October is Raynaud’s Awareness Month and for many people with Raynaud’s (pronounced Ray-NODES) the chilling and uncomfortable truth is - living with it, can be incredibly chilling and uncomfortable.
Five to ten percent of the population live with this blood flow condition that affects the body’s ability to send blood to the extremities. Primarily affecting the hands and feet, it causes the area to become very cold, and can change the color of the hands or feet to white, gray, or blue. The lack of circulation can cause numbness or tingling, and in severe cases, cause ulcers and sores, and (at its worst) lead to gangrene, and partial amputation.
Raynaud’s Disease can occur as a “primary” disease; that is, with no associated disorder. It can also occur as a “secondary” condition (often referred to as Raynaud’s Syndrome or Raynaud’s Phenomenon) related to other diseases, such as scleroderma, rheumatoid arthritis, and lupus.
This blog is intended to shed light on a disease that, over a hundred years after its discovery, is still very mysterious, and has no exact known cause or cure.
History of Raynaud’s Syndrome
Raynaud’s was named after the French physician Maurice Raynaud, who described the condition in 1862 in his doctoral thesis. He characterized a set of symptoms that caused “Intermittent pallor and cyanosis of the extremities” and “Cold-induced vasospastic attacks of the fingers” which in severe cases, could lead to the development of gangrene.
In 1929, Sir Thomas Lewis set out to challenge the enigma behind Maurice Raynaud’s theory - stating it was caused by an over-reactivity of the sympathetic nervous system. Lewis believed that it was not nervous system related, rather, from a “local fault” of the digital artery. Both opinions were considered throughout the early twentieth century until the discovery of cold-induced cutaneous arterial vasoconstriction (narrowing of the blood vessels) which bridged the gap between both theories.
In 1932, the first set of classification criteria to differentiate primary Raynaud’s disease from secondary Raynaud’s phenomenon was published, and since then, rheumatologists, vascular specialists, and internists have been treating patients all over the world with this condition in its primary and secondary forms.
Raynaud’s symptoms can vary from mild to severe. Most individuals experience the following:
Cold fingers and toes
Color changes in the skin (white, gray, blue) in response to cold or stress
Numbness or tingling in the fingers and toes (can be on the ears, nose, and nipples as well)
Redness, stinging or throbbing pain upon warming or stress relief
Sores or ulcers in the tips of fingers and/or toes
Changes in the finger or toe nails
What is a “Raynaud’s Attack?” During an attack of Raynaud's, affected areas of your skin usually first turn white or gray. Then, they often turn blue and feel very cold and numb. As you warm up and your circulation improves, the affected areas may turn red, throb, tingle or swell. It can take approximately fifteen minutes for the blood vessels to release and return proper blood flow to the affected area.
Lupus and Raynaud’s
If you are living with lupus or another autoimmune disease, it can be scary and frustrating to be told that you may also have Raynaud’s. Raynaud’s is a common ‘overlap’ disease associated with lupus and other autoimmune conditions like scleroderma, rheumatoid arthritis, and Sjogren’s Syndrome.
As mentioned above, if you have lupus and develop Raynaud’s, your rheumatologist will be the one overseeing your care. Your doctor may suggest you implement these tips to help prevent the frequency and severity of the symptoms.
Keep the extremities warm, wear mittens or gloves when it is cold outside or when handling cold items
Wear comfortable shoes and wool socks
Avoid medications that cause tightening of the blood vessels
Treatments for Raynaud’s may include:
Calcium channel blockers: These medications help dilate (enlarge) the blood vessels, thereby increasing circulation to the extremities. Examples: nifedipine and diltiazem.
Vasodilators: These medications relax the walls of the blood vessels. Examples: Viagra (sildenafil), cozaar, sarafem.
Alpha Blockers: These medications block the effects of the hormone that constricts the blood vessels, norepinephrine. Examples: of this type of medication are Minipress (prasolin) and Cardura (doxazosin).
Surgical intervention: In very rare cases where the blood flow has been completely blocked, gangrene may be a serious issue. Partial amputation to remove the affected and damaged tissue may be the only option.
Alternative therapies: Acupuncture, biofeedback, and fish oil supplements may help slow down the narrowing of the blood vessels.
If you are considering trying an alternative treatment option, it is imperative that you speak with your doctor first. Only your physician will know of any potential drug interactions or side effects of these alternative therapies.
While Raynaud’s is rarely life threatening, if the symptoms are not addressed, complications can develop. Working together with your physician to find the right treatment plan specific to your needs, is the best course of action. Sometimes Raynaud’s improves or symptoms simply disappear. Every person with Raynaud’s is unique.
For more updated information on Raynaud’s please visit : https://www.raynauds.org/
**All resources provided by this blog are for informational purposes only, not to replace the advice of a medical professional. Kelli encourages you to always contact your medical provider with any specific questions or concerns regarding your illness. All intellectual property and content on this site and in this blog is owned by morethanlupus.com. This includes materials protected by copyright, trademark, or patent laws. Copyright, More Than Lupus 2019.