Topic Overview
What is Raynaud's phenomenon?
Raynaud’s
(say “ray-NOHZ”) phenomenon is a problem with blood flow. Your body doesn't
send enough blood to your hands and feet, so they feel very cold and numb. In
most cases, this lasts for a short time when your body overreacts to cold
temperatures.
There are two kinds of Raynaud’s phenomenon.
Primary Raynaud’s is also known as Raynaud’s disease. It occurs on its own and
is the most common form. Secondary Raynaud’s is also called Raynaud’s syndrome.
It most often forms as part of another disease.
People may not talk to a
doctor about symptoms of Raynaud's. For most people, it is more of a nuisance than a
disability.
What causes Raynaud's phenomenon?
Primary
Raynaud’s has no known cause. Secondary Raynaud’s may be a symptom of another
disease such as
lupus,
scleroderma,
rheumatoid arthritis, or
atherosclerosis. Taking certain medicines, using
vibrating power tools for several years, smoking, or having frostbite may also
cause Raynaud’s.
Certain things, such as stress and taking certain
medicines, can trigger an attack. But the most common trigger is exposure to
cold. In the cold, it’s normal for the body to narrow the small blood vessels
to the skin and to open the blood vessels to the inside parts of the body to
keep the body warm. But with Raynaud’s, the body overreacts and restricts blood
flow through the small vessels to the skin more than necessary.
What are the symptoms?
During an attack of
Raynaud’s, the body limits blood flow to the hands and feet. This makes the
fingers or toes feel cold and numb and then turn white or blue. As blood flow
returns and the fingers or toes warm, they may turn red and begin to throb and
feel painful. In rare cases, Raynaud’s affects the nose or ears.
An
attack most often lasts only a few minutes. But in some cases it may last more
than an hour.
How is Raynaud's phenomenon diagnosed?
To diagnose
Raynaud’s, your doctor will ask you questions about your symptoms and past
health. He or she will also do a physical exam. Since Raynaud’s attacks are so
sudden and brief, your doctor probably won't get to see you have an attack. So
your doctor will want you to describe what happens to you during an attack.
There are no simple tests that your doctor can use to see if you
have Raynaud’s. You may have a blood test or other tests to rule out certain
diseases that may be causing your symptoms.
How is it treated?
If you have secondary Raynaud’s
that is caused by another disease, your doctor can treat that disease. This may
relieve your symptoms.
There is no cure for primary Raynaud’s, but
you may be able to control it by avoiding the things that trigger it. These
triggers include cold temperatures, stress, smoking, caffeine, cold medicines
with pseudoephedrine, and beta-blockers. But don't stop taking prescribed
medicines unless you talk to your doctor first.
You may be able to
prevent Raynaud’s attacks with these home treatment tips:
- Remember to keep your body warm at all times.
- Wear mittens or gloves when it is cold outside.
- Use
potholders or oven mitts when you get something from the refrigerator or
freezer.
- Keep your feet warm by wearing wool or synthetic socks
rather than pure cotton socks.
- Try running warm water over your
hands. It can increase blood flow to them.
If you can't control your symptoms with home treatment,
your doctor may give you a medicine called a calcium channel blocker. This may
increase blood flow to your hands and feet and relieve symptoms.
Frequently Asked Questions
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Being diagnosed:
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Getting treatment:
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Ongoing concerns:
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Living with Raynaud's phenomenon:
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Symptoms
Areas affected by
Raynaud's phenomenon may:
- Feel cold or numb, as if they have fallen
asleep.
- Turn white or blue.
- Turn blue, then red with
warming. As colors develop, the affected areas may throb, ache, tingle, or feel
cold or numb.
The hands, feet, nose, and ears can be affected by
Raynaud's phenomenon. Raynaud's may affect one finger or several. Even nipples
may be affected.
Exams and Tests
Because an attack of
Raynaud's phenomenon typically ends quickly, your doctor most often will determine whether you have Raynaud's phenomenon by
your description of your symptoms. Your doctor will review your
medical history, perform a physical exam, and do blood tests or other
tests to rule out a secondary cause of Raynaud's phenomenon. If possible, you
may want to take a color photograph of your hands when you are having symptoms. Then you can bring the photo to your appointment.
A
rheumatologist or
dermatologist may examine the small blood vessels
(capillaries) at the base of your fingernails using a small magnifying lens.
Known as "capillaroscopy," this simple examination may help distinguish between
primary Raynaud's and secondary Raynaud's that is part of a connective tissue
disease such as
lupus,
scleroderma, or
rheumatoid arthritis.
Treatment Overview
There is no cure for primary
Raynaud's phenomenon, although the condition often can
be effectively controlled. You may be able to limit or reduce the severity of
attacks by keeping warm; managing emotional stress; and avoiding medicines or
other substances that affect blood flow, such as nicotine, caffeine, or cold
medicines that contain pseudoephedrine. Avoiding beta-blockers, which are often
used to treat high blood pressure and fast or irregular heart rates, is also
advised. Beta-blocker medicines slow the heart rate and decrease how forcefully
the heart contracts, causing even less blood to flow through your capillaries
and making symptoms of Raynaud's worse. Do not stop taking medicines your doctor has
prescribed, such as beta-blockers, without talking with your doctor.
If Raynaud's phenomenon can't be effectively controlled with home
treatment and it interferes with your daily activities, your doctor may
prescribe medicines that help increase blood flow and relieve symptoms. These medicines might include a high blood pressure medicine such as a calcium channel blocker, a nitroglycerin ointment, or an erection-enhancing medicine such as sildenafil (Viagra).
Some alternative treatments have shown promise in
treating Raynaud's phenomenon. But they have not been shown to work for everyone. Examples of alternative treatment include herbal supplements and biofeedback training.
If the condition is related to another disease,
a drug, or a specific activity (secondary Raynaud's), treating the disease or stopping the drug or activity may also reduce the symptoms of
Raynaud's phenomenon.
Home Treatment
Symptoms of
Raynaud's phenomenon can often be relieved by home
treatment.
To prevent or relieve symptoms that affect your hands or feet:
- Wear mittens or gloves anytime it is cool
outside. Mittens are warmer than gloves, because they keep your fingers
together. Gloves underneath mittens will keep your hands warmer than gloves
alone.
- Wear mittens or gloves or use pot holders or oven mitts when
getting something from the freezer or refrigerator.
- Drink hot
liquids. This helps maintain your internal body temperature.
- When
drinking from a cold container such as a can or bottle, use an insulated
cover.
- Warm your hands by running warm water over them or rubbing
them together. This often will increase blood flow to your hands, relieving an
attack of Raynaud's phenomenon. Be careful not to burn your hands under water
that is too hot.
- Wear wool, synthetic, or cotton-blend socks rather
than pure cotton socks. They keep your feet drier and warmer by pulling
moisture away from your skin.
- Use foot powder to help absorb
moisture from your feet. When your feet are damp, they are more easily
chilled.
- Swing your arms rapidly in a circle at the sides of your
body ("windmilling"), which can temporarily increase blood flow into your
fingers.
To keep your whole body warm:
- Wear layers of warm clothing. The inner layer
should be made of a material such as polypropylene that pulls moisture away
from your body.
- Wear a hat. You lose more body heat from your head
than from any other part of your body.
- Do not wear clothing that is
too tight. Tight clothing can decrease or cut off circulation.
- Try
to stay dry. Choose waterproof, breathable jackets and boots. Being wet makes
you more likely to become chilled.
- Keep rooms at the same temperature.
In general:
- Quit smoking, and avoid caffeine (in coffee,
some soft drinks, and nonherbal teas). Nicotine and caffeine can cause blood
vessels to become narrower (constrict). These drugs may trigger an attack of
Raynaud's phenomenon or make an attack worse.
- Avoid
taking certain medicines that may cause or aggravate Raynaud's phenomenon, such
as drugs that affect blood flow, including cold medicines that contain
pseudoephedrine; some heart and blood medicines; and migraine headache
medicines. Do not stop taking medicines your doctor has prescribed, such as
beta-blockers, without talking with your doctor. Talk to your doctor about other steps you can take to reduce the effect of Raynaud's
phenomenon while still taking these medicines.
- Drink plenty of
liquids to prevent dehydration, which can lower the amount of blood moving
through the blood vessels and help bring on an attack of Raynaud's phenomenon
or make an attack worse.
- Try eating a hot meal before going
outside. Although there is no proof that this will help, some people believe
that eating raises your body temperature and helps keep you warm.
Other Places To Get Help
Organizations
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Arthritis Foundation
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| P.O. Box 7669 |
| Atlanta, GA 30309 |
| Phone: |
1-800-283-7800 |
| Web Address: |
www.arthritis.org |
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The Arthritis Foundation provides grants to help find a
cure, prevention methods, and better treatment options for arthritis. It also
provides a large number of community-based services nationwide to make living
with arthritis easier, including self-help courses; water- and land-based
exercise classes; support groups; home study groups; instructional videotapes;
public forums; free educational brochures and booklets; the national, bimonthly
consumer magazine Arthritis Today; and continuing
education courses and publications for health professionals.
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National Heart, Lung, and Blood Institute
(NHLBI)
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| P.O. Box 30105 |
| Bethesda, MD 20824-0105 |
| Phone: |
(301) 592-8573 |
| Fax: |
(240) 629-3246 |
| TDD: |
(240) 629-3255 |
| Email: |
nhlbiinfo@nhlbi.nih.gov |
| Web Address: |
www.nhlbi.nih.gov |
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The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
and treating:
- Diseases affecting the heart and circulation, such as heart
attacks, high cholesterol, high blood pressure, peripheral artery disease, and
heart problems present at birth (congenital heart diseases).
- Diseases that affect the lungs, such as asthma, chronic
obstructive pulmonary disease (COPD), emphysema, sleep apnea, and
pneumonia.
- Diseases that affect the blood, such as anemia,
hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.
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National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS), National Institutes of Health
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| 1 AMS Circle |
| Bethesda, MD 20892-3675 |
| Phone: |
1-877-22-NIAMS (1-877-226-4267) toll-free (301) 495-4484 |
| Fax: |
(301) 718-6366 |
| TDD: |
(301) 565-2966 |
| Email: |
niamsinfo@mail.nih.gov |
| Web Address: |
www.niams.nih.gov |
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The National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) is a governmental institute that serves the public
and health professionals by providing information, locating other information
sources, and participating in a national federal database of health
information. NIAMS supports research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases and supports the training of
scientists to carry out this research.
The NIAMS Web site provides
health information referrals to the NIAMS Clearinghouse, which has information
packages about diseases.
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Scleroderma Foundation
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| 300 Rosewood Drive |
| Suite 105 |
| Danvers, MA 01923 |
| Phone: |
1-800-722-HOPE (1-800-722-4673) (978) 463-5843 |
| Fax: |
(978) 463-5809 |
| Email: |
sfinfo@scleroderma.org |
| Web Address: |
www.scleroderma.org |
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The Scleroderma Foundation's mission is threefold:
support, education, and research. The foundation aims to help patients and
their families cope with scleroderma through mutual support programs, peer
counseling, physician referrals, and educational information. It promotes
public awareness and education through patient and health professional
seminars, literature, and publicity campaigns. The foundation also stimulates
and supports research to improve treatment and ultimately find the cause of and
cure for scleroderma and related diseases.
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Vascular Disease Foundation
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| 1075 South Yukon |
| Suite 320 |
| Lakewood, CO 80226 |
| Phone: |
1-888-833-4463
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| Web Address: |
www.vdf.org |
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The Vascular Disease Foundation is a non-profit organization that provides information and support for patients and their families about vascular diseases. This organization also provides public education through its press releases, Web site, and printed materials.
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References
Other Works Consulted
- Pope J (2008). Raynaud's phenomenon (primary), search date May 2008. Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.
- Zaghloul SS, et al. (2010). Raynauld's disease and phenomenon. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 650–653. Edinburgh: Saunders Elsevier.
Credits
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By
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Healthwise Staff |
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Primary Medical Reviewer
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Anne C. Poinier, MD - Internal Medicine |
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Specialist Medical Reviewer
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Stanford M. Shoor, MD - Rheumatology |
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Last Revised
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June 30, 2010 |