Although much has been written about the diagnosis. and management of shoulder-hand syndrome, diverse opinions remain with respect to the optimal treatment. For purposes of definition, the shoulder-hand syndrome should be considered an aspect of the more general term—reflex sympathetic dystrophy. There are many names which have been used for this clinical condition, including reflex physiopathia, reflex neurovascular dystrophy, posttraumatic fibrosis, Sudeck's atrophy, causalgia, atrophic hand, and postinfarctional sclerodactylia, among many others. Our purpose in reviewing our experience with the shoulder-hand syndrome over the last ten years is to reemphasize the successful results of physical treatment, which Silas Weir Mitchell recommended in his description of causalgia in 1864. Review of the Literature Mitchell1 described causalgia of the hands and feet resulting from gun-shot wounds in the Civil War. The syndrome included burning pain and a swollen, shiny extremity. He noted that many soldiers filled their boots with water for