In 2005, Wysowski and Chang2 published a letter regarding a series of case reports submitted to the Food and Drug Administration (FDA) on severe bone, joint, and muscle pain associated with the use of alendronate sodium and risedronate sodium for 1995 to 2002. In all, 116 case reports of serious adverse events were voluntarily submitted. A subsequent FDA Alert was issued on January 2008 concerning serious and sometimes incapacitating bone, joint, and muscle pain associated with bisphosphonate use.3 One such case was seen at Massachusetts General Hospital, prompting an investigation into the literature on the topic. The patient pointed us to a patient-oriented Web site called “Askapatient” (http://www.askapatient.com) that noted multiple case reports of the development of an influenzalike syndrome early in the treatment with bisphosphonate drugs and subsequent severe and sometimes incapacitating joint, bone, and muscle pain. The site posts comments from patients on their experiences with prescription drugs and asks them to rate the drug using a scale of 1 (poor) to 5 (excellent). Several patient reports indicated a persistence of symptoms for months.