Raynaud’s Phenomenon

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Summary

  • Raynaud's phenomenon is the short-term interruption of blood flow to the extremities, such as the fingers and toes
  • It may be a sign of an underlying autoimmune disorder such as scleroderma or lupus, so it is important to see your doctor for diagnosis
  • Management options include avoiding cold weather and sudden temperature changes

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Raynaud’s phenomenon is a condition that can cause discomfort as the blood supply to your fingers and toes becomes reduced. When this happens, you will notice your fingers and/or toes change colour. 

It can happen in cold temperatures or emotionally stressful situations. 

Raynaud’s phenomenon can be primary, where it occurs on its own, or it can be secondary when it’s linked to another disease or condition. It can last from just a few minutes to many hours. 

Around five per cent of the population has the condition to some degree. It’s much more common in women and girls, with those under the age of 25 more commonly affected. 

Raynaud’s phenomenon doesn’t usually cause permanent damage. However, it can be a symptom of more serious underlying illnesses, so it’s important to see your doctor if you experience it.

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Symptoms of Raynaud's phenomenon

The body prevents heat loss in cold weather by redirecting the blood away from the extremities. In a person with Raynaud’s phenomenon, this reaction is exaggerated. The blood vessels constrict tightly, starving the tissues of blood and causing the characteristic blue or white colour change.  When blood flow returns, the skin turns from blue to red and finally back to the normal pink colour. Circulation to the rest of the body is generally perfectly normal. There can also be pain, tingling and numbness in the fingers or toes.

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Primary Raynaud's phenomenon

Primary Raynaud’s phenomenon (or Raynaud’s disease or just Raynaud’s) is the most common form of Raynaud’s phenomenon. It is called ‘idiopathic’ because there is no clear underlying cause. It is often so mild that the person never seeks medical attention.

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Secondary Raynaud's phenomenon

Secondary Raynaud’s phenomenon is generally more complex and serious than primary Raynaud’s. The most common causes of secondary Raynaud’s are underlying autoimmune disorders such as rheumatoid arthritis, scleroderma and systemic lupus erythematosus (SLE or lupus). 

Other common causes are:

  • mechanical vibration – such as using a power tool for long periods. It's thought that the vibrations disrupt the nerves
  • atherosclerosis – in which a narrowing of the arteries is caused by a build-up of fatty plaques. Blood flow to the extremities may be hampered by this condition
  • smoking – constricts blood vessels
  • some medication – such as beta blockers, which contain ergotamine, certain chemotherapy agents and medication that causes blood vessels to narrow
  • frostbite.

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Diagnosing Raynaud’s phenomenon

It's not hard to diagnose Raynaud's phenomenon, but it is sometimes hard to tell the difference between the primary or secondary form of the disorder.

Your doctor may use a range of methods to decide which form you have including:

  • a complete medical history
  • physical examination
  • blood tests
  • examining fingernail tissue with a microscope.
  • a cold stimulation test for Raynaud's phenomenon.

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Treating Raynaud’s phenomenon

For most people, primary Raynaud’s phenomenon is a nuisance rather than a disabling condition. However, if Raynaud’s phenomenon does occur, warming the body and the extremities is helpful. If you’re outside, go indoors and soak fingers or toes in warm water. If a stressful situation triggers the attack, try to remove yourself from the situation and relax. 

The general response to secondary Raynaud’s phenomenon is to treat the underlying condition (eg lupus or rheumatoid arthritis). In severe cases, to prevent tissue damage you may be prescribed medication that dilates your blood vessels. Surgery may be needed if you develop skin ulcers or serious tissue damage.

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Preventing Raynaud’s phenomenon

There is no cure for Raynaud’s phenomenon. Managing the condition requires avoiding known triggers, particularly exposure to cold temperatures and stressful situations. 

Some suggestions include:

  • avoid prolonged exposure to cold weather or sudden temperature changes, such as leaving a warm house on a cold day or air conditioned rooms in hot weather
  • make sure your whole body is kept warm, using several layers of clothing to trap body heat. Keep your extremities warm with gloves and woollen socks. Some people also find it helpful to use hand warmers  
  • it may be helpful to talk to an occupational therapist
  • be aware that even holding something cold, such as a can of drink, can trigger symptoms
  • don’t smoke cigarettes or drink caffeinated beverages, since nicotine and caffeine constrict the arteries
  • review your medications with your doctor. You may need to find alternatives medications that cause you to experience a Raynaud’s attack 
  • learn to recognise and avoid stressful situations. Stress and emotional distress can trigger an attack, particularly for people with primary Raynaud’s phenomenon. Relaxation may decrease the number and severity of attacks you experience
  • keep a journal of when episodes occur. Triggers for these episodes may become evident
  • look after your hands and feet. Dry hands and feet can develop skin cracks, so it’s important to moisturise them to prevent dryness. Protect your hands when in water with barrier creams and/or rubber gloves
  • exercise regularly to maintain blood flow and skin condition. Physical activity can also help increase your energy levels, control your weight, improve your cardiovascular (heart) fitness and help you to sleep better. Talk to your doctor before starting any exercise program.
  • eat a healthy and well balanced diet for general overall good health.

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Complications 

In most cases, Raynaud's phenomenon is harmless and has no lasting effects. In severe cases, however, loss of blood flow can permanently damage the tissue. 

Complications of severe Raynaud's phenomenon include:

  • impaired healing of cuts and abrasions
  • increased susceptibility to infection
  • ulceration
  • tissue loss
  • scarring
  • gangrene.

Talk with your doctor if you notice any of these problems or if you notice other changes to your symptoms.

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Where to get help

  • Your doctor
  • MOVE muscle, bone & joint health
    Help Line Tel. 1800 263 265

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Things to remember

  • Raynaud's phenomenon is the short-term interruption of blood flow to the extremities, such as the fingers and toes.
  • Raynaud's phenomenon may be a sign of an underlying autoimmune disorder such as scleroderma or lupus, so it is important to see your doctor for diagnosis.
  • Management options include avoiding cold weather and sudden temperature changes.

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More information

  • Need medical information regarding your condition and commonly prescribed treatments? Or assistance navigating the health, disability and social services systems? Contact our nurses on the Help Line on 1800 263 265 or email helpline@move.org.au.
  • Interested in finding out about our upcoming webinars and seminars and other events. Click here to learn more. 

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This information has been provided by the Better Health Channel and has been produced in consultation with and approved by: MOVE muscle, bone & joint health Ltd.

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