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Is pamidronate effective for acute rheumatic pain?
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Parenteral pamidronate is licensed in the United Kingdom for the management of Paget's disease, tumour related hypercalcaemia, and metastatic bone pain, where it can rapidly relieve symptoms.1 It is also widely used for the prevention and treatment of osteoporosis, although this represents unlicensed use of the drug, and there is some evidence that it can be rapidly effective for pain relief in patients with osteoporotic vertebral fractures.2,3 It has been used with some effect for the management of ankylosing spondylitis,4 but the full extent of any analgesic properties of the drug has not been fully explored. These properties became apparent to us quite by chance in …