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CRPS Treatment: pain in foot for 8 months

General details and patient's info

Gender:Female.
Age:59 years old at the time of treatment.
Home Country:United States of America.
Illness duration:8 months prior to the Neridronate Treatment.
Cause:Aggressive physiotherapy session and cold laser after Morton’s neuroma surgery.
Symptoms:Skin redness, swelling, foot feels tight and stiff. Burning, stinging, tingling pain which gets worst at night. She needs crutches or a knee walker to move.
Clinical evaluation:CRPS type II diagnosis. The left foot is slightly swollen and erythematous in comparison to non-affected sites. Using bilateral crutches for assistance. Tenderness/hypersensitivity over the distal incisional scar; hypersensitive to light touch and pinwheel over incisional scar third webspace area.
Time of treatment:February 2019.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient was rejected from the Neridronate trial in USA, after researching on the net she decided to undergo the treatment in 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.

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, followed by check-in at her Hotel in Vicenza. 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: Morning pick-up by her Patient Manager, short visit of Vicenza then rest. 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 and 1st Neridronate infusion. The Rehabilitation session went smoothly, it was focused on relaxing the patient who had prior traumatic experience with physiotherapy; the therapist Doctors taught the patient self-massage movements. She then proceeds with Light therapy in her hotel room.

DAY 4: Morning pick-up by her Patient Manager and 2nd Neridronate infusion. The patient feels well, no side effects but she is tired, she needs to rest. She then proceeds with Light therapy in her hotel room.

DAY 5: Morning pick-up by her Patient Manager and 3rd Neridronate infusion. The patient has some flu-like side effects such as shivering, feeling cold, headache. 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 and last Neridronate infusion. The patient feels tired since she did not sleep well the previous night. She then proceeds with Light therapy in her hotel room.

DAY 7: Morning pick-up by her Patient Manager, 2nd Rehabilitation session, the doctors explained her how to treat the scar tissue. The patient highly appreciates the physiotherapy offered in Italy. She then proceeds with Light therapy in her hotel room.

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

DAY 9: Morning meeting with her Patient Manager, rest day. She then proceeds with Light therapy in her hotel room.

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

Follow up

APRIL 2019 (2 months after Neridronate treatment): the patient has her first improvements. She can move her toes and starts walking a bit without the knee walker. She is following the Italian physiotherapists exercises program.

MAY 2019: (3 months after Neridronate treatment): the patient keeps on slowly improving, her foot is not as red as before. She is positive about seeing more progress during the next months.

JULY 2019 (5 months after Neridronate treatment): the patient is doing better and better, she walks 5.000/7.000 steps per day without help, she only uses the knee scooter when she is tired.

JANUARY 2020 (11 months after Neridronate treatment): the patient completely recovered from pain and symptoms.

AUGUST 2020 (18 months after Neridronate treatment): the patient confirms to be in full remission, she also keeps on exercising every day.

AUGUST 2023 (4 years and a half after Neridronate treatment): the patient confirms to be well; she is doing great and only has rare short and mild flares up.

Conclusion

This patient had a CRPS TYPE 2 diagnosis, which is less frequent, and involves a nerve damage. Neridronate showed to be effective in both CRPS type 1 and CRPS type 2.
The patient is now in full lasting remission both of pain and other symptoms.

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.