Is paget’s disease of bone related to paget’s disease of the breast?

No, they are two distinct disorders. Paget’s disease of bone is a rare disorder in which the balance between bone formation and breakdown is altered. Over time, the affected bones become very fragile, alter in shape and may fracture. Paget’s disease of bone is more common in older individuals. The disease tends to affect bones in the pelvis, skull and legs. As the bones start to grow abnormally, one may develop nerve compression, hip pain, hearing loss or headaches. Beside fractures, Paget’s disease of bone can cause osteoarthritis, heart failure and even cancer of bone.

I have a very painful bunion. Is there anything I can do at home to reduce the pain?

Bunions are a big problem in our society and various treatments have been developed. The earlier one seeks treatment, the less the chance of developing joint deformity. In all cases, the initial treatment is conservative and includes the following:

- Change your shoe wear and get something with plenty of toe space

- Pad the shoes around the toes to relieve pain and eliminate stress

- Most people require some type of pain relief. Over the counter NSAIDs suffice in most cases.

- Physical therapy including wearing splints, ultrasound or whirlpool baths can help sooth the pain and assist in ambulation

- Often shoe inserts can help control abnormal movement of the foot. Shoe inserts can be acquired without a prescription. The more expensive shoe inserts with a prescription are no better at pain relief than the ones you can buy in any shoe store.

-Rest and soak your foot in warm water at least 2-4 times a day

I have a bunion and my doctor says I need surgery. Should I go for it?

 Tell your doctor to take a hike. The initial management of all bunions is conservative. When all non-surgical treatments fail after 9-12 months, surgery may be the only other alternative. Surgery involves removal of the swollen tissues and realigning the toe. Do not be in a rush to jump in line for surgery- the results are at best mediocre, pain is significant and bunions do come back. Moreover, you will have to take at least 4-6 weeks off work after surgery. Most patients are not satisfied with surgery. To prevent recurrences one should wear proper shoes and avoid high heels.

What are the features of a bunion?

Symptoms of bunions include:

- An unattractive bulge at the side of the big toe

- Swelling, redness or pain

- Corns or calluses at the base/side of the big toe

- Limited movement of the big toe

- Difficulty wearing shoes

Most individuals with bunion have one complain- pain. The pain can be variable but is usually constant and can be severe. Because the bunion pushes the other toes, crowding and ingrown toes nails are also common. Bunions once acquired can be worsened in individuals who wear high heels or ill fitting shoes. Individuals with flat feet and arthritis also have a tendency to develop bunions.

Can you please tell me how I got a bunion on my foot? I am only 23

Bunion is an abnormal bony protrusion that develops on the joint of the big toe. The toe joint becomes progressive large, distorted and crowds the other toes. The outward pressure of the joint gradually increases, leading to pain and an abnormal profile of the foot. Bunions can occur for many reasons but the most common is wearing of tight fitting shoes- especially at the toes.

Other causes of bunions may be congenital, bad luck, trauma or stress on the toes from another medical disorder.

The chief reason why bunions are more common in women is because of tight restrictive shoes. Looking good sure does have a few setback and developing bunions is one of them

What drugs work for osteoporosis?

Osteoporosis is a chronic medical disorder which develops gradually over many years, in fact several decades. Most cases of osteoporosis are diagnosed in the 5th -6th decade of life but the disease process actually starts in the 3rd-4th decade. Thus, consumers have to understand that no drug is immediately going to work and prevent fractures within a span of 1-2 years. All the available drugs for osteoporosis have been shown to decrease fractures but none is 100 percent effective. Moreover each and every one of these drugs has potent side effects which limits their use in many people with weak or thin bones.

However, physicians believe that these facts should not deter patients with osteoporosis from taking the drugs. All consumers should know something about osteoporosis and the different drugs available before starting on therapy

One thing to understand is that all the currently available drugs can increase bone mass as has been proven by bone scan testing. However, evidence to show that these drugs can also prevent fractures is lacking. Osteoporosis is a gradual disease and many people lose bone mass before becoming completely osteoporotic. In individuals who have only lost bone mass, there is no evidence that these drugs reduce fractures.

In general, osteoporosis is measured by defining a bone mineral density T score. When the score is minus 2.5 or lower, osteoporosis is confirmed. Lesser degrees of bone loss is known as osteopenia and these individuals may not show any benefit from drugs. For these individuals, a decent healthy diet, rich in calcium, regular exercise, limited alcohol intake and cessation of smoking is the best treatment in preventing osteoporosis.

Do bone strengthening pills help prevent fractures?

In the last 2 decades, physicians have been prescribing bone strengthening pills to everyone who walks into their office. The fears of osteoporosis and fractures have created a major hysteria and today millions of individuals take these expensive pills. However, all consumers should understand that just because one faithfully takes these pills does not mean that fractures won’t occur. In fact fractures still occur at an alarming rate despite regular use of these pills. Most people seem to believe that these bone strengthening pills are a cure and guarantee that no fractures will occur.


What the consumer has to understand is that there is no ideal drug for osteoporosis. More data seem to indicate that many clinical trials are done by unscrupulous physicians who work for drug companies and so the truth about the effectiveness of many drugs is always questionable.

The question is, “do these pills work?” This depends on when you started the pill and the status of your bone. If there is mild bone thinning, then the pills will strengthen the bone and prevent fractures. However, if moderate to severe osteoporosis has set in, the pills will do jack shit. So far no pill has ever been shown to prevent fractures in people with moderate to severe osteoporosis. Moreover, these pills have to be taken for many months and years. Besides having potent side effects, the pills are also expensive.

If you want to prevent bone fractures, eat healthy, exercise or walk everyday and do not smoke. While this advice may sound trivial, it is cheap, not associated with complications, works and if free