Fibromyalgia and Bisphosphonates

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Bisphosphonates: What Conditions can it Treat?

Bisphosphonates are used to slow down the rate of bone loss. Unfortunately, this group of drugs does not build bone, it simply slows down the process of bone loss. Bisphosphonates can be taken orally or by injection, and commonly include alendronate (Fosamax), ibandronate (Boniva), risedronate and zoledronic acid (Reclast). Bisphosphonates help treat bone disorders, including osteoporosis. Osteoporosis is more likely to occur due to age, menopause, and other medical conditions or medications.

Although bisphosphonates are meant to reduce bone fractures in patients with osteoporosis, it can create some unwanted side effects. One side effect is severe pain that mimics fibromyalgia symptoms. Here we will examine other conditions bisphosphonates can treat and look at its relation to fibromyalgia. Please note that I am not a doctor. This article has undergone research, but it should not replace the advice of your doctor. Reach out to your healthcare professional if you have any questions or concerns.

What can it treat?

As previously mentioned, bisphosphonates are a group of drugs that help treat bone problems. Specifically, bisphosphonates help patients who have bone loss or who have thin or fragile bones. Patients who have abnormal bone densities or have had several bone fractures are more likely to be given bisphosphonates by their doctor. These medications are prescribed to the patient in order to stop future bone fractures or other injuries.

Besides osteoporosis, there are other conditions that may require bisphosphonate therapy. Other bone disorders include osteopenia, Paget’s disease, and metastatic bone disease. Here is a list in detail of each bone disorder:


Osteoporosis is usually treated with bisphosphonates. It tends to occur in older patients and those individuals with loss of estrogen. The name actually means “porous bones,” which is exactly what the bone looks like in patients with osteoporosis.


Although osteopenia is similar to osteoporosis, it does have its differences. It occurs when the bones are weaker, but not weak enough where the bones will break easily. Osteopenia is a condition in which the body has difficulty making new bone at the same pace as reabsorbing old bone. Women are more at risk as well as older adults.

Paget’s Disease of Bone

Also known as PDB or osteitis deformans, Paget’s disease is a condition that interferes with the replacement of old bone tissue with new bone tissue. It can lead to fragile or misshapen bones. It more likely affects older adults and commonly occurs in the legs, pelvis, skull, and spine.

Metastatic Bone Disease (MBD)

This disorder is where cancer spreads from the organ to the bone. Cancer can start in the lungs, breast, or prostate, and then it can spread to the bone. Your doctor may suggest several treatment options besides bisphosphonates for this disease.

Other reasons that can lead to bone loss include lack of exercise, nutritional or genetic reasons, and hormones.

Side Effects of Bisphosphonates

It is possible to experience severe pain from bisphosphonates. Additionally, there are other possible side effects. Surprisingly, some side effects involve a different form of osteonecrosis. One example is ONJ or osteonecrosis of the jaw. Osteonecrosis of the jaw tend to occur in patients who are treated for long periods of time with high doses of bisphosphonates. The following is a list of some possible side effects of bisphosphonates, including ONJ:

  • atypical fractures (for example: atypical femoral shaft fractures)
  • atrial fibrillation
  • bone or joint pain
  • severe pain
  • muscle aches
  • nausea
  • biphosphonate-related osteonecrosis
  • diarrhea
  • constipation
  • headache
  • bladder infections
  • tiredness
  • dizziness
  • head colds
  • the flu
  • sinus or throat infections

If you experience any severe side effects that you believe to be life threatening, call 911 immediately.

How is it related to fibromyalgia?

Unfortunately, some research has shown that bisphosphonates can trigger pain-like symptoms similar to fibromyalgia. In fact, FDA issued an alert to caution patients about the possible side effect of severe musculoskeletal pain associated with this drug.

However, there have also been some cases in which patients have received IV Pamidronate or other IV bisphosphonate medicines for pain. These have been used to reduce pain specifically in patients with pain-related conditions, including Complex Regional Pain Syndrome, ankylosing spondylitis, rheumatoid arthritis, chronic back pain, and more. However, there has not been very much research on the topic. The benefits of bisphosphonates should outweigh the risks and side effects if you are considering taking this medicine.

Contact your doctor to find the right treatment option for your condition. Ask your doctor for more information if you have any more questions or concerns or visit American Bone Health online.


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