Shoulder-hand syndrome is also known as reflex sympathetic dystrophy. The syndrome often occurs within 1 to 3 months after stroke, with an incidence of about 12.5% to 70%. The difference in incidence may be related to different diagnostic criteria. The pathogenesis of shoulder-hand syndrome is not clear. It may be related to sympathetic nervous system dysfunction, wrist joint being pulled and palmar flexion under compression, excessive pulling, fluid infusion into the hand tissues during infusion, and small injuries to the hand by accident. The clinical manifestations are sudden onset of shoulder pain, restricted movement, swelling and pain in the hand, and later hand muscle atrophy and finger contracture deformity may occur until the movement of the affected hand is permanently lost. The clinical course is often divided into three stages: Stage I (also known as early stage): Pain in the shoulder with limited motion. The patient’s hand quickly becomes swollen and joint movement is significantly limited. Passive movements tend to cause severe pain, which is a characteristic feature of this syndrome. Bone changes (localized decalcification) of the hand and shoulder are mostly seen on X-ray during this stage. Stage II (also known as late stage): Spontaneous pain and hand swelling in the shoulder and hand disappear, skin atrophy and hand muscle atrophy gradually worsens. Sometimes Dupuytron contracture-like hypertrophy of the palmar musculature occurs. The limitation of joint movement of the fingers becomes increasingly obvious. This stage lasts 3 to 6 months, and if not treated appropriately, the disease moves to stage III. Stage III (also known as the posterior stage): Skin and muscle atrophy becomes more pronounced. The fingers are completely contracted, forming a typical deformity, and the movement of the affected hand is permanently lost. 3. Treatment Prevent the causes of shoulder-hand syndrome as much as possible by avoiding trauma (even if it is a minor injury), pain, excessive stretching and prolonged draping of the patient’s upper limbs, especially the hand. Avoid intravenous infusion of fluids on the affected side if swelling is already present. Early diagnosis and treatment of shoulder-hand syndrome is important because early treatment (stage I) can achieve better results. The main goal of treatment is to reduce edema, pain and stiffness as soon as possible. Placement In the prone position, the affected upper limb can be elevated appropriately; in the seated position, the affected upper limb is placed on a small table in front and secured with a small splint to avoid wrist flexion. Centripetal compression wrapping, centripetal compression wrapping of the fingers or endings is a simple, safe and dramatic effect treatment. Using a long wire about 1 to 2 mm thick, wrap it from distal to proximal, first around the thumb, then around each of the other fingers, and finally around the palm and back of the hand, until it is just above the wrist joint. ②Cold therapy It has the effect of relieving pain, relieving spasm and reducing swelling. Soak the affected hand in cold water at 9.4℃～11.1℃ for 30 minutes, once/day. ③Active and passive exercises First perform scapular activities, after which three-dimensional shoulder joint activities can be performed with the upper limb raised. Weight-bearing activities of the affected upper limb that make extension should not be practiced. Passive movements of the affected upper extremity can prevent shoulder pain and maintain the mobility of each joint, but these activities should be very gentle to the extent that they do not produce pain. Sympathetic nerve blocks Stellate sympathetic ganglion blocks are very effective in early SHS, reducing or eliminating shoulder pain and hand swelling but are less effective in later stage patients. ⑤ Steroid preparations can be taken orally or injected into the shoulder joint cavity and tendon sheath. It has a good effect on shoulder pain and can reduce the local inflammatory reaction. ⑥Other treatments High thoracic sympathetic ganglion dissection is effective for some patients. Various physical therapy methods are also available.