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Neridronate Infusions for CRPS

Neridronate infusions, a deeper look into its effects and history

Throughout the years, researchers and doctors have been looking for a correct answer in the treatment of CRPS. This was also because, at the beginning of the 90s, countries like the U.S. started experiencing an epidemic in the use of opioids and pain management drugs. As we have seen in our previous articles, this epidemic is caused by many factors, from Healthcare and Pharmaceutical Policies, all the way to the peculiarity of CRPS and the diagnostic and treatment complications it involves. It represents a real National Emergency as, the latest researches have shown, this epidemic in drug abuse and opioids overdose kills an average of 130 Americans a day, causing a great expense in matters of funding and human lives. 

Treatment for CRPS is been at the center of researches for many years in many countries and, although a standard treatment is impossible to find due to the huge of variety of symptoms, there actually is a pharmaceutical treatment in the market that has proven to be safe and effective: Neridronate infusions. To understand how Neridronate infusions work on CRPS, we need to back up a little bit in analyzing what CRPS is. Complex Regional Pain Syndrome is a condition consisting of a chronic inflammatory reaction of the affected area as a result of some trauma of any sort. Of course, when it comes to the symptoms, pain is the dominant sensation but it can’t be treated alone: by being only one of the symptoms, the treatment will eventually result in a lifelong pain management path that will be less and less effective throughout time, without solving the problem. 

Neridronate is a bisphosphonate and, unlike other drugs from the same class, it is completely safe to use on people all the way to 24 months old, showing no side effects in the long term, with manageable and minor side effects during the treatment. It was created specifically for the treatment of rheumatic conditions like CRPS, Paget’s disease of bone or Osteoporosis (which is a common consequence of long-lasting CRPS). Other bisphosphonates might occasionally show good results, but they represent a readapted treatment coming from other conditions like, for example, bone cancer. In addition to this, other bisphosphonates show cases of side effects like Jaw Necrosis.

However, clinical trials have reported how Neridronate does not only act on the regional bone loss and bone edema that is often is present in CRPS patients: it also inhibits serum inflammatory cytokine levels, alleviating the pain in CRPS. Furthermore, this drug will stay in the bloodstream for about a day but will be absorbed by the bones and affect them for up to 10 years. This is why this treatment path is the one showing results in the longest term and, even for people suffering from this condition for years, it can prevent the outburst of Osteoporosis.


With an early enough diagnosis, this treatment alone can put patients into remission but, when sided by a specialized rehabilitative program, it creates a therapy path that is now adopted by the whole Italian Healthcare. This option is available only in Italy but is currently being studied in many other countries, especially in the far east. In 2017, Italian Healthcare has published the Guidelines for the Treatment of CRPS in which it is clearly stated that this therapy path should be the first choice in the treatment of this condition, to be sided with anti-inflammatory or minor pain management drugs for a few months, which is the time Neridronate needs to make its effects appreciable.

In conclusion, to this day, this is the only therapy path that has been scientifically linked to a remission from this condition. Even the other pain management treatments show poor results in their trials, due to their extremely subjective nature: for example, the fact that a patient who undergoes a trial is already taking pain medications can strongly affect the outcome of the trial. The trials on Neridronate, on the other hand, were performed with double-blind randomized studies on patients that still were in the early stages of CRPS. To the moment, Neridronate is the only pharmaceutical recognized to be useful for the treatment of CRPS, keeping in mind that a multidisciplinary approach is always the best option.