Raynaud’s Disease

February 2, 2017

Raynaud’s Disease, also known as Raynaud’s Phenomenon (RP), refers to reversible spasm of peripheral arterioles in response to cold or stress. It is a disorder characterized by one or more fingers becoming blanched, cyanotic, and red (often in that order), upon an individual’s exposure to cold stimuli or emotional stress. These color changes are attributable to several factors; however, they mainly result from vasospasms of the digital arteries.

RP is named after the French physician, Maurice Raynaud, who first described it. Although the fingers of healthy individuals may become pale in response to severe cold, the effect is exaggerated in individuals with Raynaud’s symptoms. Even mild cold exposures can cause significant symptoms. 8 percent of the sufferers are women, and as many 5 percent population of the U.S. are affected by RP.

The disease mostly affects the fingers, toes, tip of the nose and the ears. The problem is in the blood vessels that supply the skin. Smaller arteries narrow and limit blood circulation to affected areas. Areas of the body subsequently become cold and very pale. Patients typically feel pins and needles, numbness, and even burning. The sensation can be unpleasant and painful.

The disease is classified as following –

  • Primary Raynaud’s – This is the most common form, there is no apparent cause (idiopathic). It is possible for the primary form to move to the secondary form.
  • Secondary Raynaud’s – It is associated with an underlying disease, such as rheumatoid arthritis. In extreme cases this form can progress to necrosis or gangrene of the fingertips.

Raynaud’s phenomenon doesn’t usually cause permanent damage. However, it can be a symptom of more serious underlying illnesses, so it is important to see the doctor if anyone experiences it.


  • Blood vessels in spasm With Raynaud’s, arteries to the fingers and toes go into vasospasm when exposed to cold or stress, narrowing the vessels and temporarily limiting blood supply. Over time, these small arteries may thicken slightly, further limiting blood flow. Cold temperatures are most likely to trigger an attack. Exposure to cold, such as putting the hands in cold water, taking something from a freezer or encountering cold air, is the most likely trigger. For some people, emotional stress can cause an episode of Raynaud’s.
  • Connective tissue diseases – Most people who have a rare disease that leads to hardening and scarring of the skin (scleroderma) have Raynaud’s. Other diseases that increase the risk of Raynaud’s include lupus, rheumatoid arthritis and Sjogren’s syndrome.
  • Diseases of the arteries – Raynaud’s phenomenon can be associated with various diseases that affect arteries, such as the buildup of plaques in blood vessels that feed the heart (atherosclerosis) or a disorder in which the blood vessels of the hands and feet become inflamed (Buerger’s disease). A type of high blood pressure that affects the arteries of the lungs (primary pulmonary hypertension) can be linked to Raynaud’s.
  • Carpal tunnel syndrome – This condition involves pressure on a major nerve to the hand (median nerve) producing numbness and pain in the affected hand. The hand may become more susceptible to cold temperatures and episodes of Raynaud’s.
  • Repetitive action or vibration – Typing, playing piano or doing similar movements for long periods and operating vibrating tools, such as jackhammers, can increase the risk of developing Raynaud’s.
  • Smoking – Smoking constricts blood vessels and is a potential cause of Raynaud’s.
  • Injuries – Injuries to the hands or feet, such as wrist fracture, surgery or frostbite, can lead to Raynaud’s phenomenon.
  • Certain medications – Some drugs — including beta blockers, which are used to treat high blood pressure; migraine medications that contain ergotamine or sumatriptan; attention-deficit/hyperactivity disorder medications; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications — have been linked to Raynaud’s.
  • Cancers – Some types of cancer can cause secondary Raynaud’s. These are usually cancers that develop inside the blood, bone marrow or immune system, such as –
    • Acute lymphoblastic leukaemia – a cancer of the white blood cells that mainly affects children
    • Lymphoma – a cancer that develops inside one or more of the glands that are part of the immune system
    • Multiple myeloma – a cancer that develops inside bone marrow


Risk Factors

Risk factors for primary Raynaud’s include –

  • Sex – Primary Raynaud’s affects women more than men.
  • Age – Although anyone can develop the condition, primary Raynaud’s often begins between the ages of 15 and 30.
  • Climate – The disorder is also more common in people who live in colder climates.
  • Family history – A family history appears to increase the risk of primary Raynaud’s. About one-third of people with primary Raynaud’s have a first-degree relative — a parent, sibling or child — with the disorder.

Risk factors for secondary Raynaud’s include –

  • Associated diseases – These include conditions such as scleroderma and lupus.
  • Certain occupations – People in occupations that cause repetitive trauma, such as operating tools that vibrate, may be more vulnerable to secondary Raynaud’s.
  • Exposure to certain substances – Smoking, medications that affect the blood vessels, and exposure to certain chemicals, such as vinyl chloride, are associated with an increased risk of Raynaud’s.


Generally, primary Reynaud’s disease symptoms are mild, while the secondary form’s may be more severe. In the primary form both hands are affected simultaneously, usually all fingers at the same time. In the secondary form the development and appearance of symptoms is more patchy, with perhaps a couple of fingers on one side being affected.

The affected areas will become very pale (pallor), and then take on a bluish color (cyanosis) due to hypoxia (lack of oxygen to that area). They will feel very cold and numb. If all fingers are affected, trying to rummage in your pockets for specific coins becomes much more difficult. This can sometimes be distressing.

  • Cold fingers and toes
  • Color changes in your skin in response to cold or stress
  • Numbness or tingling in the fingers and toes (can be on the ears or nose)
  • Stinging or throbbing pain upon warming or stress relief
  • Ulcers in the tips of fingers and/or toes
  • Raynaud’s-type symptoms may occur during breastfeeding; the nipples will turn white and become extremely painful.


Conventional Treatment

Calcium channel blockers – These are prescription medications that help to dilate or enlarge the blood vessels, thereby increasing circulation to the extremities. These medications are helpful in reducing the severity and frequency of attacks. Some medications used are – nifedipine and diltiazem.

Vasodilators – Topical prescription medications like nitroglycerin which relax the walls of the blood vessels can provide relief. This type of drug can be used to help heal painful skin ulcers caused by the condition of Raynaud’s. Vasodilators that are typically used to treat other conditions are also prescribed to those with Raynaud’s. Such drugs as: Cozaar (used for treatment of high blood pressure), antidepressants like Prozac and Sarafem, and as odd as it may sound, Viagra (sildenafil) is also prescribed for Raynaud’s.

Alpha Blockers – These drugs typically counteract the actions of the hormone that constricts the blood vessels, norepinephrine. Some examples of this type of medication are Minipress (prasolin) and Cardura (doxazosin).

Surgeries or medical procedures – Nerve surgery to cut the sympathetic nerves in your hands and feet can help to interrupt their exaggerated response to temperature shifts, etc. This surgery is called a sympathectomy and may reduce the frequency or severity of attacks, but has not always been successful.

Chemical Injections – Physicians use chemicals injected into the sympathetic nerves to block the nerves. This procedure needs to be repeated if symptoms persist.

Surgical intervention – In very rare cases where the blood flow has been completely blocked, gangrene can set in, requiring amputation of the affected tissue.

Alternative Treatment

Omega-3 fatty acids, found in fish oil, may reduce symptoms in people with primary Raynaud’s, according to one study. High doses of fish oil can increase your risk of bleeding.

Evening primrose oil contains a different type of fatty acid that stops the body from making chemicals that narrow blood vessels. In one study, people with Raynaud’s who took EPO had fewer and less severe attacks compared to those who took placebo. More research is needed, however. People who have a history of seizures should not take EPO. EPO can increase your risk of bleeding.

Inositol hexaniacinate, a form of vitamin B3 or niacin, may reduce frequency of Raynaud’s attacks. In studies, people took high doses of inositol hexaniacinate, which can be dangerous if not monitored by a doctor.

Magnesium opens up blood vessels. Some doctors suggest taking a magnesium supplement, although there are no scientific studies to show it works. Magnesium can interact with a number of medications, including antibiotics, drugs used to treat high blood pressure, and drugs used to treat osteoporosis.

Alpha Lipoic Acid to ease the circulatory issues with Raynaud’s.

Vitamin E enhances blood flow. Vitamin E may potentiate the effect of anticoagulant drugs

Ginkgo (Ginkgo biloba) can open up blood vessels and increase circulation in the fingers. One preliminary study found that people with Raynaud’s who took 160 mg of ginkgo per day had less pain.

Flavonoids are found in a variety of herbs and produce. Vegetable juice and eating a variety of fruits is an option. Flavonoids help dilate blood vessels.










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