Raynaud’s disease (also known as Raynaud’s phenomenon or syndrome) is named after Maurice Raynaud (1834-1881) who described this condition for the first time in 1862. Raynaud’s disease is characterised by a discolouration of the fingers or toes, triggered by cold or emotions. A distinction is made between a primary and secondary variation of Raynaud’s.
There is no apparent cause or disease that causes Raynaud’s phenomenon in these cases. This variation interferes with the normal reaction that blood vessels have to cold. The arteries and arterioles in the skin of the fingers or toes cramp up and constrict. This causes the blood flow to decrease or stop and gives the fingers a distinctive white colour.
Secondary Raynaud’s is a side effect of a different condition. The primary condition in such cases is often a connective tissue system disease, such as SLE, Sjögren’s syndrome, rheumatoid arthritis or a vascular inflammation. Secondary Renaud’s can also be caused by the use of certain medication, such as beta-blockers or ergotamine.
A common phenomenon
Raynaud’s is quite common, seen in 5-21% of the population. The symptoms are usually not very severe. Raynaud’s is more often seen in women than men and often presents for the first time during puberty. The condition is seen more frequently in locations with a cold climate. Heredity is also a factor. This condition is seen more in some families than others.
Symptoms of Raynaud’s disease
The symptoms of Raynaud’s come in attacks. In response to stimulus, the small arteries in the fingers or toes cramp up for a short period of time. Blood flow to these extremities comes to a halt, which causes the tissue to be anoxic (oxygen-deprived). This may cause sharp pain. The fingers or toes take on a white colour. Once the blood flow is restored, the fingers (or toes) become a blueish-purple before turning red. During this process, the hands or feet feel cold or go numb. When circulation is restored, it may cause an uncomfortable prickly or tingly sensation. These symptoms often occur in the fingers or toes, but could also occur in the tip of the nose or ears.
What causes Raynaud’s disease?
There is no clear cause for how primary Raynaud’s starts. Research did show that there is a heightened sensitivity in certain cold receptors, and heredity also seems to play a part in the development of this condition. The attacks can be caused by a transition from warm to cold, touching a cold object, strong emotions, or working with vibrating equipment, such as a drill or keyboard.
There is a clear cause for secondary Raynaud’s. The course of this condition depends on the underlying primary condition. Secondary Raynaud’s can also be caused by the use of certain medication.
Medication isn’t normally the first course of treatment for Raynaud’s. Minor lifestyle adjustments and tips are often enough to prevent the attacks. For secondary Raynaud’s, the treatment addresses the underlying primary condition, which often automatically alleviates the symptoms.
In many cases, you can prevent severe symptoms yourself. If this does not help, your GP could prescribe medication to help to decrease the symptoms. You would usually get a vasodilator such as Nifedipine, but blood thinners could help as well. Depending on the severity of the symptoms, you can choose to use the medication continuously or only in case of an attack. Many patients only use the medication during the coldest period of the year.
If the medication does not help enough, a drip with a vasodilator could be given. This would be administered in hospital.
If your Raynaud’s symptoms are so severe that medication does not offer enough relief, a nerve block could become an option. During this procedure, the nerves that cause the stenosis of the artery are disconnected. This procedure is done by a surgeon.
Prevention of the symptoms
There are a few things you can do to prevent a Raynaud’s attack.
- Protect your hands (or feet) when you move from a warm room to a cold room or when you touch a cold object. For example: you could wear gloves or use special hand warmers
- Try to avoid intense emotions and stress if these trigger an attack
- Exercise regularly, regular exercise has a positive effect
Smoking and the use of oral contraception by women seems to influence the development of attacks, although there is no conclusive evidence yet. The symptoms of primary Raynaud’s often decrease as the patient gets older.
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Last updated on July 14, 2016.