CRPS Treatment: pain in left foot and leg for 3 years

General details and patient's info

Gender:Female.
Age:31 years old at the time of treatment.
Home Country:USA.
Illness duration:3 years prior to the Neridronate Treatment.
Cause:Multiple injuries and surgeries on left foot.
Symptoms:Non-stop pain rated generally at a level 6/10 but sometimes reaching 10+ especially after longer activities or standing. The patient, as she was prescribed, always wears a compression boot and as soon as she takes it off her ankle swells up. Can not walk without help, most of the time she uses crutches or a wheelchair. Weather changes increase the pain at her ankle and knee. Any movement feels like sharp knife. The patient also reports some brain fog and sleep issues due to the pain.
Clinical evaluation:Complex Regional Pain Syndrome.
Time of treatment:May 2024.

Why the Patient decided to undergo the CRPS Treatment in Italy

The patient was under a lot of different medications. She also tried nerve blocks which brought relief for about 4 days only. She had frequent physiotherapy and acupuncture sessions. Since all these options did not work as much as she’d like them to, she decided to travel to Italy, after her research on Neridronate. 

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 Clodronate infusions (100mg, I.v. in saline Solution 0,9% 250 ml)

4 Pantoprazole infusions; Paracetamol.

3 sessions Rehabilitation Treatment with 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.

8 nights Biophysical Treatment (5 hours each night while the patients are asleep + 45 minutes in the morning).
MTI’s Biophysical Treatment is the outcome of 25 years of research and studies. It has been certified by the best Italian Universities, partners from both public and private teams. The Biophysical treatment acts on the roots of the disease, brings relief to the inflammatory condition, helps the cells regeneration, the oxygenation, the micro-circulation, and the lymphatic system.

Meeting with the Nutritionist.

Daily Report

DAY 1: Arrival at Venice airport greeted by her patient manager, check in at Verona hotel, briefing on the treatment week. Light therapy and biophysical treatment in hotel room.

DAY 2: Rest day, in contact with her patient manager. Light therapy and biophysical treatment in hotel room.

DAY 3: Pick-up by her patient manager, blood tests, first visit with rheumatologist, first rehabilitation session, first infusions. In the afternoon the patient does the Dexa-Scan. The Rheumatologist, the Physiotherapist and the nurse suggested her trying to avoid wearing the boot or at least reduce the amount of time she is wearing it. Light therapy and biophysical treatment in hotel room.

DAY 4: Pick-up by her patient manager, meeting with the nutritionist, and second infusions. In the afternoon visit to Verona center for some shopping. Light therapy and biophysical treatment in hotel room.

DAY 5: Pick-up by her patient manager, second rehabilitation session and third infusions. Early in the morning the patient feels sick and nauseous but, in the afternoon, she feels much better and enjoys a short trip to Garda Lake. Light therapy and biophysical treatment in hotel room.

DAY 6: Rest day, in contact with her patient manager. The patient is following the medical suggestions and removes the boot, and she realizes that her ankle does not swell up anymore. Light therapy and biophysical treatment in her room.

DAY 7: Pick-up by her patient manager, second visit with the rheumatologist, third rehabilitation session, fourth infusions and last meeting with the nutritionist. Light therapy and biophysical treatment in his room.

DAY 8: Rest day, in contact with her patient manager. Light therapy and biophysical treatment in her room.

DAY 9: Pick-up by her patient manager, check out and drop off Venice airport for the flight back home.

Follow up

JUNE 2024 (1 month post-treatment): The patient says that she is having some good and some bad days but she is feeling small improvements.

AUGUST 2024 (3 months post-treatment): the pain levels dropped to a 4/10 and the patient is experiencing more and more improvements. She is following the nutritionist suggestions to help decrease the inflammation.

Ongoing follow-up

Conclusion

Beside the Neridronate infusions, for this patient, it was very important to meet the physiotherapist and the nutritionist. They both deeply investigated on her lifestyle and explained her what to change and how to improve it, through her diet and exercising. Even though CRPS affects the limbs, it is important to fight it creating the best general condition and decreasing the whole body’s inflammation.

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.