Raynaud's disease is a condition in which certain areas of your body, such as your fingers, toes, ears and nose may begin to feel numb and cold. These sensations are often due to cold temperatures and/or stress. The small blood vessels in the hands and feet basically overreact to cold and stress causing vasospasm (constriction). Vasospasm narrows the small blood vessels dramatically, temporarily limiting the blood supply to these areas of the body. When the oxygen supply is lowered, the skin color turns a bluish hue (cyanotic). Over time, these same small arteries may harden or thicken, further decreasing blood flow. When the spasms occur, the skin of the affected area turns pale followed by a bluish hue. Warming the affected area helps relieve these symptoms. Once warmed, the affected area may then become swollen and/or painful. Once the spasms subside and blood returns to the area, the skin will often then turn a bright red. In about half (50%) of individuals with the disorder, the disease may either improve or disappear after a few years.
In individuals with a normal response to cold, the body selectively reduces blood flow in your extremities by narrowing (constricting) the small arteries to limit the amount of body heat lost. This action will help to preserve your body's core temperature. If a person has Raynaud's, this response is greatly exaggerated causing the classic symptoms. Cold temperatures are the most common trigger. Exposure to cold can be as simple as putting your hands in or under running cold water, exposure to cold air or taking something out of the freezer. Stress often causes a reaction similar to cold, emotional stress alone can cause an episode of Raynaud's.
Raynaud's may a be either a primary or secondary disorder.Primary Raynaud's ("Raynaud's disease"), the most common form of the disorder and is often inherited from a parent. It occurs without any underlying disease or associated medical problems that may provoke the arterial spasms and symptoms. Secondary Raynaud's ("Raynaud's phenomenon") is caused by some underlying problem. Although secondary Raynaud's is less common than the primary form, it is usually more serious.
Causes of secondary Raynaud's:
1. Atherosclerosis, a chronic inflammatory condition in which the walls of arteries thicken due to the accumulation of fatty materials such as cholesterol in the form of plaque.
2. Scleroderma, a rare disease that leads to hardening and scarring of the skin and organs. Ninety percent (90%) of scleroderma patients will have Raynaud's disease. This is often called CREST syndrome.
3. Lupus, an autoimmune disease that can affect many parts of the body including joints, skin, lungs, blood vessels, liver, kidneys, and the nervous system.
4. Rheumatoid arthritis, a systemic (whole body) autoimmune inflammatory condition causing pain and stiffness in the joints and may also affect many other tissues and organs.
5. Sjogren's syndrome, a systemic autoimmune disease in which cells attack and destroy the glands in your body whichproduce tears and saliva.
6. Buerger's disease (Thromboangiitis obliterans) , progressive inflammation and thrombosis (clotting) of small to medium arteries and veins primarily in the hands and feet. The main symptom is pain and it is strongly associated with smoking.
7. Certain medications such as ergotamine (a migraine medication), beta blockers (blood pressure medication), certain chemotherapy medications and estrogen have been linked to Raynaud's.
8. Thyroid disorders such as hypothyroidism (low thyroid) may contribute to Raynaud's.
9. Other causes include as Carpal Tunnel Syndrome, injury, overuse of the affected area, cancers including leukemia and lymphoma or diabetes. Workers who repetitively operate vibrating tools can develop a type of Raynaud's phenomenon called "vibration white finger." Certain chemicals or toxins have also been associated with Raynaud's.
Stop smoking, primary Raynaud's is rare among nonsmokers. Avoid secondhand smoke if possible.
Treat any disorders listed above as risk factors.
Avoid trigger factors, such as cold, stress or use of vibrating tools as much as possible.
Avoid medications which can worsen symptoms (see above).
Keep hands or feet warm; wear layers of clothing, hats, mittens (rather than gloves), scarves and warm socks during cold weather. Use hand and foot warmers in cold weather.
Also, consider wearing gloves or mittens when removing food from the refrigerator or freezer.
Warm up your car before leaving in cold weather.
Avoid stressful situations and learn relaxation techniques.
A regular exercise program is recommended as it improves circulation.
The patients history and physical are the two most helpful things in diagnosing Raynauld's. Medical tests may include specific blood studies and a cold challenge test (simply putting your hands in cold water). A nail fold capillary test (using a small magnifying lens to check tiny blood vessels in the skin at the base of a fingernail) may also be of value.
Treatment: mostly involves treating any underlying cause, lifestyle changes, and occasionally medications.
Stay warmer, indoors, as much as possible during cold weather.
Wiggle or massage your fingers and toes.
Try soaking your hands or feet in warm water.
Move your arms in circles or shake your arms or feet.
Biofeedback training may teach you how to raise skin temperature may help.
Surgery to sever (cut) sympathetic nerves to the involved hands or feet (rare).
Topical prescription medications may be applied to the fingertips to protect them from ulceration.
Vasodilator drugs (widen blood vessels) such as calcium channel blockers and alpha blockers may be prescribed to improve circulation.