Q: I am a 57-year-old female with Raynaud’s disease. Whenever I get cold, my fingers turn white from the mid-finger to the tops and are numb. Then when they warm up, they can turn bluish in splotches and tingle, after which they go back to a normal color Is there a cure for Raynaud’s disease or some kind of relief?
A: You have described the condition very well for other readers, so I thank you. Raynaud’s disease,
a/k/a Raynaud’s phenomenon or syndrome, is a disorder of the blood vessels that commonly affects the fingers and toes. Other areas of the body including the ears, nose and lips may be similarly affected. When exposed to cold, when stressed, or when other as yet unidentified triggers occur, blood vessels narrow, blood cannot reach the surface of the skin through smaller arteries which produces vasospasms, and the result is white and blue digits. As the blood returns to the area(s) which may take about 15 minutes, the skin will take on a red appearance and will tingle or even throb. The digits may swell as circulation improves. Individuals that live in colder areas of the country are more likely to develop Raynaud’s than are others who live in warmer climates. Women over the age of 30 are more prone to it than are men.
There is also a condition known as secondary Raynaud’s caused by specific medications, injury, or other disorders. This form does have an underlying cause which triggers it. Those causes may be carpal tunnel syndrome, a connective tissue disorder, arterial disease, a smoking habit, injury, and specific medications. Carpal tunnel syndrome places pressure on a major nerve that goes to the hand and causes numbness and pain. Connective tissue disorders may exhibit scleroderma, a scarring or hardening of the skin. Arterial disorders include the possible of atherosclerosis, a buildup of plaque in the blood vessels or Buerger’s disease in which the blood vessels become inflamed. Smoking is known to constrict blood vessels and is a possible cause of your condition. While the secondary form is less common, it tends to be more serious. Injuries to the extremities as the result of a fall, fracture, or surgery may also be the cause. Lastly, specific medications including beta blockers, specific chemotherapy drugs, cold medications that could cause blood vessels to narrow and beta blockers taken for hypertension may contribute to the condition.
Physicians have a method by which they can differentiate between primary and secondary Raynaud’s through examination under a microscope of the skin at the base of the fingernail. Capillaries that are enlarged or deformed may indicate an underlying condition or secondary Raynaud’s; however, some secondary diseases may not be detected through this particular testing. In some cases of secondary Raynaud’s, there will be a decreased number of capillary loops. Then there is an antinuclear antibody (ANA) blood test which may indicate a stimulated immune system common in individuals with a connective tissue disease or another autoimmune disorder. An ESR (erythrocyte sedimentation rate is a blood test that determines the rate at which red blood cells settle to the bottom of a test tube. A rate faster than normal may signal an autoimmune disease or an underlying inflammatory disease.
Treatment may begin with avoiding stressful situations whenever possible, keeping the hands and feet warmer when exposed to colder temperatures, soaking your hands or feet in warm water at the first sign of tingling or the blanching, and avoiding taking specific medications such as those listed above. If medication is required, calcium channel blockers, vasodilators or alpha blockers may provide relief.
On the home front, discontinue smoking if appropriate, exercise whenever possible to increase the circulation throughout your body, avoid stress, and avoid rapidly changing temperatures such as entering an air conditioned building from extremely high heat out of doors. While unproven in terms of relief, acupuncture and biofeedback have been recommended, as has been ginkgo or fish oil supplements. Speak with the physician who diagnosed you for a recommendation on what to consider and what to avoid.
