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#5 Case study report: Neridronate Treatment for CRPS in right ankle and foot for 5 years

General detailsPatient’s info
Age:18 at the time of treatment
Home Country:United States of America
Duration of illness:5 years prior to the Neridronate treatment
Cause:Right ankle injury while snowmobiling
Symptoms:Excruciating pain in the lower and upper leg, stabbing pain in the ankle, hypersensitivity to anything, cannot wear pants, socks, shoes. The wind, the cold, and the water hurt. All movements hurt, cannot run, jump; walks a little bit with crutches or a cane and when he goes out, he needs a wheelchair.
Clinical evaluation:CRPS diagnosis, pain level: 8. Anterolateral right ankle joint pain. Sensory abnormalities noted, touch felt as pins and needles and pain in the ankle and top of the foot. Nerve type injury of the superficial peroneal nerve.
Period of treatment in Italy:November 2022


The patient tried several treatments during the 5 years from the onset of his CRPS but none of them helped. He also took different medications, a few of them brought some relief but that lasted only 30 minutes. His life was very much affected by his painful condition, and he could not go out from his house very often, since he lives in a cold area in the mountains and could not stand clothes on his legs.

His parents contacted MTI and at the same time other clinics in USA to find a solution. His mother is a physical therapist, and she has a medical training; after studying all available options she thought that the Neridronate treatment was the most reliable one. His father at the same time got in touch with the father of a young girl, a cheerleader, that had already travelled to Italy and MTI for the same issue and was finally in remission and pain free, this is why they decided to pursue the Italian protocol.



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.


3 neridronate infusions (100mg, I.v. in saline Solution 0,9% 250 ml) and 1 neridronate infusion (75mg, 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.

3 sessions Neuromuscular Rehabilitation Treatment with the Physical Therapist.

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.

9 days Light Therapy (in 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.

9 nights Biophysical Treatment (5 hours each night while the patients are 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 the 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 Rheumatologist Doctor, rehabilitation session and first Neridronate infusion. Visit to a mall for some shopping. Light therapy and bio-physical treatment in the hotel room.

  • DAY 3: Meeting with the Health Planner, second Neridronate infusion. The patient is tired and has a mild stomachache. Light therapy and bio-physical treatment in the hotel room.

  • DAY 4: Meeting with the Health Planner; the young boy has some side effects, such as light fever, nausea, pain.  The Rheumatologist Doctor decides to skip the infusion today to give him time to recover. Second rehabilitation session. 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 third infusion. The patient feels tired, but he chooses to visit the Verona center in the afternoon, while sitting in the wheelchair. Light therapy and bio-physical treatment in the hotel room. 

  • DAY 6: Meeting with the Health Planner, rehabilitation session, and fourth infusion. Due to previous side effects, the Rheumatologist decides to decrease the Neridronate dosage to 75mg. In the afternoon the patient feels better. Visit to the Ferrari center in Verona: the patient is very happy, since he is passionate about cats. All followed by a short stop to Soave, a nearby town. Light therapy and bio-physical treatment in the hotel room.

  • DAY 7: Meeting with the Health Planner and rest day. Short walk in Vicenza with the wheelchair. Light therapy and bio-physical treatment in the hotel room.

  • DAY 8: Meeting with the Health Planner and rest day. Light therapy and bio-physical treatment in the hotel room.

  • DAY 9:  Meeting with the Health Planner and day trip to Lake Garda. The patient feels rested but he still needs the wheelchair most of the time. Light therapy and bio-physical treatment in the hotel room.

  • DAY 10: Meeting with the Health Planner and drop off at the Venice airport for the flight back home. The patient feels tired, but he does not have further side effects.



DECEMBER 2022 (1 month after treatment): the patient is still in a lot of pain but says “he feels something different in his bones”, he keeps on exercising. 

JANUARY 2023 (2 months after treatment): the patient himself does not refer any improvement but both his parents see that he is doing better, walking more, climbing stairs, and they realize that all his movements are easier.

MARCH 2023 (4 months after treatment): the patient is doing better, pain decreased, and he lowered the dosage of his medications. He moves better and does not use his cane anymore to walk, he exercises on a regular base.

APRIL 2023 (5 months after treatment): the patient keeps on slowly improving and he can wear trousers for some time.

MAY 2023 (6 months after treatment): the patient is doing better every day, weaning off pain medication. He could wear trousers for several hours, socks and shoes and even dance at school parties. 



Neridronate was fully studied, trialed, and patented in Italy by a team of doctors, rheumatologists and Professors from the Verona hospital and university.  AIFA (Italian FDA) approved the protocol of 4 Neridronate infusions 100mg I.V. in saline Solution 0,9% 250 ml. Neridronate is a strong drug which never brings adverse side effects. However, the patient could feel tired, show flu like symptoms, have some fever, nausea, and pain. All that generally disappears in a couple of days and is well tolerated by patients. These reactions sometimes are heavier on children and teenagers: in these cases, the knowledge and expertise of the MTI Professors make the difference, since they adjust the treatment to each patient and their case. 

During his stay in Italy the patient could understand the importance of exercising and have a correct nutrition, he still follows his new healthy routine, and he is likely to have further general improvements.

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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