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

General details and patient's info

Gender:Male.
Age:55 years old at the time of treatment.
Home Country:United States of America.
Illness duration:18 months prior to the Neridronate Treatment.
Cause:Foot surgery.
Symptoms:Stiffness, numb sensation, occasional swelling.
Clinical evaluation:CRPS diagnosis. Following foot surgery in December 2020, discomfort in left foot: mild pain, sensitivity to pressure, constant numbness.
Time of treatment:August 2022.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient is an active man recently diagnosed with CRPS. He can walk and swim. He tried a couple of medications that did not help. He did not want invasive procedures and he discovered that Neridronate treatment available in Italy could be the best chance for him to get better.

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.

Daily Report

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

DAY 2: Morning pick-up by his Patient Manager, 1st visit with the Rheumatologist Professor, 1st Neridronate infusion, 1st Rehabilitation session.

DAY 3: Morning pick-up by his Patient Manager, 2nd Neridronate infusion.

DAY 4: Morning meeting with Patient Manager, rest day. The patient feels well, and he goes swimming in the hotel pool.

DAY 5: Morning pick-up by his Patient Manager and 3rd Neridronate infusion, 2nd Rehabilitation session. The patient has mild bone ache.

DAY 6: Morning pick-up by his Patient Manager, 2nd visit with the Rheumatologist Professor, last Neridronate infusion. The patient feels quite well, he only reports a light headache.

DAY 7: Morning pick-up by his Patient Manager, drop-off at Venice airport.

Follow up

OCTOBER 2023 (2 months after Neridronate treatment): the patient does not feel any difference.

NOVEMBER 2023 (3 months after Neridronate treatment): still no changes in patient condition.

DECEMBER 2023 (4 months after Neridronate treatment): the patient is not improving.

MARCH 2023 (7 months after Neridronate): the patient does not report any progress.

Conclusion

This patient is one of the very few that did not have good results from the Neridronate treatment. He did not see any difference. The patient did not agree to the supplements that were prescribed by the Doctor and once at home he did not follow the rehabilitation protocol he received in Italy. A general suggestion for CRPS patients is that regular rehabilitation exercises can ease the Neridronate action, together with Vitamin D (and sometime further supplements) intake.
According to data this may happen in 2% of cases only. There is still a lot to study and research about CRPS; Italian doctors are involved in this project and hopefully in a close future every patient will have further opportunities to reach remission.
However, it is important to underline that Neridronate is extremely safe. Opposite to other CRPS treatments and medications it does not have bad lasting side effects. The worst eventuality is that, as in this case, it does not provide results: which means that it is worth trying to any CRPS patient, as early as possible.

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.