Reflex sympathetic dystrophy of the upper limb: Treatment using a series of stellate ganglion blocks

Reflex sympathetic dystrophy (RSD) is a complex syndrome with a plethora of signs and symptoms that vary, both among individuals and with the progression of the disease over time (1). Five clinical types of RSD are recognized, including minor causalgia, minor traumatic dystrophy, shoulder hand syndrome, major causalgia and major traumatic dystrophy. The term ‘causalgia’ (burning pain) is reserved to reflect RSD arising from nerve injury, while ‘traumatic dystrophy’ occurs as a result of injury to soft tissue, joints or bone, rather than damage to a specific nerve (1). Recently, a consensus group met in Orlando, Florida and revised the old system for the classification of pain syndromes previously called RSD. The new system employs the term ‘complex regional pain syndrome’ (CRPS), which is divided into two types as shown in Table 1. Type I reflects what