Raynaud’s disease affects the blood vessels, particularly the small arteries in the extremities, such as fingers and toes. It is characterised by episodes of vasospasm, where the blood vessels constrict, leading to reduced blood flow to the affected areas. This can result in colour changes in the skin, usually causing the fingers or toes to turn white, then blue and finally red when blood flow returns.
Patients have difficulty holding objects and describe a throbbing sensation as their fingers and or toes return to normal. Sometimes returning to normal may be in patches where parts of the fingers or toes are white and others look normal.
What causes Raynaud’s disease?
The exact cause of Raynaud’s disease is unknown but it is believed to involve an exaggerated response of the blood vessels to cold temperatures or emotional stress. It can occur on its own, known as primary Raynaud’s disease, or as a secondary condition, known as secondary Raynaud’s disease or Raynaud’s Syndrome, linked with other underlying medical conditions such as autoimmune diseases (eg, lupus, scleroderma as part of CREST syndrome), vascular diseases or with some medications.
Treatment for Raynaud’s disease aims to reduce the frequency and severity of attacks, relieve symptoms and prevent complications. Patients may go long periods without flare ups.
What are some common treatments?
Common approaches include:
- Lifestyle modifications: Avoiding triggers such as cold temperatures and stress is important. Keep the body warm by wearing layered clothing. Hand warmers or heated gloves may be useful and avoiding exposure to cold water can all help.
- Medications: Medications may help improve blood flow and reduce vasospasm. Examples include calcium channel blockers (eg, Nifedipine), oral vasodilators (eg, Pentoxyfilline and Sildenafil aka Viagra), intravenous prostaglandins (eg, Iloprost) and alpha-blockers.
- Biofeedback: This technique helps individuals learn to control their body temperature and blood flow by providing real-time feedback. It can be useful for some people with Raynaud’s disease.
- Avoiding vasoconstrictive substances: Certain substances, such as nicotine in tobacco, can worsen symptoms. Avoiding smoking and exposure to secondhand smoke is beneficial.
- Stress management: Learning how to reduce stress, such as relaxation exercises and meditation, may help prevent or minimise attacks that result from stress.
- Surgery: In severe cases or when complications such as ulcer and gangrene arise, surgical intervention may be considered. Sympathetic nerve surgery aims to disrupt the nerve signals that trigger vasospasm. They may be benefit those with severe secondary Raynaud’s Syndrome.
It is important to consult a medical professional for an accurate diagnosis. They will describe the most appropriate treatment plan based on individual circumstances.