When a patient with FD/MAS develops pain, the first step is to make sure it is not something that needs surgical treatment, such as fractures, bone cysts, and gait problems. Patients should also have their blood phosphate level checked, as this can worsen bone pain. For pain that is not related to these factors, the first steps in treatment should be conservative measures, including rest, massage, heat or cold packs, and over-the-counter medications such as ibuprofen and acetaminophen. For moderate or severe pain that does not respond to these treatments, intravenous medications called bisphosphonates (i.e., zoledronate and pamidronate) may help. These medicines should be given at the lowest dose and frequency needed to control the pain. Because FD is a chronic condition, long-term narcotic medications should be avoided if possible. If these medications are required, a specialist should prescribe it as part of a multidisciplinary pain plan.
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