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#4 Case study report: Neridronate Treatment for CRPS in right shoulder and left leg/foot for 5 years

General detailsPatient’s info
Age:18 at the time of treatment
Home Country:Canada
Duration of illness:5 years prior to the Neridronate treatment
Cause:2 right shoulder surgeries
Symptoms:Stabbing pain in her right shoulder, temperature changes, swelling of her right hand, hand discoloration to purple. Limited movements of the shoulder. Burning pain in her left foot and leg, left foot swelling and discoloration.
Clinical evaluation:CRPS diagnosis. Grip strength reduced in her right hand; asymmetry of the shoulders, when she would reach up with both arms the left hand would reach higher than the right. Right scapula dyskinesia. Anxiety and depression.
Period of treatment in Italy:February 2020


After being referred to several doctors the patient was taken in by a pain rehabilitation center and tried multiple treatments with no results.
She could have some relief from pain medications, which unfortunately did not last long.
She was a student, an athlete and played musical instruments at school before getting sick with CRPS. Her mother researched all available treatment options and decided to try the only one, in the world, officially approved by AIFA (Italian FDA).



Complex regional pain syndrome (CRPS) is a severely painful and disabling disease for which a multitude of therapeutic interventions have been proposed. In the past two decades, only Bisphosphonates gained credibility. In recent years, more convincing evidence has become available on the use of parenteral Neridronate. Since 2014, this drug is registered and marketed in Italy for the treatment of CRPS. To date, the only therapeutic schedule that is recognized to be able to confer benefit is the intravenous (IV) administration of 100 mg given 4 times.

4 neridronate infusions (100mg, I.v. in saline Solution 0,9% 250 ml)

See the Official Study on the Oxford Academics website:  https://academic.oup.com/rheumatology/article/52/3/534/1777330

4 Pantoprazole infusions; Paracetamol.

2 sessions, 2 hours each, of Neuromuscular Rehabilitation Treatment with the Osteopath and Physiotherapist doctors.

Rehabilitation therapy is a full body workout which focuses on the general wellbeing of the body, to help the affected limb get back to its normal self.

8 days Light Therapy (in the hotel room, 30+ more minutes each day)

30 minutes or more of usage of the MTI Light Therapy reduces inflammation, increase micro-circulation, relax nerves and muscles, reduces pain transmission, accelerates healing, regenerates cells, and promotes cells activation.

8 nights Biophysical Treatment (5 hours each night while the patient is asleep)

MTI’s Biophysical Treatment is the outcome of 25 years of research and studies. It has been certified by the best Italian Universities, partners from both public and private teams. The Biophysical treatment acts on the roots of the disease, brings relief to the inflammatory condition, helps the cells regeneration, the oxygenation, the micro-circulation, and the lymphatic system.



  • DAY 1: Arrival at Venice airport, meeting with the personal Health Planner and drive to the hotel in Vicenza. Check in, briefing and rest. Light therapy and bio-physical treatment in the hotel room.

  • DAY 2: Meeting with the Health Planner, visit with the Rheumatologist Doctor, rehabilitation sessions and first Neridronate infusion.  The patient is tired from the long flight to Italy and her veins are not very easy to find, however she is comfortable and quiet. Light therapy and bio-physical treatment in the hotel room.

  • DAY 3: Meeting with the Health Planner, second Neridronate infusion. The patient feels tired and reports that she has mild muscle fatigue. In the afternoon they visit Vicenza. Light therapy and bio-physical treatment in the hotel room.

  • DAY 4: Meeting with the Health Planner, third infusion. The patient feels tired and has bone ache. She is still in a good mood and is not worried about the discomfort. In the afternoon they visit Vicenza. Light therapy and bio-physical treatment in the hotel room.

  • DAY 5: Meeting with the Health Planner, follow up visit with the Rheumatologist Doctor and fourth infusion. The patient reports right shoulder and back pain.  Light therapy and bio-physical treatment in the hotel room.

  • DAY 6: Meeting with the Health Planner, rehabilitation session: the patient performs all exercises and shows a wider range of mobility with reduced pain levels. In the afternoon they visit the Verona center, the girl is happy about touring and seeing Italy.  Light therapy and bio-physical treatment in the hotel room.

  • DAY 7:  Meeting with the Health Planner and rest day. The patient is in a good mood but keeps feeling tired. Light therapy and bio-physical treatment in the hotel room.

  • DAY 8: Meeting with the Health Planner and day trip to Venice. The patient feels better, more rested and she has just mild achiness. She appreciates being able to visit Venice.  Light therapy and bio-physical treatment in the hotel room.

  • DAY 9:  Meeting with the Health Planner and drop off at the Venice airport for the flight back home. The patient feels better and is very positive.



MAY 2020 (3 months after treatment): the patient experienced some improvements, has less pain and she is more positive and confident.

AUGUST 2020 (6 months after treatment): the young girl is doing much better, pain level decreased to minimum bearable levels. She moves her shoulder and foot easily.

MAY 2021 (15 months after treatment): the patient is in remission; she recovered her full range of motion in her right shoulder. Right arm and left leg/foot pain disappeared. She may have some light pain when she works or walks too much but it does not last long and goes away with some rest. Her mood is positive, and she does not suffer from depression anymore.



Even though the Neridronate treatment for CRPS brings the best results when taken within 6 months from the beginning of the pain and symptoms, it is always (98% of cases) effective also with those who have had it for longer. This girl was suffering for over 5 years when she travelled to Italy and her life was harder, as a teenager, she was affected by pain, depression, decreased mobility.  After going back home she was highly motivated to exercise and the follow up with her personal Health Planner helped her work on her recovery. MTI Health Planners keep in touch with patients for a long time, encourage them and reply to any questions they may have after the treatment.

This is not a medical case study; it merely describes each patient’s journey, and it omits all personal data. The people who redacted it are not doctors but all the facts reported are objective and represent the patient’s reality thanks to the information in our possession. The report is not part of any clinical trials. It was written to provide more information to patients who have made multiple requests for treatment outcomes of cases like theirs.

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