Raynaud’s disease is a rare disorder affecting the arteries. Arteries are blood vessels that carry blood from your heart to the different parts of your body. It affects men and women, but has a greater preponderance in women.
Raynaud’s disorder is marked by brief episodes of vasospasm (narrowing of the blood vessels), which occurs mainly in the arteries supplying the fingers, but the toes can also be affected as well as the nose, ears, nipples and lips. The vasospasm usually occurs in response to a cold or an emotional stimulus.
Raynaud’s Disease and Raynaud’s Syndrome
It is important to distinguish Raynaud’s disease from Raynaud’s syndrome. In Raynaud’s disease or Primary Raynaud’s the symptoms of the disease are idiopathic (that is, they occur by themselves and no known cause can be found). The disease affects women in their teens and early adulthood. And they will often give a history of cold sensitivity. All or only some of the fingers may be involved.
Primary Raynaud’s is thought be at least partly hereditary, although no specific gene has been identified as yet. Smoking and caffeine worsens the frequency and intensity of the attacks.
Raynaud’s Syndrome or Secondary Reynaud’s
Raynaud’s syndrome or secondary Raynaud’s is usually due to a wide range of other conditions, such as disorders of the connective tissues of the body (particularly systemic sclerosis). It can also be caused by eating disorders such as anorexia nervosa, lifestyle diseases such as atherosclerosis, or even certain drugs used in the treatment of cancer.
Some occupations which involve a lot of vibrating, such as drilling, can result in Raynaud’s syndrome. And occupation’s which expose one’s hands to cold can also produce this phenomenon. Deficiencies in certain minerals have also been implicated in the cause of Raynaud’s syndrome. In secondary Raynaud’s, the patients are usually older and they do not have a long history of cold sensitivity and may have other manifestations of the underlying disease.
Typical Signs and Symptoms?
The symptoms include several cyclic colour changes. When exposed to cold temperatures, the blood supply to the fingers or toes and, in some cases, the nose or earlobes, is markedly reduced and the skin turns pale or white (pallor) and becomes cold and numb. When the oxygen supply is depleted, the skin colour turns blue (cyanosis).
The events are episodic and when the episode subsides or the area is warmed, the blood flow returns and the skin colour turns red (rubor) and then back to normal, this is often accompanied by swelling and tingling. A person will also typically complain of pain and numbness.
In some instances it can cause the tissues of the affected areas to atrophy, resulting in a thinning appearance of the digits. In severe cases it can lead to gangrene of the fingers and this will subsequently require amputation. Raynaud’s has also occurred in women breastfeeding causing their nipples to turn white and thus resulting in intense pain.
Treatment for Raynaud’s
The treatment options are dependent on the type of Raynaud’s. Secondary Raynaud’s is treated primarily by addressing the underlying cause, but includes all options for Raynaud’s disease as well.
The treatment for Raynaud’s focuses on avoiding triggers. General care measures include avoiding environmental triggers such as cold or any occupation involving vibration. Emotional stress is a recognised trigger. Although the various sources of stress cannot all be avoided, it is possible to learn healthier, more effective ways of dealing with them, thus reducing the physical effects of stress.
It is also important to keep your hands and feet warm, especially your fingers, ears and nose by wearing mittens, insulated footwear and skin masks. One should also quit smoking; avoid caffeine and other stimulants; and vasoconstrictors that have not been prescribed to you. Make sure your doctor knows about the medication you are taking, including over the counter remedies (especially hormones and drugs that regulate your hormones such as hormonal contraceptives).
Emergency Treatment
If white fingers (Raynaud’s) occur unexpectedly and a source of warm water is available, allow tepid to slightly warm water to run over the affected digits while you gently massage the area. Continue the process until the white area returns to its normal healthy colour. If triggered by exposure to cold and there is no warm water available, place affected hand in a body cavity such as the armpit or inside the mouth. Treatment of Raynaud’s may also include prescription medication that dilates the blood vessels.
In severe cases surgery can be performed, symphathectomy is a procedure where the nerves that signal the blood vessel of the finger to constrict are surgically cut. A more recent treatment for severe Raynaud’s is the use of botox, which can lead to pain reduction.
Alternative and experimental approaches include the use of the Ginkgo biloba leaf which may reduce the frequency of attacks. Fish oil supplements which contain omega3 fatty acids may help to control the symptoms of primary Raynaud’s.
