Raynaud’s Disease

Raynaud’s is a disease of the circulatory system. It causes the muscles that are present in the walls of the arteries to excessively constrict when the body is exposed to a cold environment. It is not usually dangerous but can be very unpleasant. For those severely affected, going outdoors in the cold is painful. For some, it can result in extremely painful sores at the tips of their toes and fingers.

Cause

We all have a built in mechanism to permit survival under extreme conditions. When faced with severe cold, the body diverts the blood supply from the fingers and toes to the vital organs to minimize the loss of heat and to protect the body’s core. You can survive without fingers and toes (though you might not be too happy about that) but you cannot survive if your vital organs freeze. In some people, this survival mechanism responds too enthusiastically and sometimes at temperatures that would not be considered particularly dangerous. Opening the refrigerator or freezer might be enough to set it off.

Raynaud’s is sometimes associated with other diseases but most often is not. It occurs most often in women between the ages of 13 and 40 but can affect men too. Emotional stress can also trigger the symptoms. Occupations that require constant stress to the hands and chronic exposure to the cold may make you more susceptible to Raynaud’s.

Some drugs including nicotine, some oral contraceptives, ergot-containing medications to treat migraine headaches, beta blockers to treat high blood pressure and abnormal heart rhythms and some agents used in the treatment of cancer may cause the symptoms.

 

Treatment

No treatment is perfect and in many people it gets better on its own though that may take years.

  • Avoid foods and substances that can cause constriction of the blood vessels. These include cigarette smoke and caffeine (found in coffee, many teas and chocolate).
  • Dress in layers and keep warm. Not just your hands and feet but also your torso and head. If your body is cold it will “steal” blood from the extremities as a survival mechanism. Remember, this mechanism is exaggerated in those with Raynaud’s. The head is also subject to an enormous heat loss. Wear a hat in cold weather!
  • Use thermally lined boots, thermal sock liners and windproof mittens.
  • Keep your wrists and neck warm. Nerves in the neck control blood vessels in the hands.
  • Maintain a warm indoor temperature. Wear a sweater indoors if necessary.
  • Biofeedback. The blood vessels can be “taught” to remain open even when the person is exposed to cold. The treatment requires you to sit in a room or outdoors at a temperature that would ordinarily stimulate the symptoms. A three season porch in the fall works well. Immerse your hands and feet in a pail of very warm water for 10 minutes. The conditioning, done every other day, over a period of three to four weeks, is repeated several times a day. The benefits generally last through the entire winter and may last for several years in some people.
  • Medications that dilate the blood vessels are also sometimes used. But some of the drugs lose their effectiveness over time or may have side effects that can make them unpleasant to use.