WHAT IS RAYNAUD'S DISEASE

Raynaud’s (ray-NODES or ray-NOHZ) is named for the French physician Maurice Raynaud, who first recognized the condition in 1862. The disease causes spasms in the nerve bundles surrounding blood vessels, which results in an interruption of blood flow to area affected. Typically, these spasms occur in the extremities (i.e. the fingers, toes, nose, and/or ears). Spasms are caused by exposure to a temperature differential—like stepping into an air conditioned room on a hot day or grabbing a cold drink—or emotional stress. Typically, the affected area turns white, then blue, then bright red over the course of an attack. There may also be tingling, swelling, or painful throbbing in the area. The attacks may last from minutes to hours. In severe cases, the area may develop ulcerations and infections, which can lead to gangrene, tissue damage, and even tissue loss.

Raynaud’s can occur as a “primary” disease; that is, with no associated disorder. It can also occur as a “secondary” condition related to other diseases, such as scleroderma, lupus, and rheumatoid arthritis.

Approximately 5-10 percent of all Americans suffer from Raynaud’s, but only one out of five sufferers seeks treatment. Both men and women suffer from Raynaud’s, but women are nine times more likely to be affected. Some researchers estimate as many as 20% of all women in their childbearing years have Raynaud’s.

Although it’s been over 100 years since Raynaud’s was recognized, little is still known about the condition or its cause. Currently, there is no cure for Raynaud's Disease. This has given rise to groups like The National Raynaud’s Association, which provides support to sufferers and seeks to raise awareness and understanding of this perplexing phenomenon.

Learn More by Visiting the National Raynaud's Association

TYPES OF RAYNAUD'S

There are two main classifications of Raynaud's: Primary and Secondary. In a nutshell, Primary Raynaud’s happens on its own while Secondary Raynaud’s accompanies some other health condition.

  • Primary Raynaud's is the more common form, and isn't the result of an underlying associated medical condition that could provoke vasospasm (like Lupus, Scleroderma, and Rheumatoid Arthritis). Primary Raynaud's tends to be less severe than Secondary Raynaud's. It is estimated that Primary Raynaud's is severely under diagnosed, as some sufferers simply think they are overly sensitive to cold! This condition tends to progress with age.
  • Secondary Raynaud's is caused by an underlying health condition. While Secondary Raynaud's is less common than the primary form, it tends to be more serious. Signs and symptoms of Secondary Raynaud's usually appear later in life—around the age of 40. This is sometimes referred to as White Finger Disease

SOME POSSIBLE CAUSES OF RAYNAUD'S INCLUDE:

  • Connective tissue diseases. Most people who have a rare disease that leads to hardening and scarring of the skin (Scleroderma) have Raynaud's. Other diseases that increase the risk of Raynaud's include Lupus, Rheumatoid Arthritis and Sjogren's Syndrome.
  • Diseases of the arteries. Raynaud's phenomenon can be associated with various diseases that affect arteries, such as the buildup of plaques in blood vessels that feed the heart (Atherosclerosis) or a disorder in which the blood vessels of the hands and feet become inflamed (Buerger's Disease). A type of high blood pressure that affects the arteries of the lungs (Primary Pulmonary Hypertension) can also be linked to Raynaud's.
  • Carpal tunnel syndrome. This condition involves pressure on a major nerve to your hand (Median Nerve) producing numbness and pain in the affected hand. The hand may become more susceptible to cold temperatures and episodes of Raynaud's attacks.
  • Repetitive action or vibration. Typing, playing piano or doing similar movements for long periods as well as operating vibrating tools, such as jackhammers, can increase your risk of developing Raynaud's.
  • Smoking. Smoking constricts blood vessels and carries the potential of causing Raynaud's to develop.
  • Injuries. Injuries to the hands or feet, such as wrist fracture, surgery or frostbite, can lead to Raynaud's.
  • Certain medications. Some drugs—including beta blockers, which are used to treat high blood pressure; migraine medications that contain ergotamine or sumatriptan; attention-deficit/hyperactivity disorder medications; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications—have been linked to Raynaud's.

Learn more about the factors that contribute to Raynaud's by visiting nih & mayo clinic

SYMPTOMS OF RAYNAUD'S DISEASE

Body heat is spread throughout the body by blood vessels. The body conserves heat when it is cold by slowing the supply of blood to 'non-essential' areas—like the skin and extremities. It does this by making blood vessels more narrow. With Raynaud’s Disease, the body’s reaction to cold or stress is stronger than normal. Exposure to temperature differentials causes violent vasospasms, referred to as Raynaud's attacks.

Timelapse of a Raynaud's attack.

Raynaud's attacks can last less than a minute or as long as several hours. Attacks can occur multiple times in a day, or as rare as weekly. Extremities like the hands and feet are most commonly affected. Attacks often begin in one finger or toe and move to other fingers or toes. Sometimes only one or two fingers or toes are affected. Different areas may also be affected at different times.

During an attack, the affected area may change colors due to the lack of blood and oxygen being carried to the area. They may go from white to blue to red. They may also feel cold and numb from lack of blood flow. As the attack ends and blood flow returns, the skin can throb and tingle. After the cold parts of the body warm up, normal blood flow returns in about 15 minutes.

While signs and symptoms of Raynaud's depend on the frequency, duration and severity of the blood vessel spasms, some common signs and symptoms of Raynaud's Disease include:

  • Cold fingers or toes
  • Color changes in your skin in response to cold or stress
  • Numb, prickly feeling or stinging pain upon warming or stress relief

Severe Raynaud's can cause skin sores or gangrene. "Gangrene" refers to the death or decay of body tissues. See your doctor right away if you have a history of severe Raynaud's or if you develop a sore or infection in one of your affected fingers or toes.

Learn more about the Symptoms of Raynaud's by visiting nih & mayo clinic

HOW DOES A DOCTOR DIAGNOSE RAYNAUD'S?

Even though it is understudied and under diagnosed, it is fairly easy to determine if a person has Raynaud’s based on the visual color changes in the skin. The difficulty lies in identifying whether a person has the primary or the secondary form of the disease.

Doctors (typically a Rheumatologist) will diagnose which form it is using a complete history, an exam, and tests. Tests may include:

  • Blood tests
  • Looking at fingernail tissue with a microscope.
  • Cold simulation test
  • Patient description of symptoms

Treatment aims to:

  • Reduce how many attacks you have
  • Make attacks less severe
  • Prevent tissue damage
  • Prevent loss of tissue.

Primary Raynaud’s does not often lead to tissue damage, so non-drug treatments are typically pursued first. Treatment with medicine is more common with severe Raynaud’s where patients are at a high risk of tissue loss.

Severe cases of Raynaud’s can lead to sores or gangrene (tissue death) in the fingers and toes. These cases can be painful and hard to treat. In severe cases that cause skin ulcers and serious tissue damage, surgery may be used to deaden the nerves around the affected area.

Learn more about how doctors diagnose Raynaud's Disease by visiting nih

NON-MEDICATION & SELF-HELP MEASURES

Regardless of the severity, there are common ways to help reduce how long and severe attacks are:

  • Keep hands and feet warm and dry.
  • Warm hands and feet when attacks occur.
  • Avoid air conditioning.
  • Wear gloves to touch frozen or cold foods.
  • Wear many layers of loose clothing and a hat when it’s cold.
  • Use chemical warmers, such as small heating pouches that can be placed in pockets, mittens, boots, or shoes (do not place against bare skin as this may cause overheating or burns).
  • Talk to a doctor before exercising outside in cold weather.
  • Don’t smoke.
  • Avoid medicines that make symptoms worse.
  • Avoid emotional stress and learn ways to cope with stress that you can't avoid.
  • Exercise regularly.
  • Maintain a healthy diet.

See a doctor if:

  • You worry about attacks or they are increasing in intensity.
  • Attacks happen on just one side of your body.
  • You have sores or ulcers on your fingers or toes.

Learn more about self-help measures for Raynaud's by visiting nih

TREATMENT & MEDICATIONS

If lifestyle changes don't control your Raynaud's symptoms, you may need to seek medications or surgery. While there is not a current FDA approved medication specifically for Raynaud's, medicines that are used to improve blood flow may help.

Examples of medicines used to treat Raynaud's include calcium channel blockers, alpha blockers, vasodilators, prescription skin creams, and ACE inhibitors.

Rarely, people who have severe Raynaud's may develop skin sores or gangrene (tissue damage or death). If this happens, antibiotics or surgery to cut out the damaged tissue may be needed. In very serious cases, the affected toe or finger may need to be removed.

Another treatment for severe Raynaud's is to block the nerves in the hands or feet that control the arteries. This can help prevent Raynaud's attacks. This treatment is done using surgery or shots.

The surgery often relieves symptoms, but sometimes for only a few years. Shots may need to be repeated if symptoms persist or come back.

Learn more about treatments for Raynaud's Disease by visiting nih

SUPPORT FOR RAYNAUD'S DISEASE

If you or a loved one suffers from Raynauds, know that you are not alone. Many resources and support groups are available to help Raynauds patients and their families. 

The National Raynaud's Association

The Raynaud’s Association is a national non-profit (501c3) organization whose mission is to provide support and education to the millions of sufferers of Raynaud’s Phenomenon, an exaggerated sensitivity to cold temperatures. The Association was created to raise awareness and educate the public about Raynaud’s, which can be painful and, for some, may cause serious blood vessel damage.  The Association exists to help people understand that Raynaud’s should not be dismissed as a mere nuisance. Seeking medical attention is important both to find treatment and to rule out the possibility that an underlying, serious disease may be causing Raynaud's Symptoms.

Along with numerous informational pages, the National Raynaud's Association also offers a Forum for members and a marketplace for reviewed and endorsed assistive products. 

For a list of local resources for Raynaud's Disease in your area, click here