientists believe genetics and viral infection contribute to the condition.

Spine-Related Complications

The telltale of Paget’s is the bone deformities that can result in painful spine conditions, which include:

• Spinal stenosis
• Kyphosis

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 a spine x-ray to confirm a diagnosis and illuminate 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 bones regenerate too fast. It’s not only used during diagnosis but also during 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 include 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, achieving a healthy quality of life shouldn’t be a problem.

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Chiropractor Low Back Pain Relief

 

David Garcia, a maintenance facility worker, and a proud Dad in El Paso, TX, at the Region 19 Education Services Center. However, his chronic lower back pain often influences Mr. Garcia’s everyday life. After undergoing worsening symptoms for some time, Mr. Garcia was recommended to seek chiropractic care with Dr. Alex Jimenez by his sister, a former patient of Dr. Jimenez. Mr. Garcia has since experienced enormous relief from his lower back pain, and he’s grateful to Dr. Jimenez and his staff for supplying him with education regarding his health problems as well as properly caring for him. Mr. Garcia recommends Dr. Jimenez as the non-invasive surgical selection for lower back pain.

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NCBI Resources

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 and recommend 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.