greater emphasis should be given to aggressive medical management of CRPS. The use of short courses of steroids and the combination of tricyclic antidepressants and anticonvulsants for a period of not less than 4 weeks at the maximum tolerated dose should be recommended in addition to physical therapy as standard initial management. I would agree that sympathetic blockade should be reserved for all but the most refractory cases of CRPS but believe that medical therapy must be more comprehensive than that suggested in this article.