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- What is Raynaud’s Disease?
- Diagnosing Raynaud’s Disease
- What Causes Raynaud’s Disease?
- Raynaud’s Disease in Children and Infants
- More Information on Raynaud’s Disease
What is Raynaud’s Disease?
Raynaud's disease is a circulatory condition that affects blood supply to the skin and peripheries and causes the extremities of the body to lose feeling and become numb.
Raynaud's Disease is most commonly associated with cold temperatures and stress and sufferers of this condition will find their toes and fingers feel very cold or may even lose sensation in response to a stressful situation or exposure to cold. During a Raynaud's attack, the arteries and blood capillaries narrow, reducing blood circulation to affected areas, usually the extremities such as toes, fingers, ears and the tip of your nose.
This reduced peripheral blood flow is a normal protective mechanism to prevent excessive heat loss from these areas and preserve the body's core temperature. Similarly, in times of stress the body goes into a "flight or fight" response which causes the blood flow to the fingers and toes to be significantly reduced so that blood is conserved for the vital organs and muscles.
In people with Raynaud's syndrome these responses are exaggerated - causing troublesome symptoms at inappropriate times. The reduced blood flow leaves the extremities looking pale or even blue and cold as no warm blood reaches these areas.
Diagnosing Raynaud’s Disease
There are no blood tests that can specifically diagnose Raynaud's syndrome , but generally health care practitioners will make a diagnosis based on the description of your symptoms. Your doctor may examine you and order further tests to rule out other conditions and diseases of the arteries, and to determine if there is a possible underlying condition that is causing Raynaud's.
In some cases your practitioner may ask you to place your hand in cold water to bring on an episode of Raynaud's in order to make a more accurate diagnosis.
What are the Symptoms of Raynaud’s Disease?
People with Raynaud's syndrome may notice their skin changing color, first it becomes pale and then it changes to blue, when they are cold or stressed – most noticeably in the fingers. They may feel a prickly numbness in toes and sometimes a stinging pain with throbbing and redness when they begin to relax or warm up as blood returns to the extremities.
Symptoms of Raynaud’s occur in the extremities and may include the following in affected areas.
- Fingers, hands, toes, feet and other extremities feel cold
- white or bluish color
- numbness in the toes, fingers, nose and other extremities
- loss of sensory perception
- mild swelling
- redness with sensations of throbbing and/or tingling once blood flow returns to normal
Numbness Caused by Raynaud’s Disease
Numbness is one of the most frequently reported symptoms of Raynaud’s disease. Numbness or tingling most frequently occurs in the toes or fingers but in some cases numbness in the earlobes, nose, or lips can also be experienced. Cold weather and stress may intensify numbness and tingling caused by Raynaud’s disease.
What Causes Raynaud’s Disease?
Though its causes are not completely understood, Raynaud's seems to be caused by an overreaction of blood vessels in the extremities to temperature and stress. In normal physiology, when a person's body is exposed to cold, the blood vessels in the extremities become narrowed and slow down blood supply to the fingers and toes. In the case of an individual with Raynuad’s these blood vessels narrow dramatically, causing troubling symptoms.
There are two types of Raynaud’s Disease - it can develop as a complication of an underlying disorder (Secondary Raynaud's) or it can develop independently in the absence of any other underlying health conditions (Primary Raynauds).
Primary Raynaud's Disease
This is the most common form of the disorder and typically it tends to affect the digits of both hands and both feet. Researchers are now exploring the possibility that there may be a genetic link to the development of Primary Raynaud’s Disease.
Certain other factors may also increase an individual's risk of developing Primary Raynaud's. Women are generally more commonly affected as are people who live in cold places and those who suffer from chronic stress.
Secondary Raynaud's Disease
In less common cases, Raynaud's is caused by another underlying problem. Although secondary Raynaud's is less common, it is often more serious than Primary Raynaud’s and extra care should be taken. Conditions that may cause Secondary Raynaud's include:
- Eating Disorders (e.g. Bulimia and Anorexia)
- Hashimoto’s Thyroiditis
- Scleroderma, a condition that causes hardening of connective tissue
- Rheumatoid Arthritis
- Carpal Tunnel Syndrome
- Other diseases that affect the arteries including atherosclerosis
- The use of beta blockers
- Certain Chemotherapy agents and some over the counter cold and flu medications can also predispose an individual to Raynaud's.
Raynaud’s Disease in Children and Infants
Raynaud’s disease in children is extremely rare and is more likely to develop due to an underlying problem such as scleroderma, systemic lupus erythematosus, CREST syndrome, takayasu arteritis and giant cell arteritis among other conditions.
In some cases, a child has Raynaud’s for many years before the diagnosis of an underlying disease is made. Althougn symptoms such as cold hands and feet are generally attributed to Raynaud’s it is important to remember that Raynaud’s presents a three phase color change. First, fingers blanch white, then turn red as they warm up. Finally they turn a bluish color as circulation is compromised. Generally speaking, if the infant/ child’s fingers don’t turn white first it is not Raynaud’s Disease.
Help for Raynaud’s Disease
Treatment of Raynaud's often includes treatment of the underlying condition (in Secondary Raynaud's) and treatment to reduce the frequency of attacks and prevent tissue damage. There are a number of treatment methods including conventional medical methods, biofeedback and more.
A number of allopathic medications on the market work on the principle of dilating the blood vessels in order to prevent the symptoms of Raynaud's. Examples are Calcium channel blockers such as amlodipine (Norvasc), Alpha blockers such as prazosin (Minipress) and Vasodilators.
In some cases a chemical injection is recommended which works by blocking the sympathetic nerves in affected areas. In severe cases surgery on the nerves in the hands and feet may be performed.
Studies have shown that biofeedback is capable of helping people with Raynaud's Disease to control their hand temperatures and to increase blood flow to affected areas. Biofeedback requires training the body to reduce sympathetic responses to stress and reduce vasoconstriction, thereby allowing greater blood flow to the extremities. Biofeedback can result in significantly reduced symptoms, although it must be understood that this is not a quick fix and requires up to 20 sessions of training.
More Information on Raynaud’s Disease
Are there Other Complications that May be Related to Raynaud’s Disease?
Severe Raynaud’s is rare, but when it does occur there are a few potentially serious complications. In some cases, blood flow to the fingers or toes is permanently damaged resulting in deformities. If an artery is affected and an area becomes completely blocked from blood flow skin ulcers or gangrene can occur, which can be difficult to treat. In the most severe cases where the tissue dies as a result of Raynaud’s, amputation of the affected area is usually necessary.
What Should you do During an Attack?
At the first signs of an attack, the most important plan of action is to warm the area affected. Do the following to help gently warm your fingers and toes:
- Perhaps the most obvious step – get out of the cold and move to a warmer area!
- Place your hands under your armpits or between your thighs to warm them up.
- Keep things moving. Numbness in toes and fingers is a common symptome so wiggle your fingers and toes and if this fails try doing windmill motions with your arms, and jogging on the spot. Movement will help to keep the blood flowing properly.
- Run your fingers and toes under some warm water.
- Get the blood flowing by massaging your hands and feet.
- If a stressful situation has triggered the attack then remove yourself from the situation and practice some deep breathing or other relaxation techniques.
Tips for Coping with Raynaud’s Disease
Raynaud’s Disease is a condition that you have to learn to manage and adapt to. While this may be difficult at times, there are a number of ways to prevent and cope with attacks.
- Dress warmly outdoors and avoid getting cold. Winter is often a difficult time for those with Raynaud’s so it is essential to cover up with hats, gloves, thick socks and ear muffs in cold weather.
- Consider moving to a milder climate. While relocation may seem like a huge preventative measure, it is definitely something worth considering if you live in an area with extremely cold winters.
- Exercise regularly! Keeping fit with a regular exercise routine will encourage circulation and reduce the chances of Raynaud’s attacks.
- Don’t smoke and avoid secondary smoke. The nicotine in cigarettes causes the blood vessels to constrict resulting in a drop in body temperature in the extremities. This can induce an attack - so if you are a smoker, try to stop smoking naturally.
- Manage your stress levels. Stress is a common trigger of Raynaud’s so find ways to recognize and better manage your stress. Avoid those situations that tend to stress you and adopt stress relieving techniques such as yoga, meditation or deep breathing exercises.
- Look after your hands and feet. Avoid wearing things that may constrict blood flow to these extremities such as tight rings, tight socks or wrist bands.