Reflex Sympathetic Dystrophy of the Upper Limb: Treatment Using a Series of Stellate Ganglion Blocks

Abstract

Fourteen consecutive patients with reflex sympathetic dystrophy of the hand were studied. Their conditions were diagnosed based on clinical features alone and confirmed by a positive symptomatic response following a stellate ganglion test block. Treatment for all patients was a series of stellate ganglion blocks combined with a physiotherapy program. The number of blocks performed per patient ranged between three and nine blocks, and the blocks were performed at two- to 10-day intervals. Subjectively, patients were asked to rate pain before and after treatment on a scale of 0 (no pain) to 10 (unbearable pain). Objectively, the average total active motion of the fingers (ATAM) was compared before and after treatment. Before treatment, pain was rated between 7 and 10, and the ATAM of the fingers was 83°. After treatment, pain was rated between 0 and 2, and motion improved to 260°. It was concluded that stellate ganglion block is an effective and safe method of treating reflex sympathetic dystrophy as long as the diagnosis is made early, the block is given by an experienced physician and multiple blocks are performed along with a physiotherapy program.