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CRPS Treatment: pain in foot and leg for 2 years

General details and patient's info

Gender:Female.
Age:23 years old at the time treatment.
Home Country:United States of America.
Illness duration:2 years prior to the Neridronate Treatment.
Cause:Car accident trauma.
Symptoms:Pain level 9-10, burning, crushing, pins and needles, electricity, freezing. Foot swelling and color changes to red and purple. Hard to move ankle and toes. Pain worsened with activities, wind, weather change, touch. During long flares up the pain mirrors to left leg and arm. Needs cane or wheelchair to move.
Clinical evaluation:CRPS diagnosis, suggested by the patient herself and confirmed by pain doctor. Sensitivity and hypersensitivity in right foot and calf. Right leg shows redness. Swelling of right ankle. Sensation is diminished in lower right extremity, particularly in calf and foot. Marked weakness in right lower extremity, in ankle dorsiflexor and plantar flexor. Failed back syndrome, status post lumbar fusion with chronic pain and RSD of right leg, as well as radiculopathy.
Time of treatment:May 2019.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient, a student and part-time babysitter, was prescribed 6 different treatments and several medications that brought no relief. She then underwent a surgical procedure on her back (PLIF and laminectomy) and immediately regained the use, control and feeling of the leg. 4 months after surgery she fell, and the pain came back stronger than before. She found out about Neridronate through social media and pain groups and decided to come to Italy.

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;

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.

Daily Report

DAY 1: Arrival at the Venice airport, greeted by her Patient Manager and check-in at hotel in Vicenza. Light therapy has been installed in her hotel room; her Patient Manager has explained all details on how to operate the machine.

DAY 2: Morning meeting with Patient Manager and rest day. She then proceeds with Light therapy in her hotel room.

DAY 3: Morning pick-up by her Patient Manager, visit of Vicenza’s city center and rest in the afternoon. She then proceeds with Light therapy in her hotel room.

DAY 4: Morning meeting with Patient Manager, rest day, the patient has a flare up. She then proceeds with Light therapy in her hotel room.

DAY 5: Morning pick-up by her Patient Manager, 1st visit with the Rheumatologist Professor, 1st Neridronate infusion. She then proceeds with Light therapy in her hotel room.

DAY 6: Morning pick-up by her Patient Manager, 2nd Neridronate infusion. The patient feels some pain, and she refers nausea. She then proceeds with Light therapy in her hotel room.

DAY 7: Morning pick-up by her Patient Manager, 3rd third infusion. The patient has some light fever, and she still feels some pain. The Rheumatologist Professor prescribes Prednisone to help her. She then proceeds with Light therapy in her hotel room.

DAY 8: Morning pick-up by her Patient Manager, 2nd visit with the Rheumatologist Professor and last infusion. The patient feels much better. She then proceeds with Light therapy in her hotel room.

DAY 9: Morning pick-up by her Patient Manager and visit of Verona, the patient feels quite well but she needs rest. She then proceeds with Light therapy in her hotel room.

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

Follow up

JULY 2019 (2 month after treatment): the patient notices significant improvement: pain level decreased to 6 – 8 against 9-10 she felt before treatment. She walks a bit and increases it every day a little more. She managed to go on a road trip to Florida, with several breaks but she enjoys it.

AUGUST 2019 (3 months after treatment): the pain keeps generally at 6 – 8, with sometimes reaching 9 -10. She is walking significantly more and keeping as active as possible. She started a physiotherapy program and she is positive on more improvements.

NOVEMBER 2019 (6 months after treatment): the patient says she has had a general improvement of her condition of 20% .

Conclusion

Probably because of her other underlying issues (radiculopathy, failed back syndrome) causing her much pain, the treatment seemed to have provided the patient about 20% pain relief. It might not seem so relevant, but for someone suffering daily, it allowed her to finally went back to walking and other activities, and live with lesser pain.

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.