To clarify the effects of acupuncture treatment on acute and chronic shoulder-hand syndrome, 20 minutes of manual acupuncture was applied to 14 patients with posthemiplegic shoulder-hand syndrome at the hemiplegic arm and hand (eight points of keiketsu) twice a week for 5 weeks.<br>Thermographic and laser doppler measurements showed the increases in skin temperature and blood flow of the affected hand. Although manual acupuncture produced long-lasting increases in skin temperature and blood flow of both hands, its effects were inhibited when 10-mg alpha-blocker phentolamine was injected beforehand. After 5 weeks of the acupuncture therapy, the increased skin temperature and blood flow of the affected hand were gradually reduced to normal levels.<br>Subjective and objective symptoms such as pain, local heating, and swelling showed positive improvement in 10 out of 14 patients after the 5 weeks of acupuncture therapy.<br>These results may suggest that the shulder-hand syndrome is produced by unknown sympathetic vasodilating mechanisms and that acupuncture plays a therapeutic role through the suppression of increased sympathetic tone.