Raynaud's phenomenon is a reduction in the blood flow to the hands as a result of cold temperatures, causing a color change in some portions of the hands and, most notably, the fingers. Vasoconstriction, or the shrinking of blood vessels, naturally occurs to help the body core retain heat, but Raynaud's phenomenon can occur when the tiny blood vessels of the fingers hyper-respond to the cold.
15–20 percent of all women experience an episode at one time or another, but if it recurs, it may signal an underlying medical condition. While it is not usually dangerous, periods of constricted blood flow lasting more than 15 minutes can begin to starve tissue of oxygen, so prompt warming action is important.
The color changes are usually dramatic, from white, as the blood flow slows and stops, to blue when deoxygenated venous blood, having no push from the arterial side, pools in the fingers. Finally, the fingers grow red when the vasoconstriction resolves and blood rushes back in, usually within 15 minutes removed from the source of the cold temperatures. Sensations include the following:
- Numbness or tingling
- Finger/hand clumsiness
- Pain (although not a common symptom, it may be experienced)
In cases where Raynaud's phenomenon is idiopathic (no known origin), it most commonly affects women, particularly those with small frames, where the viscous blood has narrower vessels to push through to reach the fingers. Low blood pressure is also a contributor. More often, Raynaud's accompanies an underlying autoimmune disease, such as scleroderma or lupus, or more rarely, another syndrome or disease. Once a diagnosis is made, hand specialists work in conjunction with rheumatologists and primary care physicians to evaluate the best treatment options.
Regardless of the cause, the means of reducing episodes of Raynaud's phenomenon are the same.
Education and Prevention
As a front line of the defense, learn about the syndrome and become attuned to the triggers. You can help stave off episodes by doing the following:
- Wearing looser fitting sleeves to minimize external constriction.
- Dressing in layers to allow for more flexibility with climate changes.
- Keeping gloves and chemical hand warmers within close proximity to prevent or reverse a developing episode.
- Avoiding direct contact with cold beverage containers and steering wheels.
Certain medications and behaviors are associated with heightened or more frequent episodes, so try to avoid these vasoconstrictors: smoking, over-the-counter cold medications that contain pseudoephedrine, heavily caffeinated drinks, narcotics, ergotamines and serotonin receptor drugs used for depression or migraines.
Temperature biofeedback training has proven successful in many patients. Once you become aware of the physical sensations that precede an episode, you can learn to exercise some control over your body's responses to the temperature trigger.
With stress, our bodies release vasoconstricting hormones, so relaxation therapy such as practicing meditation, can be effective in teaching you to "lower the decibels" in your response to stressors. Improving cardiovascular health can be very effective, since the rigors of regular exercise increase the suppleness of the blood vessel walls and also allow the body to grow additional vessels, serving as potential detour routes for the blood to take on its way to the extremities.
If frequent or intense episodes of Raynaud's phenomenon affect the quality of your life, your doctor will likely recommend you take one of many medications that work as vasodilators. The combination of medication and other therapies are often sufficient to vastly improve symptoms.
If you are not helped by these medications and therapies, surgery can be performed to separate the outer layer of the arterial vessels from the nerves, relieving pain and increasing blood flow.