Raynaud's Phenomenon

What is Raynaud's phenomenon?

Raynaud’s phenomenon is a problem that causes decreased blood flow to the fingers. In some cases, it also causes less blood flow to the ears, toes, nipples, knees, or nose. This happens due to spasms of the small blood vessels in those areas. The spasms often happen in response to cold, stress, or emotional upset.

Raynaud’s phenomenon most often occurs on its own, called primary Raynaud’s phenomenon. It may also occur secondary to an underlying inflammatory condition. The conditions most often associated with secondary Raynaud’s are autoimmune or connective tissue diseases such as:

• Lupus (systemic lupus erythematous)

• Scleroderma

• CREST syndrome (a form of scleroderma)

• Inflammatory Myositis

• Autoimmune Thyroid Disease

Some medications as well as caffeine, tobacco and alcohol use can be associated with Raynaud’s symptoms. Primary Raynaud’s is much more common than secondary forms. It often develops between ages 15 and 25 and is less severe than secondary Raynaud’s phenomenon.

What causes Raynaud's phenomenon?

The exact cause of Raynaud’s is unknown. There are likely multiple contributing factors and different causes between individuals.  In general, small blood vessels and the nerves that control them become hyperactive and cause vasoconstriction, leading to the color changes observed.

Who is at risk for Raynaud's phenomenon?

Certain factors can increase your risk of developing the condition, such as:

• A connective tissue or autoimmune disease

• Chemical exposures including caffeine, tobacco and alcohol

• Injury or trauma

• Repetitive actions, such as typing or use of tools that vibrate like a jack hammer

• Side effects from certain medicines

What are the symptoms of Raynaud's phenomenon?

Symptoms can occur a bit differently in each person. Common symptoms include:

• Fingers that turn pale or white then blue when exposed to cold, or during stress or emotional upset, then red when the hands are warmed

• Hands that may become swollen and painful when warmed

• Sores on the finger pads develop, in severe cases

How is Raynaud's phenomenon diagnosed?

The process starts with a medical history and a physical exam. Your healthcare provider may also look at the tiny blood vessels by your fingernails. You may have blood tests to see if your condition is primary or secondary.

How is Raynaud's phenomenon treated?

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. There is no cure for Raynaud’s phenomenon, but it can be managed with proper treatment. Treatment may include:

• Avoiding exposure to cold

• Keeping warm with gloves, socks, scarf, and a hat

• Stopping smoking

• Getting enough sleep

• Staying well hydrated

• Avoiding trauma or vibrations to the hand (such as with vibrating tools)

• Taking blood pressure medicines during the winter months to help reduce constriction of the blood vessels

• Talk with your healthcare providers about the risks, benefits, and possible side effects of all medicines.

What are the complications of Raynaud’s phenomenon?

In rare cases, sores on finger pads may occur. These sores may progress to gangrene. In rare cases, gangrene may lead to finger amputation.

Living with Raynaud’s phenomenon

For most people living with Raynaud’s is more of an inconvenience than a serious problem. Avoiding triggers, primarily cold exposures, can reduce the spasms that lead to symptoms. If there is an underlying cause, such as scleroderma or lupus, it may be more difficult to manage attacks. If you have secondary Raynaud’s, work with your healthcare provider to manage your underlying condition. This may decrease Raynaud’s symptoms.

When should I call my health care provider?

If your symptoms get worse or you have new symptoms, let your healthcare provider know.

Key points about Raynaud’s phenomenon

• Raynaud’s phenomenon is a disorder that causes decreased blood flow to the fingers. In some cases, it also causes less blood flow to the ears, toes, nipples, knees, or nose.

• Spasms of blood vessels happen in response to cold, stress, or emotional upset.

• Secondary causes of Raynaud’s include lupus, scleroderma, and other diseases.

• Symptoms of Raynaud’s include fingers that turn pale or white then blue when exposed to cold, or during stress or emotional upset. They then red when the hands are warmed.

• The most important intervention in managing Raynaud’s is keeping both your extremities and core warm.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Before your visit, think about your symptoms and write down questions you want answered.

• Bring someone with you to help you ask questions and remember what you discussed. Know why a new medicine or treatment is prescribed, how it will help you and potential side effects.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know how you can contact your provider if you have questions.