Raynaud's Disease
What is Raynaud's Disease?
Raynaud’s disease is a rare disorder that affects the peripheral blood vessels located in the fingers or toes. The disease is characterized by excessive constriction of blood vessels in the fingers, impairing blood flow which causes discomfort and discoloration for a brief duration during the episode.
Individuals afflicted with the disorder fall into one of two categories: primary or secondary. Those with primary Raynaud’s disease have a mutation in their genes, whereas those with secondary Raynaud’s have an underlying condition that makes them predisposed to constriction of the blood vessels (vasoconstriction). Raynaud’s disease is the proper name for primary Raynaud’s whereas Raynaud’s phenomenon is secondary Raynaud’s. Distinguishing between these two types is important to determine the course of treatment for a patient.
Raynaud’s disease is a rare disorder that affects the peripheral blood vessels located in the fingers or toes. The disease is characterized by excessive constriction of blood vessels in the fingers, impairing blood flow which causes discomfort and discoloration for a brief duration during the episode.
Individuals afflicted with the disorder fall into one of two categories: primary or secondary. Those with primary Raynaud’s disease have a mutation in their genes, whereas those with secondary Raynaud’s have an underlying condition that makes them predisposed to constriction of the blood vessels (vasoconstriction). Raynaud’s disease is the proper name for primary Raynaud’s whereas Raynaud’s phenomenon is secondary Raynaud’s. Distinguishing between these two types is important to determine the course of treatment for a patient.
Primary Raynaud’s disease is more common than secondary Raynaud’s disease and occurs in 3-5% of the adult population, with women presenting with the disease slightly more than men. Primary Raynaud’s begins in the affected individual’s late teens or early twenties, whereas secondary Raynaud’s usually starts after the age of 30.
Normally, when a person is exposed to either warm or cold stimuli, the natural bodily response is for blood vessels near the surface of the skin to widen (in the former case) to allow more blood to flow and cool off or to constrict (in the latter case) to keep blood near the body’s vital organs. This intricate bodily response is governed by the interaction between the nervous system and muscle cells in the walls of the blood vessels.
In Raynaud’s disease, there is an excessive constriction and abnormal spasms of the blood vessels in response to cold stimuli or even to stress. In primary Raynaud’s disease, there may be a genetic component that makes certain people predisposed to inheriting the disease, however, those genes or gene has not yet been identified. In secondary Raynaud’s disease, there is typically an underlying autoimmune disorder such as Lupus, Scleroderma, or Rheumatoid arthritis. It can also be associated with thyroid disorders or certain cancers.
Raynaud’s disease targets the fingers, but ears, nose, nipples, knees or toes can also be afflicted. The constriction of blood vessels in the fingers reduces circulation, causing discomfort, numbness and a pins and needles sensation. Skin discoloration can also occur, where the fingers turn blue or white from the lack of blood circulation. Raynaud’s disease is episodic, meaning the excessive constriction lasts for about 15 minutes after exposure to the stimuli. In severe cases of Raynaud’s, sores on the pads of the fingers or cellular tissue death can occur.
A correct diagnosis can only be made by a medical professional. A cold test stimulation may be performed by a medical professional to trigger Raynaud’s symptoms. A device to measure temperature is taped to the individual’s finger. If it takes longer than 20 minutes for the individual’s finger to return to normal temperature after a brief exposure to ice water, the individual may have Raynaud’s.
A nailfold capillaroscopy can also be performed to differentiate primary Raynaud’s from secondary. A physician will examine the tiny blood vessels at the base of the individual’s fingernails. If a normal pattern exists, the individual has primary Raynaud’s; if there are abnormal patterns in the tiny blood vessels, the patient has secondary Raynaud’s. Blood tests, such as antinuclear antibody and C-reactive protein are also used to help diagnosis Raynaud’s disease.
There is no specific treatment for Raynaud’s, but lifestyle changes and medicines can reduce the severity of the episodes. Avoiding triggers such as cold temperatures, stressors, smoking cigarettes, and vibrations can reduce the number of episodes. Medicines, in a class called vasodilators or calcium channel blockers, can help open up the blood vessels, reducing the intensity of the episode.
Prognosis of primary Raynaud’s disease is very favorable, with no mortality. The prognosis for secondary Raynaud’s disease is dependent on the underlying cause.
Individuals with Raynaud’s can cope by making lifestyle adjustments. This includes protecting oneself from cold temperatures, using mittens and hand warmers, and avoiding air-conditioned spaces. Raynaud’s patients should avoid or learn to cope with stress that may trigger a flare-up. They should try to lead a healthy lifestyle and avoid smoking.
Sources
https://www.nhlbi.nih.gov/health-topics/raynauds
https://www.raynauds.org/wp-content/uploads/2018/04/Raynauds-Guide-PDF-V3C.pdf
https://www.rheumatology.org/Portals/0/Files/Raynauds-Phenomenon-Fact-Sheet.pdf
https://ghr.nlm.nih.gov/condition/raynaud-phenomenon
https://www.sciencedirect.com/science/article/pii/S2255502114001904
Last updated 9 Oct 2014, 11:12 PM
9 Oct 2014, 11:12 PM
Hi Larry I take Nifedipine which really makes a difference to my Raynauds. I was on it a good 6 months though before it really kicked in. Never tried massage for this though and not sure if chiropractor can help sorry. Katrina
8 Oct 2014, 02:15 AM
I want to report that 6 massage sessions over a period of 6 weeks did not help my Raynauds one bit. The therapist massaged areas of my upper body that she said might help with the circulation in my hands. I am reluctant to try chiropractic because of this. Larry
17 Jul 2014, 01:53 AM
Larry, Do you have stiffness with your Raynauds? You may want to talk with a neurologist for other related diseases like myotonia congenita, paramyotonia congenita, etc. I have Raynauds and paramyotonia congenita. Massage therapy and chiropractors didn't work. You need to try to stay warm. The easiest way to stay warm is heat your body core - drink warm fluids, wear gloves/scarf/hat. I take diltiazem (cardizem) which eases my Raynauds symptoms - it is always a higher dose in the winter time. I hope this helps.
Last updated 16 Apr 2014, 04:50 AM
16 Apr 2014, 04:50 AM
I have redness around the nails. As I understand it, the redness is caused by unusually shaped blood vessels which have shown a correlation to pulmonary hypertension.
26 Feb 2014, 09:22 PM
Does anyone have just one finger that seems to get cold first and last longer than the others. Are you noticing redness around the nails? Just curious.
Last updated 13 Mar 2014, 06:36 AM
13 Mar 2014, 06:36 AM
I have Raynauds & Livedo Reticularis and was diagnosed with Sneddons after 3 strokes from the age of 33.
Last updated 2 Nov 2010, 12:05 AM
2 Nov 2010, 12:05 AM
After having ulcerated fingertips last year my consultant has recommended iloprost infusions this winter. Has anybody had any success with this?
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Massage therapy/ Chiropractor??
Created by Larry | Last updated 9 Oct 2014, 11:12 PM
Cold Fingers
Created by Tessa | Last updated 16 Apr 2014, 04:50 AM
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Created by tash | Last updated 13 Mar 2014, 06:36 AM
Iloprost infusions
Created by Kat201 | Last updated 2 Nov 2010, 12:05 AM
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