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CRPS Treatment: pain in both legs and arms for 1 year and a half

General details and patient's info

Gender:Female.
Age:20 years old at the time of treatment.
Home Country:Poland.
Illness duration:21 months prior to the Neridronate Treatment.
Cause:Parvovirus B19 infection.
Symptoms:Sensation that the limbs are crushed, and bones twisted, shooting burning pain when flare up occur. Both hands and feet are alternately freezing cold, blue, then hot and red. She is not able to straighten her fingers. Her arms and legs are weak and often tremble. Excessive sweating.
Clinical evaluation:CRPS type 1, the patient meets the Budapest Criteria.
Time of treatment:September 2023.

Why the Patient decided to undergo the CRPS Treatment in Italy

This young girl could not find much help from the Doctors back home, none of them had any idea about her severe condition. She was clever enough to do the research herself and, after discovering the Budapest Criteria, she suspected a CRPS diagnosis. Her neurologist, after reviewing all the information, confirmed she was indeed right. At that point the patient kept on studying the disease and ended up considering Neridronate as the treatment of choice for her condition.

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; Ketorolac 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.

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.

Daily Report

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

DAY 2: Morning pick-up by her Patient Manager, 1st visit with the Rheumatologist Professor, 1st Rehabilitation session, and 1st Neridronate infusion. The patient is a bit nervous but during the morning she feels better.

DAY 3: Morning pick-up by her Patient Manager, 2nd Neridronate infusion. The patient today feels safe, and she is much more relaxed, even if she is in a bit of pain.

DAY 4: Morning pick-up by her Patient Manager, 2nd Rehabilitation session and 3rd Neridronate infusion. The patient reports a headache, the Rheumatologist Professor prescribes Ketorolac to cope with the treatment side effects. The Physiotherapist explains stretching exercises, how to self-treat her scars and gave tips on an appropriate nutritional plan.

DAY 5: Morning pick-up by her Patient Manager, 2nd visit with Rheumatologist Professor.

DAY 6: Morning pick-up by her Patient Manager, 3rd Rehabilitation session, 4th Neridronate infusion. The patient feels tired and needs to rest during the afternoon.

DAY 7: Rest day in the hotel, in contact with her Patient Manager.

DAY 8: Pick-up by her Patient Manager and drop-off at Treviso airport.

Follow up

NOVEMBER 2023 (2 months after Neridronate treatment): the patient could manage to go back to university. Her pain levels vary day to day, and she thinks they are impacted by the work and stress from being back to her studies after a long stop (due to the disease!).

DECEMBER 2023 (3 months after Neridronate treatment): pain levels are decreasing, and the patient does not have any more sharp pains. She can notice an improvement in her hand’s mobility. She keeps on exercising and following a correct diet. Unfortunately, she slipped and fell on ice, which brought some new issues.

FEBRUARY 2024 (5 months after Neridronate treatment): both the symptoms and mobility are improving. Probably due to extra work from the university, at night she feels that pain increases but she is confident that taking some rest will help.

Conclusion

This case reflects how complicated it is for CRPS patients to find knowledgeable medical professionals to help them. According to MTI’s experience, most patients research and find solutions on their own. Spreading information on the Italian 360° approach is very important and may contribute to save lives. It is also important to see how patients manage to go back to their activities, works, studies and how feeling better and better brings them new hope and energy.

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.