Do not use bisphosphonates without scientific evidence, neither in treatment nor prophylactic, in the treatment of stress fractures

Stress fractures: definition, diagnosis and treatment

“… 10 , 11 The patient should be reexamined every two to three weeks, to monitor the changes to the symptoms and pain during resting and rehabilitation periods. 6 , 53 , 54 , 55 , 56 IN order to maintain flexibility, strength and cardiovascular physical conditioning during the resting period, the patient needs to be engaged in a physiotherapy program 6 , 53 , 54 and a controlled exercise program. 57 …”

Metatarsal Stress Fractures in Patients with Multiple Myeloma Treated with Long-Term Bisphosphonates

“…Whether these drugs enhance or impair the fracture-healing process remains the subject of ongoing debate 65 . Some studies showed that N-BPs adversely affect healing; thus, the authors recommended cessation of N-BP therapy until the fracture has resolved 66,67 . However, other studies showed that N-BPs can have a positive impact on healing by increasing bone mineralization, volume, strength, and callus size [68][69][70][71] .…”

Stress Fracture / Stress Reaction of the Lower Leg and Foot

“…It has also been postulated that bisphosphonates may have a prophylactic effect by preventing stress fractures during intense training, although this is yet to be proven (Ekenman 2009). When military recruits were given a loading dose of 30 mg of risedronate daily for 10 doses during the first 2 weeks of basic training followed by once-a-week maintenance dose for 12 weeks, no reduction in the incidence of stress fractures was seen (Milgrom et al 2004).…”