My rheumatologist put me on Fosamax for my bones as soon as I started prednisone. I have osteopenia which means my bone density is more than 10% below what a young person would have, not as bad as osteoporosis. I have gained around 4% of bone density in the 1.5 years I've been on it but would like to get off now that I am on a lower prednisone dose ( 6.5 mg). One of the listed side effects is muscle and joint pain. I don't know if it is adding to the significant pain I have but I would like to find out and will ask my rheumy about it next visit. I've read a paper stating that drugs like Fosamax are recommended for people with osteopenia taking 7.5 mg or more of prednisone. Below 7.5 there is no opinion one way or the other.