Following an injury to the shoulder joint, a New York Yankees catcher developed a "catcher's mitt hand" or shoulder and hand syndrome. There was swelling of the right upper extremity, skin atrophy, and vasomotor instability. He also complained of a burning sensation in the involved extremity. What would be the next step in management?

Prednisone for 2 weeks in resistant cases is given and then tapered. The "shoulder-hand" syndrome is a reflex autonomic dystrophy occurring after an injury (usually shoulder) that causes immobilization of the ipsilateral extremity. Treatment is directed toward gradual physical therapy and nonsteroidal analgesic drugs. Stellate ganglion block may be helpful in resistant cases.