I was on Tymlos for four months until Cigna revoked my pre-authorization. I did get the sharp sudden pains you mention. I called them "zingers" because they felt like electric zaps. I had them in my lower legs, feet, forearms, wrists and hands. They disappeared a couple of days after I stopped taking Tymlos.

I did not experience knee pain but my elbows and wrists did hurt. That also went away after I stopped.