What is Raynaud's disease

Raynaud’s disease is a common condition. It affects up to 20% of the adult population worldwide. There may be as many as 10 million people with the condition in the UK.

Raynaud's disease causes some areas of your body such as your fingers and toes to feel numb and cold in response to cold temperatures or stress. In Raynaud's disease, smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas.

Symptoms of Raynaud's disease

Raynaud's affects your blood circulation. When you're cold, anxious or stressed, your fingers and toes may change colour. Other Symptoms can include: Pain, Numbness, Pins and Needles, Difficulty moving the affected area.

Some people also find their ears, nose, lips or nipples are affected. The symptoms of Raynaud's may last from a few minutes to a few hours.

This condition tends not to go away, but it also tends not to get any worse. Most people with primary Raynaud's can manage their symptoms with minor lifestyle changes, and don't need medication.

Causes of Raynaud's

There are two different types of Raynaud's, Primary and Secondary. Primary is usually the less serious of the two types as the condition is mild and manageable whilst people experiencing secondary Raynaud's will usually have more severe symptoms.

It seems that primary Raynaud's is caused by disruptions in how the nervous system controls blood vessels. There is no clear evidence on the causes of Raynaud's. There's some evidence that primary Raynaud's may be an inherited condition, as cases have been known to run in families.

Causes of secondary Raynaud's include: Diseases of the arteries: Atherosclerosis, a build-up of plaque in blood vessels, or Buerger's syndrome, a disorder where blood vessels in the hands and feet become inflamed, can cause Raynaud's symptoms. Primary pulmonary hypertension has also been linked to the disease.

Risk factors

Risk factors for primary Raynaud's include:

• Sex. More women than men are affected.
• Age. Although anyone can develop the condition, primary Raynaud's often begins between the ages of 15 and 30.
• Climate. The disorder is also more common in people who live in colder climates.
• Family history. A first-degree relative; a parent, sibling or child having the disease appears to increase your risk of primary Raynaud's.

Risk factors for secondary Raynaud's include:

• Associated diseases. These include conditions such as scleroderma and lupus.
• Certain occupations. These include jobs that cause repetitive trauma, such as operating tools that vibrate.
• Exposure to certain substances. This includes smoking, taking medications that affect the blood vessels and being exposed to certain chemicals, such as vinyl chloride.

When to refer

Most patients can be managed by the doctor. In the following circumstances a referral is necessary.

• Immediate admission is required if there is evidence of inadequate blood supply to organ and most importantly the heart.
• People with suspected Raynaud’s.
• Children under the age of 12years.

In most cases Raynaud’s is caused due to connective tissue disorder, thus a referral to the rheumatologist is necessary.

Treatment Options

Many times, you can help prevent symptoms of Raynaud's. One of the most important things you can do is to stop smoking. Nicotine shrinks arteries and decreases blood flow. Other ways you can help prevent symptoms include:

• Protecting yourself from cold, especially outdoors in the winter
• Guarding against cuts and other injuries to affected areas
• Avoiding caffeine
• Avoiding stress
• Exercising to increase circulation
• Maintaining a healthy diet

Often, this may be enough to manage Raynaud's phenomenon, although several types of drugs are used to treat Raynaud's phenomenon, for example:

• Calcium-channel blockers may reduce the frequency and severity of attacks
• Some supplements may help including:
  • Omega-3 fatty acids, found in fish oil, may reduce symptoms.
  • Evening primrose oil (EPO). EPO contains a different type of fatty acid that stops the body from making chemicals that narrow blood vessels.
  • Inositol hexaniacinate, a form of vitamin B3 or niacin, may reduce frequency of Raynaud's attacks.
  • Magnesium opens blood vessels.
• Homeopathy, Acupuncture and Mind-Body Medicine can also be considered.

Following Up

Most cases of Raynaud's are not severe. Avoiding cold and stress, and not smoking, can help manage symptoms.