Overview
Raynaud’s disease is causes numbness in your finger and toes. The numbness results in response to stress or cold temperatures. When a person is affected with Raynaud’s disease, the blood vessels and small arteries that supply the blood tend to shrink or become narrow. As a result, there will be a limitation in the blood flow in the affected parts of the body, which is called vasospasm.
A person affected with the disease will experience severe pain in the extremities, like the fingers and toes, when the temperature drops. Maurice Raynaud, a French doctor, first identified the condition, and so the name of the disease.
According to NCBI, Raynaud’s disease affects 1% of men and 20% of women. However, the results may vary depending on the selected population. The disease is common in people who live in colder regions. In most cases, Raynaud’s disease will not cause any disablement in movement. However, it can affect the quality of life.
Difference between Raynaud’s disease, Raynaud’s phenomenon and Raynaud’s syndrome
There is no major difference between Raynaud’s phenomenon, syndrome and disease. However, people tend to interchange and use it incorrectly.
Raynaud’s disease
Raynaud’s disease will occur on its own and is not linked with any other health condition or illness. Raynaud’s disease is also called as Raynaud’s syndrome.
Raynaud’s Phenomenon
Raynaud’s phenomenon occurs due to an underlying health condition. It can be caused due to certain medications or lifestyle changes. Raynaud’s phenomenon is also called as secondary Raynaud’s syndrome.
Raynaud’s syndrome
Raynaud’s syndrome can refer to both the primary and secondary Raynaud’s disease.
Types of Raynaud's disease
Types of Raynaud’s disease include
- Primary Raynaud’s disease
- Secondary Raynaud’s disease
Primary Raynaud’s disease is the most common and affects people who do not have any medical health condition or illness.
Secondary Raynaud’s disease is caused when there is an underlying health condition or illness. The occurrence of Raynaud’s disease is less common, and the symptoms can be severe. Other names for secondary Raynaud’s disease include Raynaud’s syndrome or Raynaud’s phenomenon.
The symptoms of secondary Raynaud’s disease usually sets in after 40. Primary Raynaud’s disease symptoms usually appear even before that.
Symptoms of Raynaud's disease
Some of the common symptoms of Raynaud’s disease include
Cold toes and fingers
Parts of the body or the areas of the skin that turn white or pale and then blue. However, the colour change will depend on the skin tone. In some cases, these colour changes can be hard to notice.
- Numbness
- Pricking feeling
- Stinging pain when trying to warm
- Skin ulcers
- Gangrene
The symptoms of Raynaud’s disease can be episodic, which can come and go. An episode can last for about 15 minutes or even more. However, the attacks can be even shorter.
The initial symptoms of Raynaud’s disease can be skin colour change. Initially, the skin looks white and then may turn blue or red. When your skin gets exposed to cold weather, you will feel the attack due to reduced blood flow. When the normal blood flow returns, your toes and fingers may feel throb or warm.
The toes and fingertips are commonly affected as part of Raynaud’s disease. They can also affect the lips, nose and ears. Breastfeeding women can get affected by Raynaud’s phenomenon. Their nipples can be subjected to symptoms like numbing and tingling sensations.
The symptoms of Raynaud’s disease are usually triggered by cold weather or even stress. The symptoms of people affected with primary Raynaud’s disease are mild, whereas people affected with secondary Raynaud’s disease can have severe symptoms like skin ulcers.
Causes of Raynaud's disease
The cause of primary Raynaud’s disease is not known. People living in cold temperatures are mostly affected by primary Raymond’s disease. Blood vessels, especially in the hands and feet, tend to react to cold weather, which can result in the thickening of the blood. Thickening of blood can affect blood flow.
Secondary Raynaud’s disease can be caused due to an underlying health condition. According to research, people affected with connective tissue diseases are commonly diagnosed with Raynaud’s disease, which can reduce the blood flow to your toes and fingers.
Other causes of Raynaud’s disease can be due to certain medications and repetitive motion.
Some of the common underlying health conditions that can cause secondary Raynaud’s disease are
- Pulmonary hypertension
- Lupus
- Hypothyroidism
- Cancer
- Carpal tunnel syndrome
- Buerger’s disease
- Dermatomyositis
- Mixed connective tissue disease
- Rheumatoid arthritis
- Thoracic outlet syndrome
- Vasculitis
- Scleroderma
- CREST syndrome
- Sjögren’s syndrome
- Peripheral artery disease
Common medications that can cause the Raynaud’s phenomenon are
- Caffeine
- Beta-blockers
- Chemotherapy
- Cocaine
- Epoxy resin
- Nicotine
- Stimulant medication that helps to treat hyperactive disorder/attention-deficit
- Migraine medication that contains ergot amine
- Decongestants that contain pseudoephedrine or phenylephrine
Other causes for Raynaud’s phenomenon include
- Traumatic vasospasm
- Frostbite
Diagnosis of Raynaud’s disease
Raynaud’s disease can be diagnosed with the set of symptoms a person has. The healthcare professional monitors skin colour changes and when the colour change occurs.
Certain physical tests will be required to confirm whether it is primary or secondary Raynaud’s disease.
Nail fold Capillaroscopy is a test that tests the capillaries on your fingernail. A drop of oil will be placed on the base of the skin of the fingernail. The nail fold will be observed under a microscope. If the capillaries look abnormal or enlarged, it indicates that a person has tissue disease and is affected with secondary Raynaud’s disease.
Other commonly used tests are
- Antinuclear antibody test to check for autoimmune disease.
- Complete blood count to check for various conditions.
- Erythrocyte sedimentation test— a blood test that indicates inflammation in the body. It also helps to diagnose rheumatoid arthritis and autoimmune diseases.
- Urinalysis that checks for the abnormality.
Treatment for Raynaud's disease
The treatment for Raynaud’s disease will depend on the type. For primary Raynaud’s disease, protection against cold weather will treat the disease. Dressing according to the weather can protect against these episodes. Wearing gloves for hands and legs can help with the symptoms.
There are medications available to treat Raynaud’s disease. Some of the commonly used ones are
Calcium channel blockers and Vasodilators
Calcium channel blockers help to relax and open small blood vessels that are narrowed in the feet and hands. Additionally, these drugs can also help treat and heal sores in the fingers and toes. Some of the commonly used are nifedipine, felodipine and isradipine. Vasodilators are also used to relax the blood vessels.
Nerve surgery: Sympathectomy
Invasive surgery might be required for people with severe Raynaud’s disease.
The sympathetic nerves control the vasoconstriction that causes Raynaud’s disease. A healthcare professional will make a small incision and strip the nerves from the blood vessels. This will reduce the frequency and severity of the attacks. However, the success rate of the surgery is still not clear.
Chemical injections
Chemical injections can help block the sympathetic nerve fibres that cause vasoconstriction. Local anaesthesia can work well for people. However, the effect will go off in a few days, and treatment needs to be repeated.
Risk factors for Raynaud's disease
Some of the common conditions that can increase the risk factor are
- Autoimmune disease
- Connective tissue disease
- Smoking
- Alcohol consumption
- Chemical exposure
- Trauma
- Injury
- Certain medications can also trigger an attack.
Complications of Raynaud's disease
Raynaud’s disease is usually treatable, and if they are left untreated, it can lead to life-threatening complications.
Raynaud’s disease can cause complications that can affect blood circulation and flow. It can also cause complications related to the skin. It can make the skin itchy, swollen and red. Additionally, it can also make you feel burning hot and tender in the affected skin.
If the blood flow is affected, and if it is left untreated for a long time, it can lead to deformity.
If the oxygen supply is completely cut off from a particular part of the skin, it can cause skin ulcers and gangrenous tissues start to develop. In severe cases, severe amputation may be required.
Prevention of Raynaud's disease
You cannot prevent Raynaud’s disease. However, you can prevent attacks and triggers. Try to identify the activities that can trigger an episode.
If you have any symptoms or side effects due to taking any medication, consult your doctor. Regular health check-ups can help prevent the disease. Certain lifestyle changes can also help prevent the disease.
The symptoms can be on and off for people affected with primary Raynaud’s disease. The condition is not life-threatening and can be treated.
The treatment will depend on the underlying health condition or the disease for people affected with secondary Raynaud's disease.
Living with Raynaud’s
People affected by Raynaud’s disease can take certain measures to avoid triggers, which can improve their quality of life.
- Keep your house warm and wear gloves on your hands and socks on your feet to avoid triggers.
- Avoid touching cold metals or cold water. This can also trigger Raynaud’s disease.
- Limit the use of tools like jackhammers that vibrate.
- Avoid air conditioners and limit or avoid cold spaces.
- Try to avoid emotional stress. Stress can also trigger an episode.
- Physical activity and exercise can keep a person healthy and reduce stress.
- Try to avoid medication that can trigger an episode.
- Avoid smoking.
- Limit alcohol consumption and caffeine intake.
If the sores develop, consult your doctor.
What triggers Raynaud’s disease?
The symptoms of Raynaud’s disease can worsen due to the following.
- Cold weather, air-conditioned rooms or cold spaces.
- Anxiety, stress or over-excitement.
- Consuming cold drinks.
- Sweats that can cool your skin.
When to consult a doctor?
Consult your doctor if you have symptoms like
- Sores or ulcers that do not heal on your fingers and toes.
- When you notice a new sore.
- When the symptoms are worsening or getting worse.
- If you experience new side effects from any medication.
Conclusion
Raynaud’s disease or syndrome or phenomenon is a common condition that can affect the quality of life. The way to treat the disease is to manage the symptoms.
Avoid cold attacks and stress that can trigger an attack or episode. If you think your symptoms are worsening or if a certain medication causes the symptoms to worsen, consult your doctor immediately.
