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CRPS Treatment: pain in foot and calf for 1 year and a half

General details and patient's info

Gender:Female.
Age:56 years old at the time of treatment.
Home Country:USA.
Illness duration:21 months prior to the Neridronate Treatment.
Cause:There was no trigger event.
Symptoms:Constant pain in foot and calf, tingling, numbness and drop foot. Walking is difficult and she needs a cane. Standing increases the pain. Cannot straighten her right leg and always keeps it folded even in bed. She has difficulty in sleeping, the anxiety triggers flare-ups.
Clinical evaluation:CRPS diagnosis. Her doctor affirms the pain has progressively worsened during the past year.
Time of treatment:October 2022.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient tried 7 different treatments before the Neridronate and only one of them brought some relief. She also used to take pain medications, but they only helped her a bit at the beginning and for a short period of time; she cannot take too many medications due to allergies. She met a well renowned Rheumatologist in the USA that informed her about the Neridronate given in Italy to CRPS patients; one of her relatives is a neurologist researcher and he said that Neridronate can be effective; her family Doctor encouraged her to travel to Italy to try it, especially because it was proven that it could not hurt her in any way.

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.
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.

5 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.

5 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 short drive to the Hotel in Vicenza. Check-in, briefing focused on the next days 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 her Patient Manager, visit with the Rheumatologist Professor, 1st Neridronate infusion, 1st rehabilitation session. The patient has very thin veins and, knowing that could be a problem, she asks to keep the needle in her arm for the next 3 days, in fact the nurse did not have troubles with the procedure. The woman feels well, in the afternoon they visit Verona, she walks with her cane, resting from time to time. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 3: Morning pick-up by her Patient Manager, 2nd Neridronate infusion. The patient feels well, due to her very fragile veins, the I.V. requires more time. She is very happy because the previous night she could lay her right leg on the bed (which hasn’t happened since she developed CRPS). She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 4: Morning pick-up by her Patient Manager, 3rd Neridronate infusion. The patient feels well and comfortable but a bit tired. She says that her toes are not as painful as usual. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 5: Morning pick-up by her Patient Manager, last Neridronate infusion and 2nd rehabilitation session. After the treatments, a tour of Vicenza by car: the patient feels well but is a bit tired and does not want to walk much. She then proceeds with Light therapy and Biophysical treatment in her hotel room.

DAY 6: Morning pick-up by her Patient Manager, check-out of the Vicenza’s Hotel, and drive to Venice followed by a tour and a gondola ride. The patient feels well, she is very happy to see Venice and she walks with the cane.

DAY 7 to 9: Rest Day in Venice on their own while keeping in touch with the Patient Manager. The patient is ok, enjoying Venice and she can walk with the cane.

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

Follow up

NOVEMBER 2022 (1 month after treatment): the patient is doing well; she is using the static bike as suggested by the doctors and walking without the cane.

DECEMBER 2022 (2 months after treatment): the patient is doing well, and she realized she has more strength in her leg. She has a few bad days sometimes, but the pain never lasts as long as it used to before the treatment.

JANUARY 2023 (3 months after treatment): the patient is doing ok, pain levels decreased, and she is exercising every day.

FEBRUARY 2023 (4 months after treatment): the patient unfortunately fell at home, and she hit her CRPS right knee, twisted her ankle and bent her big toe. The knee was swollen but she had no pain. On the contrary, she says that she feels a 70% reduction of the pain.

MARCH 2023 (5 months after treatment): the pain level is good and under control, the patient keeps the cane only for walking outside her house, just to feel safer, but she does not actually need it anymore. She is back to all her activities and can spend time playing with her grandson.

APRIL 2023 (6 months after treatment): the patient is doing well and working quite a lot because she and her husband are moving. Sometime the pain is higher, but she thinks that it is due to tiredness and overwork, so she manages it with more rest.

JUNE 2023 (8 months after treatment): the patient is doing well, and she confirms a reduction of pain of 70%. She is very happy about this result, and she can do a lot of work in the new house, including painting, which she thinks would have been impossible before treatment.

Conclusion

The patient experienced very good outcomes after the Neridronate treatment in Italy. After 8 months she reported the 70% of pain and symptoms reduction.
She is back to all her activities and can spend time playing with her grandson.

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.