Raynaud Disease and Phenomenon

Definition

Raynaud phenomenon is a problem with the blood vessels. It leads to blood flow problems in the fingers, ears, nose, and lips. It may be:

• Primary—not linked to another health problem (common form)
• Secondary—linked to another health problem, such as systemic sclerosis, joint disease, blood disorder, or blocked arteries

Causes

Blood vessels narrow when a person is cold or under stress. In Raynaud, the blood vessels narrow too much. This leads to poor blood flow to nearby tissue. Fingers are often affected.

The exact cause of primary Raynaud is not known. Secondary Raynaud is caused by the linked disease.

Risk Factors

This problem is more common in women. Other things that may raise the risk are:

• Repeated activity or stress to the hands, such as:
  • Typing
  • Playing piano
  • Using vibrating tools, as in construction
  • Exposure to certain chemicals
• Connective tissue disease, such as scleroderma
• Diseases of the arteries, such as atherosclerosis
• Injury of the hands or feet, such as wrist fractures or frostbite
• Smoking
• Some medicines, such as:
  • Beta-blockers
  • Cancer chemotherapy
  • Cold medicine
  • Migraine medicine that has ergotamine
  • Medicines that have estrogen in them

Symptoms

Symptoms appear in attacks. They are most common in cold weather and when a person is under stress. Problems may last a few minutes to a few hours.

During an attack, a person may have:

• A change in skin color to white, then to blue when blood flow is slowed
• Skin color changes to red once blood is flowing again
• Throbbing and tingling, stinging, pain, and swelling of the area when blood flow returns

Constriction of Blood Vessels.

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Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis. Other tests may be done to look for a cause.

Treatment

There is no cure. The goal of treatment is to lower the number of attacks and decrease how severe they are. Treating any related health problem will help manage secondary Raynaud.

Options are:

• Identifying triggers and taking steps to avoid them
• Avoiding or quitting smoking
• Working out regularly
• Taking medicine to help blood flow, such as:
  • Calcium channel blockers
  • Alpha-blockers
  • Vasodilators

Nerves control the size of blood vessels. Procedures to destroy or stop the nerves may be needed if other steps have not worked. The nerves may be stopped with:

• A chemical injection that stops the nerves from working
• Surgery to cut the nerves—this is rare

Prevention

There are no known guidelines to prevent this health problem.