CRPS Treatment: pain in left hand and wrist for 1.5 years

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CRPS Treatment: pain in left hand and wrist for 1.5 years

Contents

General details and patient's info

Gender:Male.
Age:13 years old at the time of treatment.
Home Country:Australia.
Illness duration:1.5 years prior to the Neridronate Treatment.
Cause:Wrist fracture while playing soccer.
Symptoms:Extreme pain, burning, sensation that the hand is squeezed and pressed by a heavy stone. The young patient does not go to school anymore because of the pain, he had to quit his soccer team as well as all leisure activities.
Clinical evaluation:CRPS type I.
Time of treatment:January 2023.

Why the Patient decided to undergo the CRPS Treatment in Italy

Beside the horrific pain and other CRPS symptoms that this child was experiencing, his parents were very worried for the mental impact CRPS brought to their son; the child was followed closely by a psychologist. After following a pain management program for a year, and not seeing results good enough to give this young man his life back, they did deep online research and found out about Neridronate. They quickly talked to the team to make sure their son could benefit from Neridronate. After some research, their family doctor also reassured them on the medication safety. They flew to Italy 2 weeks after.

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 (60mg, 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 (60mg, I.v. in saline Solution 0,9% 250 ml)
4 Pantoprazole infusions; Paracetamol.

2 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.

10 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: The patient and his parents arrive at Venice airport, where they met their Patient Manager. Check in at Verona hotel, briefing on the next days and on the week program. Light therapy in hotel room.

DAY 2: Rest day. The young boy feels tired, and he is anxious about the treatment. The Patient Manager visits the family, take them for some Italian ice cream which seemed to make the boy very happy. Light therapy in hotel room.

DAY 3: Morning pick-up by his Patient Manager, 1st visit with the Rheumatologist Professor, 1st Rehabilitation session, and 1st infusions. The young patient is scared of needles, but our loving nurse makes it easy and painless for him. Light therapy in hotel room.

DAY 4: Morning pick-up by his Patient Manager and 2nd infusions. The boy’s mood is better than the previous days, he feels a bit nauseous. Light therapy in hotel room.

DAY 5: Day trip to Venice with his Patient Manager. The boy loves the town and enjoys the gondola ride. Nausea is gone and he enjoys pizza and ice cream. Light therapy in hotel room.

DAY 6: Afternoon pick-up by his Patient Manager, 2nd Rehabilitation session and 3rd infusions. The patient feels tired, and he reports a bit of muscle pain. Light therapy in hotel room.

DAY 7: Morning pick-up by his Patient Manager, 2nd visit with Rheumatologist Professor and last infusion. Light therapy in hotel room.

DAY 8: The patient feels a bit better, and he agrees to go visit Vicenza’s center with his Patient Manager. He is still taking Paracetamol and he is in a good mood. Light therapy in hotel room.

DAY 9: Rest day, in contact with the Patient Manager. The boy and his parents visit Verona and do some shopping. He does not feel bad anymore and says that his feels his hand feels “different”. Light therapy in hotel room.

DAY 10: Light therapy in hotel room. Afternoon pick-up by his Patient Manager, drop-off Venice airport to go back home. The boy feels energetic and happy, he says he would love to stay longer in Italy (and we would too!).

Follow up

FEBRUARY 2023 (1 month after the Neridronate treatment): there are no significant changes in pain levels, but his mom says that he has started to meet his friends again.

MARCH 2023 (2 months after the Neridronate treatment): the patient reports a lowering of pain levels, as well as fingers and wrist mobility. He still meets the psychologist once a month.

APRIL 2023 (3 months after the Neridronate treatment): the patient says that the pain is still decreasing, and his mom says this has an amazing effect on his mood too, she says her boy starts feeling like his old self.

JUNE 2023 (5 months after the Neridronate treatment): the patient feels well, and he is back at school.

JULY 2023 (6 months after the Neridronate treatment): the patient does not report pain or other symptoms anymore.

NOVEMBER 2023 (10 months after the Neridronate treatment): the patient’s parents say that he is doing amazing, living his life as a young teen. He has even re-joined his soccer team again!

Conclusion

This is a successful experience that improved the patient and his parent’s lives. Treating children requires a different care and attention. The Rheumatologist Professor prescribed for this boy a reduced dosage of Neridronate, according to his age and weight. Usually, the youngest patients may experience heavier side effects, as it happened. However, they never last more than 2 or 3 days and can be managed with some rest and additional medication. MTI medical team, from Rheumatologist Professor to nurses and physiotherapists are always empathetic and dedicate a special care to kids and teens.
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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.