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CRPS Treatment: pain in ankle for 11 months

General details and patient's info

Gender:Female.
Age:55 years old at the time of treatment.
Home Country:U.S.A.
Illness duration:11 months prior to the Neridronate Treatment.
Cause:Left ankle surgery.
Symptoms:Tingling and burning pain at the top and the bottom of the foot, it increases with activities; Color changes in the limb; slower nails growth; tremors, vertigo.
Clinical evaluation:CRPS diagnosis. Existing systemic symptoms along with the ones of the foot. Mild diffused muscle atrophy of the foot and lower leg, discoloration ranging from very red to Cyanosis, shiny skin, brittle flaking nails. Dysesthesia, hyperhidrosis on the sole of the foot. The pain doctor suspected a central process such as multiple sclerosis.
Time of treatment:June 2022.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient tried 3 different treatments before, all lasting for several sessions, which did not help. She took pain medications which brought just very mild relief, that was never lasting.
The lady personally met a previous MTI patient that underwent Neridronate Treatment for CRPS and reported her good experience and outcomes.

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; Prednisone.

2 sessions, 2 hours each, of Neuromuscular Rehabilitation Treatment with the Osteopath and Physiotherapist.
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 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 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 her Patient Manager and short drive to the Vicenza hotel. Check-in, briefing focused on the next treatment days, 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 her Patient Manager, 1st visit with the Rheumatologist Professor, 1st Neridronate infusion, 1st Rehabilitation session. The patient feels well, no side effects, she actively cooperates with the therapists. Light therapy and Biophysical treatment in the hotel room.

DAY 3: Morning pick-up by her Patient Manager, 2nd Neridronate infusion. The patient feels well and comfortable, no side effects. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 4: Morning pick-up by her Patient Manager, 2nd visit with Rheumatologist Professor and 3rd Neridronate infusion. The patient stays in a very good mood and reports light side effects such as skin rashes and a bit of neck ache. The Professor prescribes Prednisone to control them. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 5: Morning pick-up by her Patient Manager, the patient feels better, no more skin rashes and neck pain. She is in a very good mood. The Patient Manager drives her and her husband on a trip to Garda Lake and Sirmione. Once they are back at the hotel, she just feels a bit tired. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 6: Morning pick-up by her Patient Manager, last Neridronate infusion; 2nd rehabilitation session where the patient and the therapists can appreciate improvements in the exercises and the motion range. She feels well and the Patient Manager shows her and her caregiver around Verona. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 7: Rest day, keeping in contact with her Patient Manager. The patient feels well and spends the day at the hotel’s pool. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 8: Morning pick-up by her Patient Manager, check-out at the hotel in Vicenza and check-in at the Venice hotel. The patient feels well, no side effects, she walks around Venice.

DAY 9: Morning pick-up by her Patient Manager, covid testing and guided visit of Venice. The patient feels well.

DAY 10: Morning pick-up by her Patient Manager and drop-off at the Venice airport to fly back home.

Follow up

AUGUST 2022 (2 months after treatment):
the patient reported 40%-50% reduction of pain, skin redness and dysesthesia.

SEPTEMBER 2022 (3 months after treatment):
the patient reduced her daily dose of medications, improved her range of motion and daily activities.

OCTOBER 2022 (4 months after treatment):
the patient tried to get off all medications but went back to only 1 pill at night. She could perform many more activities.

FEBRUARY 2023 (9 months after treatment):
the patient reported a reduction of pain and symptoms of 60% – 70%. She could go back to most of her activities, including skiing. She still referred a mild pain when she is overworking, quickly resolvable by just resting, without the need for medications.

Conclusion

The patient experienced very good outcomes after the Neridronate treatment in Italy, she reported 60% – 70% of pain and symptoms reduction.
According to data and studies, even better results could have been reached if she was treated earlier. The Neridronate treatment is demonstrated to be more effective if it is done no later than 6 months from the onset of the disease.
In case of long-lasting disease, important improvements can still be expected. Side treatments (such as Physiotherapy, Light Therapy, Biophysical Therapy) are important to boost Neridronate action.
In case of long lasting CRPS, it is suggested to use the side therapies for a longer period to maximize the results.

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.

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