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CRPS Treatment: pain in leg -previously also arm- for 3 years

General details and patient's info

Gender:Female.
Age:18 years old at the time of treatment.
Home Country:United Kingdom.
Illness duration:3 years prior to the Neridronate Treatment.
Cause:None confirmed, pain started after playing tennis.
Symptoms:Hypersensitivity to touch and cold weather, skin changes. Stabbing and cramping pain, pins and needles sensation. Movements are painful and pain increases with activities. She can walk only short distances, cannot bend her knee, cannot run. Her foot hurts when walking. She suffers from headaches which makes it hard to sleep.
Clinical evaluation:CRPS diagnosis. Sharp pain around lower scapula area. No abnormalities detected from MRI and nerve conduction studies. Not using her right arm at all and walking with a very stiff right leg with supinated ankle on the right side. Kyphotic sitting posture. Evidence of left trapezius muscle spasm. Evidence of allodynia around her right shoulder and arm going down right leg. Movement of shoulder and elbow particularly painful. Sweaty palms indicating anxiety in the background.
Time of treatment:January 2019.

Why the Patient decided to undergo the CRPS Treatment in Italy

This young girl got CRPS on her right arm and shoulder in 2016 with unknown trigger event. It spread around the body and quickly went into remission. Unfortunately, after 2 years, in 2018, it was showing again especially in her right leg. She was a very sporty girl, not being able to practice sports affected her a lot and resulted in mental difficulties, such as anxiety, claustrophobia, insomnia.

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
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.

Daily Report

DAY 1: Arrival at the Verona airport, greeted by her Patient Manager and check-in in Verona Hotel.

DAY 2: Rest day, always in contact with her Patient Manager.

DAY 3: Morning pick-up by her Patient Manager, 1st visit with the Rheumatologist Professor, 1st rehabilitation session and 1st Neridronate infusion. The patient feels relaxed and enjoyed the rehabilitation.

DAY 4: Morning pick-up by her Patient Manager, 2nd Neridronate infusion. The patient is doing well, no side effects.

DAY 5: Morning pick-up by her Patient Manager, 3rd Neridronate infusion. The patient reports side effects such as muscle pain and tiredness.

DAY 6: Morning pick-up by her Patient Manager, last Neridronate infusion and 2nd visit with the Rheumatologist Professor. The patient still refers side effects as headache and cold symptoms.

DAY 7: Morning pick-up by her Patient Manager, 2nd rehabilitation session. After that the patient feels better and is ready to enjoy some rest

DAY 8: Morning pick-up by her Patient Manager, check-out and drop-off Verona airport for flight back home. The girl is doing well, she is relaxed and positive.

Follow up

FEBRUARY 2019 (1 month after treatment): the patient is doing better, both with her daily activities and mood.

JUNE 2019 (7 months after treatment): the patient feels much better and started a sports coaching apprenticeship.

AUGUST 2019 (8 months after treatment): the patient feels she is 90% – 100% better. Her mother says she is so thankful to have her daughter back and acknowledges the immense help the treatment has provided on a mental level as well as the pain and symptoms improvements.

Conclusion

Usually, CRPS shows after an injury, a fracture, a surgery. In this case however there was no physical trigger event, however the patient’s mother suspected a psychological trauma when she was 14.
The patient is now very close to a full remission: feels she is 90% to 100% better. Her mother says she is so thankful to have her daughter back and acknowledges the immense help the treatment has provided on a mental level as well as the pain and symptoms improvements.

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.