Physiotherapy, an adjunct to stellate ganglion and brachial plexus blocks for post-traumatic sympathetic dystrophy

Reflex Sympathetic Dystrophy has been described under various different names such as Shoulder-hand Syndrome, Causalgia, Sudeck's Atrophy and several others (Bonica, 1973). However, the underlying pathophysiology seems to be similar in all and relates to an abnormality in sympathetic outflow to the limb as a primary disturbance. Therefore, the term Reflex Sympathetic Dystrophy appears to be an appropriate general term for all of these conditions. However, there are always quite diverse symptoms relating to disordered physiology outside the Sympathetic Nervous System as a result of pain and disuse. The presenting symptom in these patients is almost invariably a severe burning pain, which tends to divert the attention away from the abnormalities of sympathetic activity in the limb.