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by Badash M

Definition

Raynaud phenomenon is a problem with the blood vessels. It leads to blood flow problems in the fingers ears, nose, and lips. Raynaud may be:

  • Primary—most common form. It is not linked to another medical issue.
  • Secondary—linked to another health problem such as systemic scleroris, joint disease, blood disorder, or blocked arteries.

Causes

Blood vessels narrow with cold temperatures or emotional stress. In Raynaud, the blood vessels narrow too much. It leads to poor blood flow to nearby tissue. Fingers are often affected.

It is not clear what causes Primary Raynaud. It may be caused by a problem of the nervous system. Secondary Raynaud is caused by the linked disease.

Risk Factors

Raynaud is more common in woman. It tends to first show between 15 to 40 years of age. The chance of Raynaud may increase with one or more of the following:

  • Repeated activity or stress to hands such as:
    • Typing
    • Playing piano
    • Regular operation of vibrating tools, as in construction
    • Exposure to certain chemicals
  • Connective tissue disease, such as scleroderma
  • Diseases of the arteries, including atherosclerosis
  • Injury of the hands or feet, such as wrist fractures or frostbite
  • Smoking
  • Some medicine, such as:
    • Beta-blockers
    • Cancer chemotherapy
    • Cold remedies
    • Migraine medicine that has ergotamine
    • Estrogen-containing medicine

Symptoms

Symptoms appear in attacks. They may last a few minutes to a few hours. During an attack, symptoms may include:

  • Change in skin color to white then to blue—as blood flow is slowed
  • Skin color change to red once blood is flowing again
  • Throbbing and tingling sensations, stinging, pain, and swelling of the area—at the end of the attack as blood flow returns

Symptoms are more likley with cold temperature or stress.

Constriction of Blood Vessels
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Copyright © Nucleus Medical Media, Inc.

Diagnosis

The doctor will ask about symptoms and health past. A physical exam will be done. The doctor may suspect Raynaud based on the symptoms. Symptoms may not be present at an appointment. A cold stimulation test may be done to start an attack. It will let the doctor see symptoms. Other tests may be done to look for a cause.

Treatment

Raynaud cannot be cured. Treatment can help to lower the number of attacks and decrease how severe they are. Treating any related health problem will help to manage secondary Raynaud.

Management of both types of Raynaud may include:

Medicine may help to improve blood flow and ease symptoms. Blood vessel size can be increased with:

  • Calcium channel blockers
  • Alpha-blockers
  • Vasodilators

Nerves control the size of blood vessels. Procedures to destroy or stop the nerves may be needed if other steps have not worked. The nerves may be stopped with:

  • Chemical injection—chemical stops nerves from working well.
  • Surgery—nerves are cut. Not a common treatment step.

Prevention

There are no steps to stop Raynaud phenomenon from developing.

RESOURCES

Arthritis Foundation  http://www.arthritis.org 

National Heart, Lung, and Blood Institute  http://www.nhlbi.nih.gov 

CANADIAN RESOURCES

The Arthritis Society  http://www.arthritis.ca 

Heart and Stroke Foundation of Canada  http://www.heartandstroke.com 

References

Herrick AL. Evidence-based management of Raynaud’s phenomenon. Ther Adv Musculoskeletal Dis. 2017;9(12):317-329.

Raynaud phenomenon. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115788/Raynaud-phenomenon  . Updated November 28, 2018. Accessed September 10, 2019.

Raynauds phenomenon. Cedars Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Health-Conditions/Raynauds-Phenomenon.aspx. Accessed September 10, 2019.

Raynaud's phenomenom. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Raynauds%5FPhenomenon/raynauds%5Fphenomenon%5Fff.pdf. Accessed September 10, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 03/2019
  • Update Date: 01/16/2020