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

General details and patient's info

Gender:Male.
Age:57 years old at the time of treatment.
Home Country:USA.
Illness duration:16 months prior to the Neridronate Treatment.
Cause:Improper location of the tetanus injection (inferior to patient’s deltoid muscle).
Symptoms:Intense burning, stabbing, throbbing, gnawing pain in the entire right upper limb. Pain is triggered by any quick movement, reaching overhead, carrying weights. The patient is unable to perform physical tasks without pain, including showering, cooking, cutting food. He refers to his pain levels being generally 6-7/10 on a daily basis.
Clinical evaluation:CRPS diagnosis.
Time of treatment:September 2023.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient is a very active man, fond of sports, especially basket. He also works in the sport business. He underwent several surgeries for different issues and following CRPS diagnosis he tried different treatments and medications options, such as nerve blocks, ketamine infusions, Calmare therapy. It was the Doctor providing Calamare sessions that suggested to the patient to look into the Neridronate infusions. He looked it up and even talked to previous patients who told him about their positive outcomes.

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; Ketorolac.

Daily Report

DAY 1: Arrival at hotel in Verona, driving his rental car from Milano airport.

DAY 2: Meeting with his Patient Manager at the clinic, ,1st visit with the Rheumatologist Professor and 1st Neridronate infusion. The patient feels quite well, and he is in a good mood.

DAY 3: Meeting with Patient Manager at the clinic, 2nd Neridronate infusion. The patient feels a bit nauseous, which is his usual reaction when he takes medications. To help with this, he wears an anti-nausea band supplied from his Patient Manager.

DAY 4: Meeting with Patient Manager at the clinic, 2nd visit with Rheumatologist Professor and 3rd Neridronate infusion. The patients reports joints ache, especially where he has surgical plates and screws from previous procedures.

DAY 5: Meeting with Patient Manager at the clinic and 4th Neridronate infusion. To help the patient with the treatment side effects, the Rheumatologist Professor prescribes Ketorolac, which works well in about 30 minutes. In the afternoon the Patient Manager drove the patient and his caregiver to Vicenza Hotel.

DAY 6: Transfer from Vicenza to Venice by train, for a couple of rest days.

DAY 7: The patient enjoys Venice and rests.

DAY 8: Flight back to USA from Venice airport.

Follow up

NOVEMBER 2023 (2 months after Neridronate treatment): the patient says his pain level, especially the burning sensation, has decreased to 2/3 (against the 6/7 before the Neridronate treatment).

JANUARY 2024 (4 months after Neridronate treatment): the patient does not refer any further improvements. He is being followed for a mental issue, and he is starting a neurological program to deal with stress and anxiety.

Conclusion

This patient had an important reduction of pain, which is usually life changing for CRPS patients. At MTI we often see that it is not always easy for patients to focus on the treatment outcomes. Sometime their anxiety or stress, due to their condition, brings further problems, which is why it is good to face and treat it: CRPS affects both body and mind and stress often triggers higher 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.