Raynaud's syndrome

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 23, 2016
StartRaynaud's syndrome

Raynaud’s syndrome is a condition which causes discomfort but is usually not serious. Also known as Raynaud syndrome, Raynaud’s disease, or Raynaud's phenomenon, it can occur by itself or in tandem with other health problems. This disorder affects more women than men, and individuals living in chilly climates have a greater likelihood of having Raynaud’s.

Contents

Definition & Facts

When a person is exposed to cold or experiences psychological stress, external parts of the body react. This response to temperature change or tension occurs because tiny arteries carrying blood to the skin contract, reducing blood flow (a phenomenon known as a vasospasm). The blood vessels may, as time progresses, become a bit thicker, further diminishing blood supply to these areas.

These characteristics appear in two types of Raynaud syndrome: primary and secondary. Primary Raynaud’s occurs independently, and usually commences in women between 15 and 30. This type is not usually uncomfortable. The disorder is considered secondary when it happens in connection with other diseases. This form usually affects individuals over 40.

Symptoms & Complaints

Exposure to cold temperatures (even reaching into a freezer, coming into contact with frozen food, or immersion in cold water) results in the sensations associated with Raynaud syndrome. Fingers and toes are the most commonly affected but the nose, ears, and even nipples can react symptomatically to a chill or emotional stress among those with Raynaud syndrome.

Color changes often occur—first white, then blue—and the affected skin feels cold and numb. As the areas warm up again, they may turn red. Swelling, tingling, throbbing, or stinging, which may be intense, are common reactions following an episode. However, not all changes in hue occur in the above order, and they may not happen at all. An attack may be over in a few minutes or continue for several hours.

Causes

No one knows what causes primary Raynaud syndrome. However, people between the ages of 15 and 30, women, individuals with a family history, and residents of chilly climates have a greater tendency to develop Raynaud’s.

Secondary Raynaud’s (which is frequently referred to as Raynaud’s phenomenon) on the other hand, has multiple known triggers. This form can be caused by a variety of conditions, habits, and activities. Atherosclerosis, pulmonary hypertension (high blood pressure affecting arteries in the lungs), and other vascular diseases can cause the disorder. Carpal tunnel syndrome results in pressure on the median nerve in the hand, resulting in pain and lack of sensation. The affected hand is more likely to feel the effects of icy temperatures.

Autoimmune diseases, in which the immune system mistakes a part of the body for a foreign invader and launches an attack, are commonly associated with Raynaud phenomenon. Sjögren’s syndrome, lupus, scleroderma, and rheumatoid arthritis are conditions with a strong connection to Raynaud’s. Repetitive movements such as typing, playing an instrument, and using heavy equipment can harm the nerves that command small arteries.

Chemicals like vinyl chloride often trigger conditions that lead to Raynaud’s. Smoking can also contribute to this condition as it causes the narrowing of the arteries. Hand or foot surgery, injuries, and frostbite can bring on the disorder. In addition, some chemotherapy drugs, beta blockers for high blood pressure, over-the-counter cold medications (they cause narrowing of blood vessels), certain migraine medications, and drugs used to treat attention deficit hyperactivity disorder (ADHD) can all lead to Raynaud phenomenon.

Diagnosis & Tests

There are several tests that can diagnose Raynaud syndrome—and rule out a simple case of having cold hands, feet, noses or ears. A doctor will probably initially examine fingertip blood vessels with a specific lens. The test, known as nailfold capillaroscopy (NV) distinguishes between absence of Raynaud’s or its primary form and secondary Raynaud phenomenon. This examination can also identify a possible connective tissue disease.

Blood tests can help determine the presence and type of autoimmune and cardiovascular diseases that are often behind the syndrome. A vascular or Duplex sonography can give doctors an understanding of how blood travels through veins and arteries. Duplex ultrasound is a combination of two types of ultrasound: that which forms images from sound waves reflecting off blood vessels, and Doppler, which measures sound waves as they bounce off material in motion (like blood) to assess how the blood is flowing and the condition of arteries and veins. 

Treatment & Therapy

Treatment of both types of Raynaud syndrome varies but involves avoiding exposure to cold and treating any underlying conditions. Gloves or mittens are important to wear when venturing outdoors in chilly weather—and even when reaching into the freezer and coming into contact with its contents. Additional precautions include wearing warm (preferably wool) socks and comfortable shoes with plenty of room; always wearing shoes when outside; taking steps to warm up after swimming or any other physical activity; and taking off coats indoors as perspiration can make people feel even chillier when they go back out.

People who smoke should quit. Avoiding medications that make blood vessels contract is another important step. Health care providers can recommend alternatives to any cold, migraine, blood pressure medications that may be contributing to or causing the condition.

Prevention & Prophylaxis

Since no one knows what causes primary Raynaud syndrome, preventing the disorder poses difficulties. However, there are many ways to keep episodes at bay. Warm food and plenty of fluids (the non-carbonated kind) can help reduce symptoms. Increased liquid intake increases blood volume which can prevent or mitigate symptoms.

Wearing waterproof outerwear and boots that breathe is important. Clothes and socks which remove perspiration from the body are helpful.

Since stress is a Raynaud culprit, practicing relaxation techniques and stress reduction. Exercise can help reduce stress and improve cardiovascular health. Following treatment instructions for underlying conditions is important in helping to keep symptoms at bay.