What is Raynaud's phenomenon?
Raynaud's phenomenon is a disorder that causes decreased blood flow to the fingers. In some cases, it also causes less blood flow to the ears, toes, nipples, knees, or nose. This happens due to spasms of blood vessels in those areas. The spasms happen in response to cold, stress, or emotional upset.
Raynaud's can occur on its own, known as primary form. Or it may occur with other diseases, known as secondary form. The diseases most often linked with Raynaud's are autoimmune or connective tissue diseases such as:
- Systemic lupus erythematous (lupus)
- CREST syndrome (a form of scleroderma involving calcium skin deposits, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia)
- Buerger's disease
- Sjögren's syndrome
- Rheumatoid arthritis
- Occlusive vascular disease, such as atherosclerosis
- Blood disorders, such as Cryoglobulinemia
- Thyroid disorders
- Pulmonary hypertension
The primary form of Raynaud's is the most common type. It often begins between ages 15 and 25. It's less severe than secondary Raynaud's. People with primary Raynaud's do not often develop a related condition.
What causes Raynaud's phenomenon?
The exact cause of Raynaud's is unknown. It is possible that some blood disorders may cause Raynaud’s by increasing the blood thickness. This may happen due to excess platelets or red blood cells. Or, special receptors in the blood that control the narrowing (constriction) of the blood vessels may be more sensitive.
Who is at risk for Raynaud's phenomenon?
Certain factors can increase a person's risk for developing Raynaud's, such as:
- A connective tissue or autoimmune disease
- Cigarette smoking
- Repetitive actions, such as typing or use of tools that vibrate (like a jack hammer)
- Injury or trauma
- Chemical exposure
- Side effects from certain medications
What are the symptoms of Raynaud's phenomenon?
Symptoms can occur a bit differently in each person. Common symptoms include:
- Fingers that turn pale or white then blue when exposed to cold, or during stress or emotional upset, then red when the hands are warmed
- Hands that may become swollen and painful when warmed
- Sores on the finger pads develop, in severe cases
- Gangrene in the fingers that causes infection or needs amputation (rare)
How is Raynaud's phenomenon diagnosed?
The process starts with a medical history and a physical exam. Your health care provider may give you a cold challenge test. This is done to see the color changes in the hands and fingers. During the test, your hands are exposed to cold. Your health care provider may also look at the tiny blood vessels in your fingernails (nailfold capillaroscopy) with a microscope. Adults who start to have Raynaud's phenomenon after age 35 may be tested for an underlying disease. You may have blood tests to see if your condition is primary or secondary.
How is Raynaud's phenomenon treated?
Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. There is no cure for Raynaud's phenomenon, but it can be managed with proper treatment. Treatment may include:
- Avoiding exposure to cold
- Keeping warm with gloves, socks, scarf, and a hat
- Stopping smoking
- Wearing finger guards over fingers with sores
- Avoiding trauma or vibration to the hand (such as with vibrating tools)
- Taking blood pressure medications during the winter months to help reduce constriction of the blood vessels
Talk with your health care providers about the risks, benefits, and possible side effects of all medications.
What are the complications of Raynaud’s phenomenon?
In rare cases, sores on finger pads may occur. These sores may progress to gangrene. In rare cases, gangrene may lead to finger amputation.
Living with Raynaud’s phenomenon
For most people living with Raynaud’s, it is more of an inconvenience than a serious problem. Avoiding triggers, primarily cold, can reduce the spasms that lead to symptoms. If there is an underlying cause, such as scleroderma or lupus, it may be more difficult to manage attacks. If you have secondary Raynaud’s, work with your health care provider to manage your underlying condition. This may decrease attacks of Raynaud’s.
When should I call my health care provider?
If your symptoms get worse or you have new symptoms, let your health care provider know.
Key points about Raynaud’s phenomenon
- Raynaud's phenomenon is a disorder that causes decreased blood flow to the fingers. In some cases, it also causes less blood flow to the ears, toes, nipples, knees, or nose.
- Spasms of blood vessels happen in response to cold, stress, or emotional upset.
- Secondary causes of Raynaud’s include lupus, scleroderma, and other diseases.
- Symptoms of Raynaud’s include fingers that turn pale or white then blue when exposed to cold, or during stress or emotional upset. They then red when the hands are warmed.
- Managing Raynaud’s includes avoiding cold, dressing warmly, and stopping smoking.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
- Weisbart, Ed, MD
- Ziegler, Olivia Walton, MS, PA-C