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Reflex sympathetic dystrophy is fairly common after injury, with a reported incidence of approximately 40% after Colles' fracture or tibial fracture. Fortunately, only approximately 5% of patients with these fractures will have chronic pain. The history of reflex sympathetic dystrophy and causalgia are reviewed, as is the literature on their management. A management approach is recommended that includes physical therapy, medications, local anesthetic blocks, and, when appropriate, psychologic intervention.