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CRPS Treatment: pain in both feet for 6 years

General details and patient's info

Gender:Female.
Age:25 years old at the time of treatment.
Home Country:United Kingdom.
Illness duration:6 years prior to the Neridronate Treatment.
Cause:Unknown. The patient suddenly started to have excruciating pain in her toes’ joints, with no apparent causes.
Symptoms:Frequents flares-up, every hour, affecting feet and ankles. Intense burning and crushing sensation as if the feet were run over by a truck. Sensation that toes are bent in the wrong direction. Feeling that her feet are set in concrete, unable to move them. Unable to bear the lightest touch on her skin. Any vibration of movement of her body causes a flare up.
Clinical evaluation:CRPS.
Time of treatment:December 2023.

Why the Patient decided to undergo the CRPS Treatment in Italy

During the last 6 years the patient tried several medications to keep the pain under control, including morphine and epidural anesthesia. The only way she could find relief during a flare-up was to soak her feet in ice cubes until they went numb. She was followed by a couple of hospital pain centers, and she could only walk a short time with aids. After her condition got even worse, her mum started a deep search on the internet, and she found out about the neridronate treatment. In the UK they offered Pamidronate infusions, which comes from the same Bisphosphonates family, but it is not specific for CRPS. At that point they decided to travel to Italy to receive the only available treatment of choice.

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 Neuromuscular Rehabilitation Treatment with 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.

Daily Report

DAY 1: Arrival at the Verona airport, greeted by her Patient Manager, followed by check-in at his Hotel in Verona. Briefing focused on the next days.

DAY 2: Rest day in the hotel, in contact with her Patient Manager. The patient and her 2 caregivers had a short visit of the city center.

DAY 3: Morning pick-up by her Patient Manager, 1st visit with the Rheumatologist Professor, 1st Rehabilitation session, and 1st Neridronate infusion.

DAY 4: Morning pick-up by her Patient Manager, 2nd Neridronate infusion. The patient experiences side effects with aches in her body, so she spends the afternoon resting at the hotel.

DAY 5: Morning pick-up by her Patient Manager, 2nd Rehabilitation session and 3rd Neridronate infusion. She is still facing some discomfort, such as headache, pain in her feet, flu-like symptoms. Since she had a hard time sleeping, her Patient Manager provided a special orthopedic mattress which MTI makes available in case of needs.

DAY 6: Rest day in the hotel, in contact with her Patient Manager.

DAY 7: Morning pick-up by her Patient Manager, 2nd visit with Rheumatologist Professor, 3rd Rehabilitation session, 4th Neridronate infusion. Side effects are getting much better. Being very close to Christmas, the patient decides to anticipate her flight back home. Her Patient Manager takes care of the drop-off to Venice airport.

Follow up

JANUARY 2024 (1 month after Neridronate treatment): the patient mother, that was one of her caregivers in Italy, says that her daughter is doing well, at the point that she is working longer than usual.

FEBRUARY 2024 (2 months after Neridronate treatment): the patient has no more pain; she is back to her full-time job.

Conclusion

Neridronate shows its best effects when taken at the disease’s early stages, even better within the first 6 months. However, it will bring relief to any patients, even with longer CRPS cases. The results are never predictable since everyone is different.
In this case, even though she had CRPS for 6 years, the patient is likely to reach remission.

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.