osteoporosis drugs

As people age, both muscle mass and bone density begin to fade. The consequences of bone loss can be devastating. When bones become weak, they break easily. If an older person fractures a hip, they may have grave difficulty regaining mobility. Sometimes the fracture even leads, directly or indirectly, to their death. Osteoporosis drugs are supposed to counteract bone loss and help prevent fractures. However, they can sometimes cause intolerable side effects.

Can Osteoporosis Drugs Cause Joint Pain?

Q. Some years ago I saw a hand surgeon for a painful thumb. She injected it with cortisone and then it locked up, so she wanted to operate.
Then I read in your column that Boniva can cause intractable joint pain. Lo and behold, I was taking Boniva!

I stopped the drug, and soon the pain stopped too. No more meds for osteopenia. I am embarrassed to tell you I am a pharmacist, still working after 59 years.

A. Thank you for sharing your experience. Others have also reported joint, muscle and back pain while taking ibandronate (Boniva) or similar medications, called bisphosphonates. Here is another reader’s report:

Joint Pain with Osteoporosis Drugs:

Q. I took Fosamax for osteoporosis and started waking up every night with hip and leg pain. One friend mentioned that she also developed bone pain while taking Fosamax while another complained of terrible backaches.

I told my doctor and he said he had never heard of such problems. After stopping the drug, the pain gradually subsided. My doctor is still dubious. What other options for osteoporosis won’t cause such terrible pain?

A. Medications like alendronate (BinostoFosamax), risedronate (Actonel, Atelvia) and Boniva can sometimes cause severe and occasionally incapacitating bone, joint or muscle pain.  We’re surprised your doctor was unaware of this complication, as the FDA has issued warnings about it. If you suspect that one of these osteoporosis drugs may be causing you side effects, we urge you to discuss your concerns with your physician.

Other Side Effects of Osteoporosis Drugs:

These drugs occasionally cause other serious side effects, such as osteonecrosis of the jaw bone or atypical femur fractures. One person told us about his sister breaking her thigh bone.

Q. My sister (60 years old) just broke her femur without any trauma. She simply stepped down and as she stepped her femur snapped.

She had taken Fosamax for five years and stopped last year when she heard of possible side effects such as broken femurs and deteriorating jaws. What can you tell us about this problem in otherwise healthy women?

A. The FDA approved Fosamax in 1995 to treat osteoporosis. A decade later the first reports of unusual thigh bone fractures began to surface. These breaks often occurred without a preceding fall or other trauma.

Someone who is exposed to bisphosphonates for more than five years may be at risk. Because the drugs linger so long in the body, the danger may persist even after the medication has been discontinued.

Other Drugs to Treat Osteoporosis:

There are other drugs for osteoporosis, such as raloxifene (Evista), teriparatide (Forteo), denosumab (Prolia) and calcitonin (Miacalcin). We discuss the pros and cons of drugs and non-drug approaches in our Guide to Osteoporosis.

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  1. Linda

    It is not unusual to find doctors with no clue as to side effects of the drugs they prescribe. My current GP had the audacity to prescribe Fosamax for my osteoporosis and osteopenia when I also have a GERD/hiatal hernia diagnosis with recurring bouts of acute gastritis and very poorly regulated IBS-D. She always tells me I should feel free to research side effects on line (so she doesn’t have to) but then seems insulted that I have rejected all her proposed prescriptions — for just about everything.

    After my research, I decided to add strontium and some other minerals to my calcium, Vit D and Vit K-2 supplements — but she poo-pooed the veracity of European clinical findings about the positive effects of strontium to remediate osteoporosis because they weren’t published in *American* journals. (Strontium is actually prescribed by docs in Europe to treat this condition.) Yeah, I know, I need to find another GP but they are few and far between in this berg I live in — with few taking new patients — especially those of us on medicare.

    • Jan

      Doing my best to avoid allopathic meds (so far, in my mid-70’s, 100% successful), I did a bit of research on Strontium (with much interest). I read that the form of strontium used in Europe is not available in the U.S.A., so I am wondering which form of Strontium that is available here is the closest to that which they use in Europe. Wondering if anyone can answer that.

  2. Pb

    I have tried several, and each one caused me hip soreness, and my jaw was locking up. My doctor prescribed Prolia, but have not been able to get it because due Medicare or Tricare for life doesn’t cover it. So after all this info, it could be a good thing.

  3. Cindy
    Seattle, WA

    It seems apparent that not only do these meds have nasty MSE’s, they also don’t even do what they’re supposed to do! Take Fosamax for 5 years, and then your leg breaks stepping off a little step?! Good grief. Every day I thank god(dess) that I take no Rx meds.

  4. Caroline

    I have been taking Prolia twice annually for three years. During the past two years I have developed sciatica in one hip and inner thigh. I am now wondering if this is related to my use of the Prolia. I am just beginning a third round of physical therapy and have had 3 rounds of injections for pain management, none of which has thus far alleviated this ongoing pain. Is this a common side effect of Prolia use?

  5. Nohemy
    Tampa, Florida

    I was diagnosed with osteopenia, after the fracture of the calcaneous bone- the doctor recommended to take actonel to help prevent future fractures , after I completed the 5 year treatment I started experiencing terrible pain on my legs, event to a vein doctor and found no problems, the bone density came back good , so I am almost sure it was the Actonel even thought my doctor said is not the medication, but after reading the comments from others I am more convinced!

  6. Mary C. Campbell
    Newark, Calif.

    I started taking Fosamax back in 1998 as I had my thyroid removed and was getting osteoporosis. I took it for about five months and had to go to the hospital because of the side effects. I waited and tried Boniva and had other problems. I was put on Forteo for two years and did ok with that, but was told to stop after two years. I was told in 2011 I needed to go on Prolia. I talked to my GP at the time and I told her how I had problems with the other drugs in the past. My rheumatologist wanted me to take Prolia. She said she wouldn’t do it if it were her as the drug was new and no one would really know the problem it would cause in the future. So far I have been taking calcium and vit. d for the last seven years. My DEXA has not gotten any worse. I watch my diet and exercise as best I can. The pain Fosamax caused is not worth it.

  7. Evelyn

    I was on Fosamax for 5 yrs and then told to stop by my doctor. I am now on Prolix, and that is a twice a year injection. But every drug out there is basically the same thing. Only a different name. I have not had any side effects with the Prolia but will have to find out how long I will need to be on this drug.

  8. Marilyn
    Glastonbury, CT

    Just wanted folks to know about a wonderful exercise approach for osteoporosis. I am a physical therapist and recently attended a seminar on the Meeks Method. Sarah Meeks is a physical therapist in Florida who developed this treatment approach 20 years ago. She has taught many therapists around the country and I suggest you guys find a trained therapist to help. The exercise program focuses on core exercises with the main emphasis on training the extensor muscles of the back. She also teaches a lot of techniques to improve your biomechanics and how to deload your spine. I too have been diagnosed with osteopenia. I left this seminar feeling really optimistic and having tools to improve my bone health.

  9. Nadya
    Seattle land

    I took fosamax for 8 years. My doctor Just forgot to stop it. I had physical each year. And he just continued all medication… After 8 years he noticed, and laughed: “Q, you had to take this only for 5 years!” We moved from Chicago to Seattle 3 years ago. Now my new doctor told me I have too low bone density (minus 2.5). so now I take Evista and cross my fingers … I didn’t have any side effects, I think. I hold my osteoporosis under control with People medicine (I have your book). I am eating a teaspoon raisins (made with gin), 10 dried tart cherries, green tea every morning , a lot of ginger, and MSM with vitamin C. I love your book and consult with it about my problems. But of course I discuss my problems with doctors regularly. Nadya.

  10. Kathleen

    When I was 42 my GP sent me to a bone specialist.. I began treatment with a drug called didronel..This was a kit that included blue calcium pills and didronel..For 6 weeks I took didronel and then for 2 weeks I stopped didronel and took these blue calcium pills. The doctors office was on the 5th floor of a building and I went there every 6 months at first to get bone density scan. Then I would take the report upstairs to his office. Over 10 years I went regularly until I was 52 in 2002. He then said I had osteopenia and that I didn’t need to come back. I kept taking didronel as before and noticed I was getting terrible headaches. I stopped the didronel and the headaches went away and I never went back on them again. I heard later that all bisphosphonates can cause necrosis of the jaw. The only result from all this was I lost all my upper teeth. They either deteriorated or came so loose that I had no choice but remove them all. Now I wear a denture. I am 70 years old now. thyroid medication also causes bone loss and the Doctor told me that I if I could reduce my meds it would be better for my bones..I couldn’t do that ..It has not been an easy road since I now have learned that synthroid meds no longer give optimal results..Swollen legs and feet and loss of hair..osteoporosis and depression have all been a part of my life. The specialist really didn’t do much for me and when I look back I realize those didronel pills probably did me more harm then good.

  11. Martin
    Spokane, WA

    Male diagnosed 10 years ago with osteoporosis at the age of 62. Prescribed fosamax but could not tolerate due to GERD reflux problems. Stopped taking any treatment at all for about 4 years and when I had a new bone scan I was considerably worse off even though I was religiously taking 1200 mg of calcium with 3000 mg of vitamin e daily. New doctor prescribed Reclast and I’m now in my 5th and final year of annual infusions with NO side effects! My bone mass measured in my lower extremities has actually increased so I’m now marginally in osteopenia instead. Upper body bone mass has strangely not improved.

  12. Nancy

    What about bio identical hormones and weight bearing exercise along with vitamin d3, k2.and a good source of silica as well as calcium?

  13. Kristin

    Ten years ago I was put on Fosamax. A few months later my jaw started locking, but my doctor said it must be from something other than the fosamax. Even so, I stopped the drug, and my jaw stopped locking several months later. Two years after that, my doctor again convinced me to go on Fosamax, and, sure enough, the same thing happened. NEVER AGAIN! I take supplements, keep my weight down, and do a lot of weight-bearing exercise. I take 10,000 D3 every day because my D is naturally VERY low, and that returned it to mid-range. Two years after I started taking that much D, my bone density exams IMPROVED (and I was NOT taking the fosamax).

  14. Veronica

    I was taking Forteo by injection for a year, but stopped because one of the side effects can be bone cancer. Hope something totally safe is approved one day soon.

  15. Alle

    I experienced pain in my shin bones while taking Bonita. It felt like someone was dragging a sharp knife up & down my bones. I took this in 2009 or 2010. I stopped taking it and the pain went away. Now I’m being advised to do the injection of Reclast.
    I don’t think I’ll do it. I don’t want to risk any more pain symptoms. I’m trying to eat foods that support bones and exercise more.

    • Amelia
      North Carolina

      My doctor advised me to take Fosomax but I resisted. Years later I was diagnosed with osteoporosis (it runs in my family) so, at the doctor’s suggestion, I did the Reclast. The procedure was painless, and I was told there shouldn’t be any side effects. Well, I did have side effects for one night; I was achy and nauseated. However, the next day I was much better. If you decide to try Reclast be aware that few people experience side effects. I was one of the few. Good luck!

  16. Linda

    I took Fosamax for a few months. Then my doctor switched me to Actonel. Soon I began experiencing uncontrollable diarrhea episodes, not on a regular basis but randomly. I thought I’d been eating something that triggered the episodes and began keeping a food diary. After about a year, I started having intense stomach aches every day around the same time, still experiencing random episodes of uncontrollable diarrhea, and neither seemed food-related. Suddenly I remembered that mom had also had the random uncontrollable diarrhea episodes and had been taking Fosamax. It ruined her life, as she was social and loved getting together with friends. I stopped taking Actonel and within a week both the stomach aches and the diarrhea also stopped. Now it seems like every older woman I know has been diagnosed with either osteoporosis or osteopenia and is taking one of those drugs.

  17. Sharon

    I have been taking ibandronate for almost 10 years. Started taking it soon after I had a hip replacement. My bone density came back last year to 5.7. The doctor was very pleased but told me I had to continue taking meds. About a week or so after I take the meds I have a lot of pain in my joints and muscles. Joint and muscle pain are listed as side effects on the information sheet with the meds but my doctor never told me anything about these side effects. Having osteoarthritis, it never dawned on me that this medication was giving me the pain.

    I will definitely talk to my doctor about changing out ibandronate for another medication.

    Thank you for all the information.

  18. Jeannette

    I broke my arm (age 49) 7 years ago, and GP wanted to put me on a bisphosphonate after body x-ray showed osteopenia. I researched the medication and was appalled it was ever suggested. My arm was as the result of my running and crashing with force into a door frame – it was not a no-or-minimal-impact injury. Otherwise was (and am) pretty fit. Having seen the ‘evolving’ side effects I am thankful I did not take up my GP’s offer. I am now 56 and only take the occasional aspirin – no other orthodox medication. I do take a few (researched) supplements.

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