Soon, the cold weather of winter will arrive, which means more bundling up with sweaters, warm coats, and gloves. For most of us, wearing warm clothing will get us through this time. But if you’ve ever noticed your fingers or toes turning blue or white, throbbing, burning, tingling, or becoming numb brought on by exposure to cold or emotional stress, you may have a condition called Raynaud’s (ray-NODES).
Up to 28 million people or about 5 percent of the U.S. population has Raynaud’s, named after a French physician, Maurice Raynaud, who first recognized the condition in 1862. This rare disorder affects the arteries carrying blood from your heart to different areas of the body. It is brought on by brief episodes of vasospasm which is a narrowing of the arteries reducing blood flow to the fingers and toes.
Primary and Secondary Raynaud’s
Raynaud’s will be either in the form of primary or secondary. Primary Raynaud’s does not have a known cause but it is the most common form and is not considered as severe as secondary Raynaud’s. This type of Raynaud is often referred to as Raynaud’s disease.
Secondary Raynaud is brought on by an underlying disease or condition and is often called Raynaud’s phenomenon. Diseases that may lead to secondary Raynaud’s include scleroderma, lupus, and rheumatoid arthritis. Other causes of secondary Raynaud’s include the following:
- Repetitive actions that damage nerves controlling the arteries in the hands or feet
- Injuries to the hands and feet
- Exposure to certain chemicals
- Medicines that narrow the arteries or affect blood pressure
Signs and symptoms of Raynaud’s
In both types of Raynaud’s, triggers can be cold temperatures or stress leading to an interruption of blood flow to the fingers, toes, and sometimes the nose and ears when a spasm occurs. During a spasm, the affected areas can turn white then blue, then bright red and can be accompanied with tingling, swelling, or painful throbbing that can last for a few minutes to hours.
An attack of Raynaud’s usually begins in one finger or toe and then will move to other fingers or toes. Secondary Raynaud’s can lead to more severe conditions of causing skin sores or gangrene. Gangrene is the decay and or death of body tissues that could result in having to have an amputation.
Risk factors for Raynaud’s
Both primary and secondary Raynaud’s have different risk factors. The risk factors for primary Raynaud’s include the following:
- If you are a woman as they are more likely to have primary than men
- Usually develops before the age of 30
- Family history
- Living in a cold climate as cold exposure can trigger Raynaud’s attacks
Secondary Raynaud’s risk factors include:
- Usually develops before the age of 30
- Having certain disease or conditions
- Living in a cold climate
To get an accurate diagnosis of Raynaud’s, it is best to start with your primary care physician. You will be asked about your medical history and symptoms associated with Raynaud’s. From there a doctor will do a physical exam of looking at your fingers and toes checking the health of your skin and for good blood flow to these areas.
There are diagnostic tests that can be more definitive of getting an accurate diagnosis – a cold stimulation test can be used to trigger a Raynaud’s attack by placing a device to measure temperature of fingers and toes when exposed to cold.
Another test called a nailfold capillaroscopy is where a drop of oil is placed at the base of the fingernail which the doctor then looks at under a microscope looking for abnormal arteries.
Even though there is no cure for either primary or secondary Raynaud’s, there are many ways one can help reduce the number and severity of attacks. The following are ways that can manage the condition:
- Lifestyle changes
- Turn down air conditioning or dress warmly in air-conditioned areas
- Warm up your car before driving in cold weather
- Wear gloves or mittens when taking food our of a freezer
- Avoid things that make you upset or stressed – try relaxation techniques
- Certain medications can affect blood flow – birth control pills, beta blockers, over-the-counter cold or allergy medicines or migraine headache medicines that contain ergotamine. Check with your physician on which ones to avoid.
- Warm hands and feet by soaking them in warm water
- Wiggle or massage your fingers and toes
- Move your arms in circles or shake your arms or feet
- Medicines and surgery
Certain medications can help treat Raynaud’s if lifestyle changes are ineffective. These include calcium channel blockers, alpha blockers, prescription skin creams, and ACE inhibitors.
In rare cases, surgery or shots can be done to block the nerves in the hands or feet that control the arteries preventing Raynaud’s attacks. Surgery can relieve symptoms but will only last for a few years while shots will usually need to be repeated as the symptoms can come back.