What is Raynaud’s Disease?
Raynaud’s disease also known as Raynaud’s phenomenon or just Raynaud’s, occurs due to the overreaction of the peripheral blood vessels to cold or stress conditions resulting in narrowing of these vessels causing discoloration and numbness in the fingers or toes. This condition is not usually serious and resolves in a short while but occasionally tissue damage may occur. It is found commonly in people living in cooler climates. It is classified as one of two types, primary and secondary.
Primary Raynaud’s disease occurs without any associated condition and usually shows mild symptoms. Secondary Raynaud's is also called Raynaud’s syndrome as it is associated with underlying conditions. It is less common but more severe.
Causes of Raynaud’s Disease
Exposure of the hands and feet to cold temperatures or situations of emotional stress normally causes some peripheral vessel constriction. In Raynaud’s disease, this reaction is exaggerated for unknown reasons.
Secondary Raynaud's disease may be associated with:
- Connective tissue diseases such as rheumatoid arthritis and scleroderma
- Vascular disease
- Carpal tunnel syndrome
- Using vibrating tools
- Injuries to the hands or feet
- Repetitive actions such as typing or playing the piano
- Medication for high blood pressure, heart diseases, weight control
Signs and symptoms of Raynaud's disease depend on the severity, frequency, and duration of the blood-vessel spasm and may include:
- Cold fingers or toes
- Color changes of the skin in response to cold or stress, first turning pale, then blue, and finally red as circulation is restoring
- Prickly feeling
- Stinging pain can also occur while circulation is restoring
Raynaud's most commonly affects the fingers and toes, but it can also affect other areas of your body, such as your nose, lips, ears, and nipples. Symptoms usually resolve within 15 minutes.
Diagnosis of Raynaud’s Disease
Your doctor will enquire about your symptoms and medical history and conduct a physical examination. To distinguish between primary and secondary Raynaud's, your doctor might perform a test called the nail fold capillaroscopy, in which they will look for enlarged capillaries in the skin at the base of your fingernails, by using a microscope.
Your doctor will also use various blood tests to rule out other conditions such as an autoimmune or connective tissue disease. These tests include:
- Antinuclear antibodies test: This test checks for the presence of antinuclear antibodies, produced by your immune system, which is stimulated if you have connective tissue diseases or other autoimmune disorders.
- Erythrocyte sedimentation rate: The rate of settling of the red blood cells is calculated in this test as people with inflammatory or autoimmune diseases will have a higher settling speed than normal.
Treatment for Raynaud’s Disease
Wearing gloves or heavy socks are usually effective for mild symptoms of Raynaud's. Medications are available to treat severe forms of the condition.
- Medications such as calcium channel blockers and vasodilators help in relieving severe symptoms as they dilate the blood vessels and improve circulation.
- Chemical injections can block the action of nerves responsible for vessel constriction.
- Nerve surgery may be recommended. Sympathetic nerves in your hands and feet control the opening and narrowing of blood vessels in your skin. Cutting these nerves can control an exaggerated response.
Raynaud's disease can be prevented by avoiding precipitating factors such as:
- Exposure to cold (keep hands and feet covered)
- Overuse injuries
- Smoking causes vessel constriction and hardening of the arteries
- Certain medications for high blood pressure, heart disease, and weight control if they worsen Raynaud’s disease