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Raynaud's Phenomenon

What is Raynaud’s phenomenon?

Raynaud's phenomenon is a condition resulting from clamping down (spasm) of the arteries, usually those in the fingers and toes. Raynaud's phenomenon frequently occurs when it is cold or when a person is in emotional distress. Hands and feet have fewer large blood vessels and when these arteries spasm, it is harder for the blood to keep flowing. Fingers and toes turn white then blue and then red. The skin of the fingers and toes feel cold because the blood that is needed to keep them warm cannot reach them. Attacks may last from minutes to hours, but they rarely cause permanent tissue damage.

Raynaud's phenomenon is named after the French doctor Maurice Raynaud, who first described the condition in the mid-1800s. Raynaud’s phenomenon is called primary Raynaud’s when there is no known associated disease and secondary Raynaud’s if it is associated with a connective tissue disease or inflammation of the blood vessels.

FAQs

What are the risk factors for Raynaud’s phenomenon?

Raynaud’s phenomenon that is not associated with any other disease (also called primary RP) often starts between the ages of 15 and 30 years old. It is more common in women and it can occur in multiple members of the same family. RP that is associated with inflammatory arthritis or a connective tissue disease can occur at older ages.

Primary Raynaud's, where there is no known associated disease, is the most common form.

Secondary Raynaud’s is associated with diseases that affect the blood vessels, including a number of different types of arthritis such as rheumatoid arthritis (RA), scleroderma, lupus or Sjogren’s syndrome. It can also follow repeated trauma to an area, particularly vibrations such as using a jack hammer repeatedly. Smoking may be a risk factor as well.

What are the warning signs of Raynaud’s phenomenon?

If you notice that your fingers or toes (or rarely nose or ears) become white when you are cold or emotionally upset, you probably have Raynaud's. It is common in those who suffer from one of several types of arthritis but it also occurs in people who have not been diagnosed with any form of arthritis.

In some people with secondary Raynaud’s (especially those with scleroderma), painful sores (ulcers) appear on the tips of the fingers or toes when blood flow is permanently reduced.

How is Raynaud’s phenomenon diagnosed?

Your doctor may be able to diagnose Raynaud's based on a review of your medical history (white fingers and toes) and by observing the effect of cold on your fingers and toes. Sometimes your doctor may order certain tests, such as blood flow tests, to help confirm the diagnosis.

How common is Raynaud’s phenomenon?

Overall, Raynaud’s phenomenon occurs in 5-20% of females and 4-14% of males in the general population.

  • Primary Raynaud’s occurs in 3% of the population
  • Secondary Raynaud’s is less common, but occurs at relatively high levels in people with lupus (25%), Sjogren’s syndrome (33%) and nearly everyone with scleroderma
Treatment

Medication

Most people with Raynaud’s will not need treatment. They should stay warm (use proper mittens, wear a hat, avoid cold and dampness of their hands and feet). If they smoke, they should discontinue smoking as it make the symptoms worse.

Medications that open the blood vessels (called vasodilators) are sometimes used to improve the circulation. Some people with secondary Raynaud’s may need other types of medication.

Treatment varies from person to person, so speak with your doctor and/or pharmacist about what kind of medications are most appropriate for you.

Surgery

Only rarely do people with Raynaud’s phenomenon need surgery.

Self-management

Although there is no cure for Raynaud's phenomenon there are things you can do to help manage the condition. Your active involvement in developing your prescribed treatment plan is essential.

Protect your body

Protect your body, especially your hands, feet and head, by wearing gloves and warm socks and a hat in cold weather. If reaching into the freezer for food triggers Raynaud's phenomenon try wearing gloves or oven mitts during this activity.

If you smoke, stop smoking. Smoking triggers vasospasms in your whole body and will worsen the symptoms of Raynaud's phenomenon.

Avoid drinks that contain caffeine (coffee, tea, colas) as caffeine can make your symptoms worse.

Relaxation

When you are emotionally upset, your nervous system triggers the clamping down of your blood vessels, which blocks your blood flow. Developing good relaxation and coping skills can give you a greater feeling of control and a more positive outlook.

What Now

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Contributors

This information was last updated September 2017, with expert advice from:

Sindhu Johnson, MD FRCPC PhD
Assistant Professor, Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Toronto
Director, Toronto Scleroderma Program, University Health Network

Janet Pope, MD, MPH, FRCPC
Chief, Department of Rheumatology, St. Joseph’s Health Care London
Professor of Medicine, University of Western Ontario

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