Raynaud's phenomenon is a condition resulting from poor circulation in the extremities (i.e., fingers and toes). In a person with Raynaud's phenomenon, when his or her skin is exposed to cold or the person becomes emotionally upset, the blood vessels under the skin tighten and the blood flow slows. This is called vasospasm. Hands and feet have fewer large blood vessels and, therefore, when a vasospasm occurs, it is harder for the blood to keep flowing and these areas may turn blue because less oxygen is reaching the skin. The skin will also feel cold because less blood is reaching the skin to keep it warm. While attacks of vasospasm may last from minutes to hours, only rarely do they cause severe tissue damage.

Raynaud's phenomenon is named after the French doctor Maurice Raynaud, who first described the condition in the mid-1800s. The condition is also known as Raynaud's syndrome or Raynaud's disease.

If you notice that your fingers, feet, nose or ears become blue when you are cold or emotionally upset, you probably have Raynaud's phenomenon. It is common in those who suffer from scleroderma or Sjogren's syndrome, but it also occurs in those who have not been diagnosed with any form or arthritis. In some cases, especially in people with scleroderma, small, painful sores may appear on the tips of the fingers or toes.

If the condition progresses the blood flow to the area can become permanently decreased. If this happens in your hands, your fingers can become thin and tapered and have smooth shiny skin and slow growing nails.

Establishing the correct diagnosis is important, because something can be done to manage most forms of arthritis, and most therapies work best when started early in the disease.
 
Your doctor may be able to diagnose Raynaud's phenomenon based on a review of your medical history and by observing the effect of cold on areas such as your fingers. Sometimes your doctor may order certain tests, such as blood flow tests, to help confirm the diagnosis or to distinguish among different diseases.

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. 

Medicine

If you have Raynaud's phenomenon your doctor may prescribe medications such as nifedipine, dilatiazem or nitroglycerine. These help relax the walls of the blood vessels.

Protect Your Body

By wearing gloves and warm socks in cold weather, your skin is protected from cold air, which reduces the risk of vasospasm. 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.

Relaxation

By not allowing yourself to get emotionally upset, your nervous system does not trigger vasospasms and your blood circulation remains normal. Developing good relaxation and coping skills can give you a greater feeling of control over your arthritis and a more positive outlook.

The Cochrane Musculoskeletal Review Group (CMSG) is a specialized group of researchers and consumer representatives that belong to the Cochrane Collaboration, an international not-for-profit organization that encourages informed decisions about health care by preparing, maintaining and promoting reviews of the effects of various health care treatments.

CMSG members review the best available literature to determine the best evidence to support specific arthritis treatments. They explore the evidence for and against the effectiveness and appropriateness of treatments (medications, surgery, education, etc) in specific circumstances. The results are medical reviews that are then included in The Cochrane Library and made available to health professionals around the world.

For members of the public who also want to be informed about the evidence concerning health care practices and decisions in their lives, the Cochrane Musculosketal Review Group have summarized their reviews into consumer fact sheets. For the Cochrane consumer reviews related to Raynaud's phenomenon, visit www.arthritis.ca/cochrane.

Along with the physical symptoms of arthritis, many people experience feelings of helplessness and depression. Learning daily living strategies to manage your arthritis gives you a greater feeling of control and a more positive outlook. To get the best results, people affected by arthritis need to form close ties with their doctors and therapists, and become full partners in their treatment. From our perspective, it's all part of 'living well with arthritis.' There are several resources you can use in finding out how best to manage your own arthritis. Here are a few:

• The Arthritis Self-Management Program (ASMP) is a unique self-help program offered by The Arthritis Society to help you better control and manage your arthritis.
• The Open Forum within this Web site is an opportunity to discuss and share information with other visitors - people who, through their own experiences, may be able to offer some useful insights.

Of course, there are many other valuable resources for people with arthritis. If you're unclear about where to look for help, be sure to call The Arthritis Society at 1-800-321-1433.