Group (A) (control group): Fifteen patients with CRPS I received traditional physical therapy program in the form of transcutaneous electrical neuromuscular stimulation (TENS), mirror therapy, and exercises for upper limb exercises in the form of gradual weight-bearing exercises by using different equipment such as balls, balloons, or silk-like cloths, combined with different positions of the patient (i.e. lying, sitting, or standing), range of motion exercises (active and self-Assisted), resisting exercises (manual and mechanical), stretching exercises (manual and self-stretching) and fine motor control training. 3 sessions/ week for 12 weeks.

Fifteen patients with CRPS I received traditional physical therapy program in the form of transcutaneous electrical neuromuscular stimulation (TENS), mirror therapy, and exercises for upper limb exercises in the form of gradual weight-bearing exercises by using different equipment such as balls, balloons, or silk-like cloths, combined with different positions of the patient (i.e. lying, sitting, or standing), range of motion exercises (active and self-Assisted), resisting exercises (manual and mechanical), stretching exercises (manual and self-stretching) and fine motor control training in addition to T3-T4 thoracic manipulation (Maitland "screw" technique grade V) 3 sessions/ week for 12 weeks.

thoracic manipulation spine at the level of T3 and T4 facet joints (Maitland (screw) technique grade V). Using hypothenar eminence of hands, applying direct downward pressure and additional force-directed caudal with one hand and cephalic with the other hand on the transverse processes.

The patient is asked to draw a line at the point that represents their pain severity perpendicular to the VAS line. The score is measured by calculating the distance (mm) on the 10-cm line between the 'no pain' anchor and the mark of the patient by using a ruler, including a selection of scores from 0-100. A higher score indicates greater pain intensity. The following cut points on the pain VAS have been recommended: no pain (0-4 mm), mild pain (5-44mm), moderate pain (45-74 mm), and severe pain (75- 100 mm). A difference of more than 12 mm is considered the minimum clinically important difference. The patient rated the pain severity at rest.

DASH is a self-assessment of symptoms and function of the entire upper extremity. Self-assessment and scoring by calculating the arithmetic mean of at least 27 of the 30 items (missing rule) is transformed by (mean - 1) x 25 into the scale from 0 no symptoms/full function to 100 maximal symptoms/no function for the DASH total score. Five of 6 items are necessary for determination of the symptoms score and 22 of 24 items for the function score. Originally, 0 best and 100 worst. All items are easy to comprehend and are not emotionally sensitive (with the exception of item 21). All items are scored on a scale of 5 (Likert) levels: (1) no difficulty/ symptoms, (2) mild difficulty/ symptoms, (3) moderate difficulty/symptoms, (4) severe difficulty/ symptoms, and (5) extreme difficulty (unable to do)/symptoms. Minimal Clinical Important Difference (MCID): 10.2 points. In our current study, the Arabic version was used