Chronic Myofascial stiffness syndrome side effect of Reclast

Posted by hrbirk @hrbirk, Jun 6 7:50pm

I had my 4th Reclast infusion in Feb ‘25, and never had any side effects from the infusions and saw improvements in my Dexas. I have completed the Reclast treat protocol.
6 months after the last infusion, I began experiencing an odd bone pain in each thigh when I stood on one leg and leaned forward. This was minor but disconcerting. Eventually, it was more a muscle irritation when I walked any distance -the push off. Then I would get a sharp pain that could fade readily with jarring movements. Finally it was bothering me enough that I saw an orthopedic doctor who ordered an MRI. This showed no abnormality in femurs or muscles/ tissues. The consideration then was overuse syndrome and I limited my higher impact activities. Now it’s been nearly a year and I just met with my rheumatologist who introduced the idea that it may be from the Reclast. We didn’t delve into that to any degree because such a late onset is rare. But doing my own research it looks like it’s something the FDA warns about- and my symptoms are consistent with Myofascial stiffness syndrome-which is described this way “ Reclast alters cellular signaling over the long term, it can leave the deep fascia- the connective tissue wrapping around the large quadriceps, chemically irritated, tight, and hyperreactive.”
This is the most accurate description of this strange pain- and I’m curious if any others have had this and if treatment involving dry needling was helpful. Thanks so much

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gently | @gently | Jun 6 8:46pm

hrberk, thanks for your post. This mechanism is a new concept for me. Do you have a link.? I hope you get some experienced answers. Are you looking at piezoelectric? There is a massage technique called myofascial release. I like your rheumatologist.

hrbirk | @hrbirk | Jun 7 7:07am

Thanks for your support. I don’t have any links to provide-the initial discussion with my doctor led to an online AI search. I’m just beginning this process of inquiry.

gently | @gently | Jun 7 8:22am

All I could find was the idea that pain can cause the fascia constriction. It sounded to me that the constriction caused the pain in your experience. Let me know if you find anything. It's interesting that it seems to be late onset and all the literature on Reclast focuses on the dreaded APR.
Best wishes for relief.

Helen, Volunteer Mentor | @naturegirl5 | Jun 7 8:32am

@hrbirk Welcome to Mayo Clinic Connect and this support group.

I'm going to do a thorough search through the peer-reviewed literature in professional journals. I'd like to see if there is evidence for this late onset syndrome that you've mentioned.

Here is an excellent discussion of myofascial syndrome and the mechanisms. I could not find anything in the peer-reviewed literature (published in professional journals) that studied Reclast with this syndrome.

Gromakovskis V (2025) Exploring fascia in myofascial pain syndrome: an integrative model of mechanisms. Front. Pain Res. 6:1712242. doi: 10.3389/fpain.2025.1712242

-- https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2025.1712242/full

I had 12 months of Evenity in 2024 followed by a Reclast infusion upon finishing the Evenity. I then had another Reclast infusion in 2025. My bone density scores have impressively improved. I too have experienced more stiffness but also hip joint pain. I have a left total hip replacement that was performed at Mayo in 2019. In the past few months I am having enough pain that I made an appointment with my orthopedic surgeon to "rule out" or "rule in" whether this is a hardware problem.

I have no regrets on the total hip replacement as I would not be able to walk or be this active had I not had it. I also have no regrets on the medication (Evenity and Reclast) ordered by my endocrinologist. I just want to know what's going on!! I lift weights a minimum of two times a week with a personal trainer. I'm wondering if I did something to my hips while lifting.

Is there anything you do to help relieve the pain? Stretching? Yoga?

gently | @gently | Jun 7 9:21am

Helen, thanks for the post. It's interesting the hrbirk can execute "jarring movements" that readily fade the sharp pain.

hrbirk | @hrbirk | Jun 7 11:08am

In reply to @gently "Helen, thanks for the post. It's interesting the hrbirk can execute "jarring movements" that readily fade..." + (show)

@gently could be my sentence construction was lacking - I meant that I could lunge forward- for example, in playing pickleball, and that quick stop- weight on one leg- could result in the sharp pain, but I could shake it off, and the pain would fade to nothing and I could continue playing. Hope that clarifies.

hrbirk | @hrbirk | Jun 7 11:18am

In reply to @naturegirl5 "@hrbirk Welcome to Mayo Clinic Connect and this support group. I'm going to do a thorough..." + (show)

@naturegirl5 thanks for your reply. I’ll take a look at the link you provided.
It appears that the stretching and foam rolling will be helpful- as well as I’m adopting a protocol to wake up my stuck fascia and muscles by doing that before I have any pain. I’m planning to continue my workouts including barre, Pilates, water fitness, and strength classes- along with pickleball and walking-(one of those a day!)
I’m just fascinated by this finding since I’ve had the hardest time describing the irritated quads to clinicians. My rheumatologist met with me just a day ago, so I’m just beginning to look into it. But feel I’m heading in the right direction now.

gently | @gently | Jun 7 1:30pm

In reply to @hrbirk "@gently could be my sentence construction was lacking - I meant that I could lunge forward-..." + (show)

@hrbirk, I think you were clear that the shaking it off caused the pain to fade. I wasn't sure but thought that the jarring movement was probably a shake, though I wondered if it were a stamp.
Since your post I've been reading about hypocalcemia with zoledronate and the effect on fascia. But I'm certain your rheumatologist is apprised of all that. The quotation from this md deserves a link. Is your doctor involved in research.

Helen, Volunteer Mentor | @naturegirl5 | Jun 7 5:06pm

In reply to @hrbirk "@naturegirl5 thanks for your reply. I’ll take a look at the link you provided. It appears..." + (show)

@hrbirk Thanks for sharing what works for you. I’m going to try more consistency with stretching and foam rolling I also find yoga works for me.

dannyandebbie | @dannyandebbie | Jun 8 7:41am

It has been just two years since I had my Reclast infusion and I have had various issues since. I have had awful shoulder pain, left foot pain, nausea, blurry vision, eye inflammation and just this past weekend I helped a neighbor move a few sheets of plywood and now both hips display intense pain. I also get intense pain in my legs when I cough; to the point I have to squat or it is like a severe electrical shock in both legs! I’ve visited Rheumatology, Neurology and endocrinology and no one can explain why I am experiencing all these symptoms. I have been going to physical therapy biweekly and VA just extended my visits to once a month. I’ll never receive another Reclast infusion! Every day is a struggle and now I’m taking Tylenol 3x a day!