SAT-LB69 Severe Disabling Musculoskeletal Pain as a Side Effect of Bisphosphonates: A Case Report and Review of Literature

We report a case of a 57-year-old woman who developed severe musculoskeletal pain after taking one dose of Alendronate 70mg for treatment of osteoporosis. The pain was so debilitating that the patient was unable to sit up, stand, or move without assistance, and any kind of movement aggravated the pain. Key words: bisphosphonate, severe muscle pain, case report, osteoporosis Methods A detailed case report is presented. A review of the current literature on the side effects of bisphosphonates was made for reference. Results Development of severe, disabling musculoskeletal pain was noted after taking one dose of Alendronate 70 mg tablet. The pain was severe enough to hinder the patient from sitting or standing up, and any form of movement seemed to worsen the pain. Discontinuation of the drug, pain relievers and complete bed rest afforded slight relief of symptoms. Complete resolution of pain only occurred after 72 hours. Review of literature showed that muscle pain with intake of bisphosphonates occurred in a few patients, and were mostly found in case reports or case series. Other commonly associated side effects with bisphosphonate therapy were also briefly discussed. Conclusion The case presented emphasizes that bisphosphonate therapy, although frequently used uneventfullyn, may still produce adverse effects in a few patients. A handful may present with severe debilitating muscle pain as seen in our patient. Literature review showed that another subset of patients may react differently and present with cardiac or ocular symptoms. What must be taken from this paper is the importance of patient education regarding these possible adverse events that although infrequent, may still happen. These unpleasant adverse effects may greatly affect compliance and ultimately have a bigger impact in the fight against osteoporosis.