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CRPS Treatment: pain in ankle and foot for 5 years

General details and patient's info

Gender:Male.
Age:18 years old at the time of treatment.
Home Country:United States of America.
Illness duration: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.
Time of treatment:November 2022.

Why the Patient decided to undergo the CRPS Treatment in Italy

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 decided 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.

Medical treatment the Patient underwent in Italy

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.
3 sessions of 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.

Daily Report

DAY 1: Arrival at the Venice airport, greeted by his Patient Manager and drive to the hotel in Vicenza. Check-in, briefing and rest. Light therapy and Biophysical treatment have been installed in her hotel room; her Patient Manager has explained all details on how to operate the machines.

DAY 2: Morning pick-up by his Patient Manager, 1st visit with Rheumatologist Professor, 1st rehabilitation session and 1st Neridronate infusion. Visit to a mall for some shopping. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 3: Morning pick-up by his Patient Manager, 2nd Neridronate infusion. The patient is tired and has a mild stomachache. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 4: Morning pick-up by his Patient Manager; the young boy has some side effects, such as light fever, nausea, pain. The Rheumatologist Professor decides to skip the infusion today to give him time to rest. 2nd rehabilitation session. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 5: Morning pick-up by his Patient Manager, 2nd visit with the Rheumatologist Professor and 3rd infusion. The patient feels tired, but he chooses to visit Verona’s city center in the afternoon, using MTI’s wheelchair. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 6: Morning pick-up by his Patient Manager, 2nd rehabilitation session, and last Neridronate 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 cars. All followed by a short trip to Soave, a nearby medieval town. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 7: Morning pick-up by his Patient Manager and short walk in Vicenza with the wheelchair. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 8: Morning meeting with his Patient Manager and rest day. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 9: Morning pick-up by his Patient Manager and day trip to Lake Garda. The patient feels rested, but he still needs the wheelchair most of the time. He then proceeds with Light therapy and Biophysical treatment in his hotel room.

DAY 10: Morning pick-up by his Patient Manager and drop-off at the Venice airport for the flight back home. The patient feels tired, but he does not have further side effects.

Follow up

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 has 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 finally wear trousers for short periods of time.

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

Conclusion

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.
The patient is doing better every day, wearing off pain medication. He can now wear trousers , socks and shoes for several hours. He also has lowered the dosage of his medications.

DISCLAIMER
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.