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CRPS Treatment: pain in foot for 3 years

General details and patient's info

Gender:Female.
Age:54 years old at the time of treatment.
Home Country:United States of America.
Illness duration:3 years prior to the Neridronate Treatment.
Cause:Right foot bunion surgery.
Symptoms:Strong pain and ice/cold worsen it. Putting the foot on the floor feels like “it is going to explode”. Sensation of foot being squeezed. Color changes. In September 2019 a second foot surgery made the symptoms spread up to whole right leg. The affected area often feels as if it is “asleep”. Can walk short time only before getting burning pain on foot. Standing is more painful than walking.
Clinical evaluation:CRPS diagnosis. Purple color on all toes and over surgical scars, another prominent area in mid foot. 1+ dorsalis pedis pulse. There is one second capillary refill. The foot is uniformly cold until about 2-3 cm above the ankle at which point the leg suddenly becomes warm. Mild puffy swelling in the lower leg and foot.
Time of treatment:January 2020.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient joined some CRPS support group on Facebook, she contacted MTI and was very well impressed by quick answers and professionalism. Meantime she tried a couple of treatments and a few different medications: they helped with temperature sensibility but made the pain even worse. When she got in touch with a previous MTI patient, she was finally trustful on the Neridronate efficacy and travelled 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;

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.

8 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 Verona airport, greeted by her Patient Manager, followed by check-in at her Hotel in Verona. Briefing focused on next days. Light therapy has been installed in her hotel room; her Patient Manager has explained all details on how to operate the machine.

DAY 2: Rest day, in touch with her Patient Manager. She then proceeds with Light therapy in her hotel room.

DAY 3: Morning pick-up by her Patient Manager, 1st visit with the Rheumatologist Professor, 1st Rehabilitation session, 1st Neridronate infusion. She then proceeds with Light therapy in her hotel room.

DAY 4: Morning pick-up by her Patient Manager, 2nd Neridronate infusion. The patient feels well but the infusion was slower than the first one because she felt some pressure on the vein. Visit to Verona. She then proceeds with Light therapy in her hotel room.

DAY 5: Morning pick-up by her Patient Manager, 3rd Neridronate infusion. The patient feels well, and she asks to back to Verona’s city center. She then proceeds with Light therapy in her hotel room.

DAY 6: Morning pick-up by her Patient Manager, 2nd visit with the Rheumatologist Professor, last Neridronate infusion. She then proceeds with Light therapy in her hotel room.

DAY 7: Morning pick-up by her Patient Manager, 2nd Rehabilitation session. The patient feels well, no side effects shown. She then proceeds with Light therapy in her hotel room.

DAY 8: Morning pick-up by her Patient Manager, day trip to Venice. She then proceeds with Light therapy in her hotel room.

DAY 9: Morning pick-up by her Patient Manager and drop off at the Verona airport to fly back home.

Follow up

FEBRUARY 2020 (1 month after treatment): the patient feels small gradual improvements.

APRIL 2020 (3 months after treatment): 10 weeks after her venue in Italy, the patient fainted and sprained her ankle which brought a flare up. As soon as the sprain healed, she felt further improvements.

FEBRUARY 2022 (2 years and half after treatment): the patient feels better and could recover most of her functionality. She reduced at minimum dosage pain medications which she just takes from time to time if she needs it.

Conclusion

This woman could experience good lasting outcomes and recover most of her functionality despite an unrelated sprain ankle injury she had 2 months after treatment. Neridronate is a strong medication acting and deeply working on bones (and on tissues around bones). Bones get stronger which helps not only with CRPS but also to face other related issues or new injuries.

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.