I had first Reclast infusion in Dec 2025. I drank lots of water, took Tylenol and felt fine after the infusion, just some fatigue. About a month later the low back and hip pain started. Then it moved to my middle back and knees. A little over two months now and still experiencing this pain. When I was put on Actonel in Nov 2022 (weekly dose) I experienced severe low back pain about 1 1/2 months out from starting the medication. I had never had any back problems in my entire life before the Actonel. The debilitating pain subsided after about a month but some pain was intermittent until I went on a drug holiday for all of 2025. My endocrinologist never mentioned bone/back pain as a side effect from Reclast to me. I am 57 and do have some diagnosed arthritis (wrist, knee) and psoriasis. I don't know if there is any connection, but I feel that there needs to be a more comprehensive review of a patient's existing conditions by treating doctors when prescribing this medication. I am osteoporotic so I am just hoping that my next Dexa in Nov 2026 will show improvement.
@mas11 Reclast should be removed in my opinion ! I received my first and last infusion 20 months ago! Nausea, fatigue, shoulder pain and left foot burns at time to the point I have to just sit with it up and nothing on it. I do go to physical therapy biweekly, helps some! Good luck!
I had first Reclast infusion in Dec 2025. I drank lots of water, took Tylenol and felt fine after the infusion, just some fatigue. About a month later the low back and hip pain started. Then it moved to my middle back and knees. A little over two months now and still experiencing this pain. When I was put on Actonel in Nov 2022 (weekly dose) I experienced severe low back pain about 1 1/2 months out from starting the medication. I had never had any back problems in my entire life before the Actonel. The debilitating pain subsided after about a month but some pain was intermittent until I went on a drug holiday for all of 2025. My endocrinologist never mentioned bone/back pain as a side effect from Reclast to me. I am 57 and do have some diagnosed arthritis (wrist, knee) and psoriasis. I don't know if there is any connection, but I feel that there needs to be a more comprehensive review of a patient's existing conditions by treating doctors when prescribing this medication. I am osteoporotic so I am just hoping that my next Dexa in Nov 2026 will show improvement.
@mas11 I agree that a patient's pre-existing conditions are a very important consideration. I have Complex Regional Pain Syndrome and bone pain like you described could be devastating for me as it could cause a flare from my CRPS and I would then be suffering from additional pain from the CRPS along with the reaction from a drug like Reclast. My pain management doctor's response when I asked about painful side effects from osteo drugs with bone pain side effects was to avoid them completely. I tried bisphosphonates but had terrible nausea and vomiting from them. I am trying to figure out what, if any, osteo drugs might work for me.
Stories like this are the reason I'm avoiding any osteoporosis medications even though my DEXA scores are severe (-4 in spine is the worst). Luckily, I've not had a fracture. I can't take Forteo or Tymos due to parathyroid issues, so Evenity or Reclast or another bisphosphonate would be my only options.
This is from AI Assist: "Severe musculoskeletal pain can occur months or even years after taking Reclast (zoledronic acid), which is a bisphosphonate used to treat osteoporosis. This pain may be incapacitating and can sometimes resolve after discontinuing the medication, but it may also persist for a long time."
I had first Reclast infusion in Dec 2025. I drank lots of water, took Tylenol and felt fine after the infusion, just some fatigue. About a month later the low back and hip pain started. Then it moved to my middle back and knees. A little over two months now and still experiencing this pain. When I was put on Actonel in Nov 2022 (weekly dose) I experienced severe low back pain about 1 1/2 months out from starting the medication. I had never had any back problems in my entire life before the Actonel. The debilitating pain subsided after about a month but some pain was intermittent until I went on a drug holiday for all of 2025. My endocrinologist never mentioned bone/back pain as a side effect from Reclast to me. I am 57 and do have some diagnosed arthritis (wrist, knee) and psoriasis. I don't know if there is any connection, but I feel that there needs to be a more comprehensive review of a patient's existing conditions by treating doctors when prescribing this medication. I am osteoporotic so I am just hoping that my next Dexa in Nov 2026 will show improvement.
@mas11 I had a very similar experience. It's been 2 years since my Reclast infusion and the deep bone pain in my right leg (hip to ankle) that began about 8 weeks later has lessened just recently. I had the same side effect, like you, about 2 months after being on Fosamax years ago. The pharmacy flagged the order for Reclast but I decided to try it anyway. My mistake. I was diagnosed with osteoarthritis of my right knee about a year ago affecting activity and my ability to walk. That continues to flare up and I have to pace myself. I never had any of these issues before the infusion and will not take another bisphosphonate though my dr. is suggesting Actonel. I think it would be the same issue.
I had Reclast infusion last December. A week later, my body experienced bone pain, and swelling. I was so bad, up to the point that I could not walk or eat (throwing up). I was finally admitted to hospital. My CRP was elevated to 116 and my SED RATE was 148 at one point. Inflammation! I am now on Predinisone w/ taper. Reclast lasts up to one year in your body. So, I'm not sure how taper of prednisone will work, but it is helping w/ pain. I have osteoporosis pretty bad before Reclast. I see Rheumatologist on Thursday. They think I may have Polymylagia Rheumatica. Prednisone is horrible. I can not stand being on it. But pain is much, much worse when off prednisone.
kabmax259,
"While the patient's symptoms, including weakness and tenderness in the upper extremities, initially resembled those of PMR, several factors argue against a diagnosis of PMR in this case. Firstly, the temporal relationship between symptom onset and zoledronic acid infusion raises the possibility of an adverse drug reaction rather than an underlying PMR. " https://pmc.ncbi.nlm.nih.gov/articles/PMC10404464/.
Reclast stays in your bone for ten years or so. Your inflammatory reaction may subside in response to the prednisone because the cytokine response is self sustaining and no longer triggered by the initial flood of zoledronic acid.
There are far more patient reports of this than medical journal reports. I hope the pain goes away.
kabmax259,
"While the patient's symptoms, including weakness and tenderness in the upper extremities, initially resembled those of PMR, several factors argue against a diagnosis of PMR in this case. Firstly, the temporal relationship between symptom onset and zoledronic acid infusion raises the possibility of an adverse drug reaction rather than an underlying PMR. " https://pmc.ncbi.nlm.nih.gov/articles/PMC10404464/.
Reclast stays in your bone for ten years or so. Your inflammatory reaction may subside in response to the prednisone because the cytokine response is self sustaining and no longer triggered by the initial flood of zoledronic acid.
There are far more patient reports of this than medical journal reports. I hope the pain goes away.
@gently can I inquire, what is PMR? I was told the same about this medication remaining in your system for years! It has been 21 months for me. Yes the symptoms seem to vary as well as bother different areas of one’s body. I had a lot of harsh symptoms, shoulders, left foot, nausea, flu like symptoms and blurred vision. Some of the symptoms have decreased in intensity yet still remain. I did the prednisone taper medication and really did not seem to do anything. I do know that I’ll never receive another infusion of any kind. It does affect people differently. Not sure if one’s health and prior medical issues play a part; wish there were a lot more studies to better provide to patients because I had none of these symptoms prior. However, I have had Ankolosing spondylitis for some 50 + years and bladder cancer 5x in the last 16 years; not sure if this played a part in my continued symptoms from the Reclast. I am a male, 69 years old, 5’2” about 119 lbs. they say I have degenerative disc disease in my lower back…of course, handling logs for the past 45+ years evidently played no part; I guess. Just Remember! We are our own advocates! Review treatments and medications before agreeing! Best of luck!
kabmax259,
"While the patient's symptoms, including weakness and tenderness in the upper extremities, initially resembled those of PMR, several factors argue against a diagnosis of PMR in this case. Firstly, the temporal relationship between symptom onset and zoledronic acid infusion raises the possibility of an adverse drug reaction rather than an underlying PMR. " https://pmc.ncbi.nlm.nih.gov/articles/PMC10404464/.
Reclast stays in your bone for ten years or so. Your inflammatory reaction may subside in response to the prednisone because the cytokine response is self sustaining and no longer triggered by the initial flood of zoledronic acid.
There are far more patient reports of this than medical journal reports. I hope the pain goes away.
@gently
Thank you for your informative response. I wish I would have known more before I had Reclast infusion. I also had cancer last year and was having Nivolumab immunotherapy infusion. After 4 months of that, I started noticing a reaction in my body (but milder than after Reclast.) I stopped the immunotherapy but 2 months later had the Reclast infusion. There is one Dr. that thought the Nivolumab caused a adrenal insufficiency or set-up the inflammatory process for the Reclast. I just don't know how to proceed with my new Rheumatologist, who I meet via telemed tomorrow. In the .gov link you sent, it mentions tests to rule out PMR. Also, my Primary said Reclast stays in system for one year. Can I find information stating 10 years? Thank you again.
@gently can I inquire, what is PMR? I was told the same about this medication remaining in your system for years! It has been 21 months for me. Yes the symptoms seem to vary as well as bother different areas of one’s body. I had a lot of harsh symptoms, shoulders, left foot, nausea, flu like symptoms and blurred vision. Some of the symptoms have decreased in intensity yet still remain. I did the prednisone taper medication and really did not seem to do anything. I do know that I’ll never receive another infusion of any kind. It does affect people differently. Not sure if one’s health and prior medical issues play a part; wish there were a lot more studies to better provide to patients because I had none of these symptoms prior. However, I have had Ankolosing spondylitis for some 50 + years and bladder cancer 5x in the last 16 years; not sure if this played a part in my continued symptoms from the Reclast. I am a male, 69 years old, 5’2” about 119 lbs. they say I have degenerative disc disease in my lower back…of course, handling logs for the past 45+ years evidently played no part; I guess. Just Remember! We are our own advocates! Review treatments and medications before agreeing! Best of luck!
@dannyandebbie, hi.
PMR is a generalized inflammatory disorder with the over production of IL 6 a protein in the immune system. It causes widespread inflammation felt in areas of high density of bursae ( hips and shoulders) and synovial tissue (joints) and areas of previous damage.
I was looking for an article that mentioned bisphosphonates not causing autoimmune systems, but reactivating dormant or exciting pre-existing systems. It seems to me that individuals with autoimmune disease are more likely to have this terrible reaction to zoledronate.
TNF inhibitors block the cytokine cascade and can slow the degeneration of discs.
I can see why you would never trust another injection. https://www.arthritis.org/diseases/polymyalgia-rheumatica
@dannyandebbie, hi.
PMR is a generalized inflammatory disorder with the over production of IL 6 a protein in the immune system. It causes widespread inflammation felt in areas of high density of bursae ( hips and shoulders) and synovial tissue (joints) and areas of previous damage.
I was looking for an article that mentioned bisphosphonates not causing autoimmune systems, but reactivating dormant or exciting pre-existing systems. It seems to me that individuals with autoimmune disease are more likely to have this terrible reaction to zoledronate.
TNF inhibitors block the cytokine cascade and can slow the degeneration of discs.
I can see why you would never trust another injection. https://www.arthritis.org/diseases/polymyalgia-rheumatica
@gently from what I see, a dose of prednisone would be an indicator if one has PMR….meaning, if prednisone treated the symptoms then it could be PMR, correct? I had prednisone therapy and it did nothing for my symptoms; symptoms that did develop after the Reclast infusion. Again, underlying conditions probably could have added to my issues, triggering these symptoms. Guess I’ll never really know as my endocrinologist sends me to rheumatologist who sends me to neurologist who suggested I see an endocrinologist. I see an endless circle that would make others wealthy and myself frustrated, so, I chose to just step out of that circle and go day by day and a little help from my physical therapist who I go to biweekly, for now!
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@mas11 Reclast should be removed in my opinion ! I received my first and last infusion 20 months ago! Nausea, fatigue, shoulder pain and left foot burns at time to the point I have to just sit with it up and nothing on it. I do go to physical therapy biweekly, helps some! Good luck!
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1 Reaction@mas11 I agree that a patient's pre-existing conditions are a very important consideration. I have Complex Regional Pain Syndrome and bone pain like you described could be devastating for me as it could cause a flare from my CRPS and I would then be suffering from additional pain from the CRPS along with the reaction from a drug like Reclast. My pain management doctor's response when I asked about painful side effects from osteo drugs with bone pain side effects was to avoid them completely. I tried bisphosphonates but had terrible nausea and vomiting from them. I am trying to figure out what, if any, osteo drugs might work for me.
Stories like this are the reason I'm avoiding any osteoporosis medications even though my DEXA scores are severe (-4 in spine is the worst). Luckily, I've not had a fracture. I can't take Forteo or Tymos due to parathyroid issues, so Evenity or Reclast or another bisphosphonate would be my only options.
This is from AI Assist: "Severe musculoskeletal pain can occur months or even years after taking Reclast (zoledronic acid), which is a bisphosphonate used to treat osteoporosis. This pain may be incapacitating and can sometimes resolve after discontinuing the medication, but it may also persist for a long time."
@mas11 I had a very similar experience. It's been 2 years since my Reclast infusion and the deep bone pain in my right leg (hip to ankle) that began about 8 weeks later has lessened just recently. I had the same side effect, like you, about 2 months after being on Fosamax years ago. The pharmacy flagged the order for Reclast but I decided to try it anyway. My mistake. I was diagnosed with osteoarthritis of my right knee about a year ago affecting activity and my ability to walk. That continues to flare up and I have to pace myself. I never had any of these issues before the infusion and will not take another bisphosphonate though my dr. is suggesting Actonel. I think it would be the same issue.
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1 ReactionI had Reclast infusion last December. A week later, my body experienced bone pain, and swelling. I was so bad, up to the point that I could not walk or eat (throwing up). I was finally admitted to hospital. My CRP was elevated to 116 and my SED RATE was 148 at one point. Inflammation! I am now on Predinisone w/ taper. Reclast lasts up to one year in your body. So, I'm not sure how taper of prednisone will work, but it is helping w/ pain. I have osteoporosis pretty bad before Reclast. I see Rheumatologist on Thursday. They think I may have Polymylagia Rheumatica. Prednisone is horrible. I can not stand being on it. But pain is much, much worse when off prednisone.
kabmax259,
"While the patient's symptoms, including weakness and tenderness in the upper extremities, initially resembled those of PMR, several factors argue against a diagnosis of PMR in this case. Firstly, the temporal relationship between symptom onset and zoledronic acid infusion raises the possibility of an adverse drug reaction rather than an underlying PMR. " https://pmc.ncbi.nlm.nih.gov/articles/PMC10404464/.
Reclast stays in your bone for ten years or so. Your inflammatory reaction may subside in response to the prednisone because the cytokine response is self sustaining and no longer triggered by the initial flood of zoledronic acid.
There are far more patient reports of this than medical journal reports. I hope the pain goes away.
-
Like -
Helpful -
Hug
1 Reaction@gently can I inquire, what is PMR? I was told the same about this medication remaining in your system for years! It has been 21 months for me. Yes the symptoms seem to vary as well as bother different areas of one’s body. I had a lot of harsh symptoms, shoulders, left foot, nausea, flu like symptoms and blurred vision. Some of the symptoms have decreased in intensity yet still remain. I did the prednisone taper medication and really did not seem to do anything. I do know that I’ll never receive another infusion of any kind. It does affect people differently. Not sure if one’s health and prior medical issues play a part; wish there were a lot more studies to better provide to patients because I had none of these symptoms prior. However, I have had Ankolosing spondylitis for some 50 + years and bladder cancer 5x in the last 16 years; not sure if this played a part in my continued symptoms from the Reclast. I am a male, 69 years old, 5’2” about 119 lbs. they say I have degenerative disc disease in my lower back…of course, handling logs for the past 45+ years evidently played no part; I guess. Just Remember! We are our own advocates! Review treatments and medications before agreeing! Best of luck!
@gently
Thank you for your informative response. I wish I would have known more before I had Reclast infusion. I also had cancer last year and was having Nivolumab immunotherapy infusion. After 4 months of that, I started noticing a reaction in my body (but milder than after Reclast.) I stopped the immunotherapy but 2 months later had the Reclast infusion. There is one Dr. that thought the Nivolumab caused a adrenal insufficiency or set-up the inflammatory process for the Reclast. I just don't know how to proceed with my new Rheumatologist, who I meet via telemed tomorrow. In the .gov link you sent, it mentions tests to rule out PMR. Also, my Primary said Reclast stays in system for one year. Can I find information stating 10 years? Thank you again.
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1 Reaction@dannyandebbie, hi.
PMR is a generalized inflammatory disorder with the over production of IL 6 a protein in the immune system. It causes widespread inflammation felt in areas of high density of bursae ( hips and shoulders) and synovial tissue (joints) and areas of previous damage.
I was looking for an article that mentioned bisphosphonates not causing autoimmune systems, but reactivating dormant or exciting pre-existing systems. It seems to me that individuals with autoimmune disease are more likely to have this terrible reaction to zoledronate.
TNF inhibitors block the cytokine cascade and can slow the degeneration of discs.
I can see why you would never trust another injection.
https://www.arthritis.org/diseases/polymyalgia-rheumatica
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Helpful -
Hug
2 Reactions@gently from what I see, a dose of prednisone would be an indicator if one has PMR….meaning, if prednisone treated the symptoms then it could be PMR, correct? I had prednisone therapy and it did nothing for my symptoms; symptoms that did develop after the Reclast infusion. Again, underlying conditions probably could have added to my issues, triggering these symptoms. Guess I’ll never really know as my endocrinologist sends me to rheumatologist who sends me to neurologist who suggested I see an endocrinologist. I see an endless circle that would make others wealthy and myself frustrated, so, I chose to just step out of that circle and go day by day and a little help from my physical therapist who I go to biweekly, for now!
-
Like -
Helpful -
Hug
1 Reaction