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Raynaud’s phenomenon: Causes, Symptoms, Risk Factors, And Treatment

Raynaud’s phenomenon or Raynaud’s disease is referred to a decrease in the blood flow to certain parts of the body. It is seen in the extremities of the fingers and toes. It is a short-term interruption of blood flow, which may even be a sign of an underlying autoimmune disease, such as lupus or scleroderma.

Raynauds PhenomenonWhat is Raynaud’s Phenomenon?

Raynaud’s phenomenon, a.k.a: Raynaud’s syndrome is a condition where the blood vessels in the fingers, toes, ears, and nose become narrowed.  The blood vessels constrict and starve the tissues with low blood supply, which causes a change in skin color either to blue or white.

Raynaud’s phenomenon can be classified into two types:

Primary Raynaud’s phenomenon: It is the most common type of Raynaud’s disease, which is not associated with any underlying medical condition. Primary Raynaud’s is usually very mild and does not require any treatment.

Secondary Raynaud’s phenomenon: This form of Raynaud’s disease occurs due to an underlying medical condition, injuries and due to certain medications. Secondary Raynaud’s phenomenon occurs less commonly when compared to primary Raynaud’s disease.

causes of Raynaud’s phenomenon:

Until today, the doctor cannot completely understand the cause of the condition. However, it is known that Raynaud’s occurs when the extremities of hands and feet are exposed to unusually cold temperatures. Extreme cold temperature is the most common cause to trigger the Raynaud’s attack. Also, people living with emotional stress can experience an episode of the condition. The most common causes of secondary Raynaud’s include:

Diseases of the arteries: Certain problems in arteries, such as primary pulmonary hypertension (a type of hypertension that affects that affects the arteries in the lungs), Buerger’s disease (inflammation of blood vessels of hands and feet), atherosclerosis (formation of plaques in the blood vessels that carry blood to the heart) may compromise the blood circulation.

Carpal tunnel syndrome: The condition causes pressure in the major nerve that carries blood to the hand, thereby producing pain and numbness in the hand. This makes the hand highly susceptible to cold temperatures.

Connective tissue disorders: Certain diseases, such as rheumatoid arthritis, scleroderma, lupus, and Sjögren’s syndrome can cause Raynaud’s phenomenon.

Smoking: Smoking can constrict the blood vessels, thereby causing reduced blood supply.

Injuries: Certain injuries to hands or feet, such as frostbite, wrist fracture or surgery can cause Raynaud’s phenomenon.

Medications: Intake of certain medications used to treat high blood pressure, migraines, attention deficit disorders, drugs used in chemotherapy and the drugs that cause narrowing of the blood vessels can lead to a Raynaud’s attack.

Repetitive action: Certain activities, such as playing piano, typing or operating vibrating tools for a long time can cause Raynaud’s phenomenon.

Symptoms:

The signs and symptoms of Raynaud’s phenomenon include:

  • Changes in the skin color in response to cold
  • Numbness or tingling in the fingers or toes
  • Stinging pain or prickly feeling after warming up of fingers and toes
  • Swollen and painful hands when warmed up
  • Gangrene in the fingers (occurs rarely)

Risk Factors:

The factors that increase the risk of developing Raynaud’s phenomenon include:

Age: Although Raynaud’s disease can occur in anyone, individuals between the age group of 15 and 30 are at high risk of developing the risk of Raynaud’s disease.

Gender: Women are at a greater risk of developing the condition when compared to men.

Family history: People with a close family history (a parent, sibling, or a child) of Raynaud’s syndrome are at a greater risk of acquiring the condition.

Environmental conditions: Individuals who live in colder climatic conditions are at high risk of developing Raynaud’s disease.

Exposure to chemicals: Excessive exposure to certain chemicals, such as vinyl chloride and smoking can increase the risk of secondary Raynaud’s disease.

Diagnosis:

To diagnose Raynaud’s disease, the doctor performs a physical examination and reviews the present as well as past medical history of the patient. Also, the doctor would recommend the following tests to diagnose the condition:

Capillaroscopy: During this test, the doctor performs a microscopic examination of the skin at the nail folds of the fingernails to determine the deformities of the blood vessels. Also, this test helps to distinguish between primary and secondary Raynaud’s disease.

If the doctor suspects that an underlying condition is causing Raynaud’s disease, he would recommend the following blood tests:

Antinuclear antibody test (ANT):  A sample of blood is collected and tested for the presence of antibodies. A positive antinuclear antibody test denotes that there is a presence of an autoimmune disorder or connective tissue disorder.

Erythrocyte sedimentation rate (ESR): A sample of blood is used to assess the rate of sedimentation. The test helps to identify the presence of any inflammatory or autoimmune disease.

Treatment of Raynaud’s phenomenon:

The treatment aims to reduce the number of Raynaud’s attacks, prevent tissue damage, and resolve the underlying condition. Treating mild symptoms of Raynaud’s can be achieved by wearing gloves and socks. The treatment options include:

Medications: The doctor prescribes calcium channel blockers (amlodipine and nifedipine) to reduce the frequency and severity of Raynaud’s attack. Also, these drugs help to heal the skin ulcers developed on fingers and toes.

Onabotulinum toxin type A injection: The doctor injects Onabotulinum toxin type A injection to block the sympathetic nerves in hands or legs.

Surgery: In severe cases of Raynaud’s phenomenon, the doctor performs a surgery to interrupt the exaggerated responses of sympathetic nerves in the hands and feet.

Prevention:

The following measures help to prevent the risk of developing Raynaud’s phenomenon:

  • Wear gloves, socks, and scarves while living in cold temperatures.
  • Take extra precautions while traveling to cold places, especially during winters.
  • Wear a warm coat to keep the body temperature warm.
  • Take necessary precautions while exposed to harmful chemicals.
  • Exercise regularly to promote proper blood flow throughout the body.

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