Raynaud’s Phenomenon
Raynaud’s phenomenon
Wondered why your fingers and toes are getting cold in winter? Painful?
Its may be Raynaud’s disease
Reynaud’s disease was described by Maurice Raynaud in 1862
What is Raynaud’s disease, it is a condition in which blood vessels and capillaries become narrow and constricted especially in extremities. Tip of nose and ears also may be included.
This condition may result due to temperature (cold) or stress conditions leading to decrease in blood supply to respective regions.
Raynaud’s disease is most likely to be in women more than men.
Symptoms:
In cold temperature finger’s blood vessels and capillaries constricted and fingers become white or pale colored (vasospastic condition).
Then they turn blue due to rapid utilization of oxygen in blood vessels and finally turn into bright red due to re-dilation of narrowed vessels again.
The last case usually accompanied by numbness, tingling and pain.
It is rare to show all symptoms at once, and usually it is mild but in some cases severe conditions may be developed.
Causes:
Raynaud’s disease mat be one of two types,
* Primary Raynaud’s
* Secondary Raynaud’s
Primary Raynaud’s NOT associated with other medical condition or disorder, so usually defined as Raynaud’s disease and it is the most common.
Secondary Raynaud’s it is caused by associated disorder although it is rare but it is serious. For examples;
Scleroderma: type of connective tissue disease causing scarring and hardening of skin and my result in 2ndry Raynaud’s disease.
Lupus: auto-immune disease affects many parts of the body as joints ,skin and other organs.
Rheumatoid arthritis: Raynaud’s disease may be a sign for Rheumatoid arthritis which is an inflammatory condition characterized by pain and stiffness in joints.
Diseases of the arteries.
Carpal tunnel syndrome: a condition in which pressure is put on this nerve, producing numbness and pain in the affected hand.
Repetitive trauma: due to repetitive damage of nerves and blood vessels.
Diagnosis:
Most doctors easily diagnose Raynaud’s syndrome when you tell them about most common signs and symptoms.
The most easiest test is exposure to cold by placing your hand into cold water or cold air stream and then evaluating symptoms this is called “Cold simulate test”.
nail fold capillaroscopy is a test used to distinguish between primary and secondary Raynaud’s disease.
During this test doctors examine nail folds and skin at the nail base under the microscope as blood vessels and capillaries at this area may give indication about the underlying cause of the disease but not all of the underlying causes can be detected with this method.
Others tests like ;
Antinuclear antibodies (ANA) test : used to detect AB for many auto-immune diseases.
Erythrocyte sedimentation rate (ESR): determines the rate at which red blood cells settle to the bottom of a tube in the space of an hour. A faster than normal rate may signal an underlying inflammatory or autoimmune disease.
Treatment:
Depending on the type of Raynaud’s, treatment is applied.
Self care is the best and the easiest available option for treatment of mild condition , the basic idea for treating mild symptoms is to avoid triggers and cold exposure as much as you can,
Medical treatment also available and many drugs used in treating Raynaud’s and many others drugs may treat and act as adjuvant in treating the underlying cause of moderate to severe symptoms.
Ex;
Calcium channel blockers: act as avaso dilator for small blood vessels in hands and feet.
Alpha-blockers: counteract the vasoconstrictor action of nor-epinephrine and avoid its vasospastic action on blood vessels.
Vasodilators : many doctors may describe vasodilator as nitroglycerin cream which is applied onto the skin .
Depending on your medical history or condition, doctors may describe one or more from the previous types of drugs.
Remember : Doctor only the person who can describe drugs for you !!
And never use a drug without reviewing your doctor to get ride from many side effects.
Surgery may be involved in treating Raynaud’s disease as ‘Nerve surgery’ Sometimes it’s necessary in cases of severe Raynaud’s to cut these nerves to interrupt their exaggerated response.
Chemical injection: chemicals may be injected to block the nerves action on tiny blood vessels in affected hands and feet…anyway it may be repeated regularly if symptoms repeated.
Amputation: this is a rare case … only used when the blood supply to certain finger or toe is completely blocked to avoid gangrene
Raynaud’s attacks prevention:
To avoid repeated attacks this is may help you,
* Dress warmly outdoors.
* Take precautions indoors(as wearing cloves).
* Consider moving to a locati0n with a milder climate.
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