• susanherdman

Raynaud’s Disease (Syndrome)

Even though it’s summertime, do you find that you’re still suffering from cold hands?

People can get cold hands for a variety of reasons, some of which include:

  • External application of cold – such as holding a nice, cold can of beer.

  • Actually being cold – such as with hypothermia and/or having low percentage of body fat – where blood flow is reduced to the extremities in an attempt to maintain normal internal body temperature of 98.6˚F or 37˚C.

  • Smoking – nicotine constricts blood vessels, reducing blood flow to the fingers.

  • Clogged arteries/atherosclerosis (which is associated with hypertension/high blood pressure, diabetes, and poor cardiovascular fitness). Similar to trying to suck up juice with a coffee stir stick versus a regular straw, a tinier hole is harder to push fluid through, resulting in less warm blood reaching the tissues.

  • Feeling anxious or scared. During the typical stress response (think “fight, flight, or freeze”), blood flow is redirected to the big muscle groups in order to protect you. This is very helpful when running away from a bear, but not so helpful when public speaking…

In all of these situations above, the hands may get cold and/or pale in colour.


However, with Raynaud’s, the symptoms are far more intense.

The blood vessels in the fingers fully constrict – resulting in a triad of skin colour changes starting with white (due to a lack of blood), turning to blue (as low oxygenated blood collects and pools in the finger tips), and finally red (as blood flow returns). Along with the cold and the red-white-and-blues, typically there is dull, aching pain and pins and needles sensations (as blood flow returns). These attacks are typically triggered by exposure to cold or stress (physical, emotional, or even mental).

[Imaged copied from: Montage of Raynaud's Syndrome in 25 yo Male with SLE; 6 October 2008; Author= Patrick Callahan, Tcal at English Wikimedia]


If these Raynaud symptoms can be associated with another condition (such as Lupus, Rheumatoid Arthritis, or Systemic Sclerosis Scleroderma), certain vasoconstrictive medications, or related to environmental exposure (such as vibration), it is classified as “Secondary Raynaud’s” or “Raynaud’s Phenomenon”.


However, the majority of sufferers have “Primary Raynaud’s” or “Raynaud’s Disease” – where the cause of these symptoms remains a mystery. Raynaud’s generally affects women between the ages of 20-40, and those in colder climates. It is estimated that Raynaud’s affects 3-5% of the general population! In severe cases or when not managed properly, sufferers can even develop ulcers on their fingertips due to repeated and prolonged reduction in blood flow.


While Sutton & Raynaud's Association report that there is no cure at this time, there are several behavioural strategies to help manage and prevent further attacks. First, it is always a good idea to get checked out by a doctor to assess for any underlying conditions. Second, the key is to avoid or at least minimize exposure to your triggers.


Tips for Managing Raynaud’s:

  • Avoid cold temperatures and environments (eg pre-warm your bed with an electric blanket)

  • Keep your body warm (eg wear a hat, dress in layers, drink hot fluids/foods)

  • Keep your hands warm (eg keep a pair of mittens with you – in purse, car, office, & at home)

  • Stay dry (eg wearing fabrics that wick away sweat)

  • Reduce/manage stress

  • Stop smoking

  • Cardiovascular exercise (to help improve circulation as well as manage stress)


For more information about Raynaud’s, management strategies, and/or help making an exercise plan that is right for you, contact InReach Physio.


By: Susan Herdman, Registered Physiotherapist – Specializing in Upper Extremity and Hand Telerehabilitation.

Book a telephysio / online physio / virtual physio appointment with a registered physiotherapist in British Columbia. InReach Online Physio services communities in northern and rural BC, such as Masset, Queen Charlotte, Fraser Lake, Fort Nelson, Fort St James, Dease Lake, Fort St John, Dawson Creek, the Gulf Islands, and more!



Resources:


American Society of Hand Therapists (2018, Mar 15). How Smoking Can Affect Your Hands. Accessed July 18/2021: https://www.assh.org/handcare/blog/how-smoking-can-affect-your-hands


American Society of Hand Therapists (2019). Patient Education Resource: Raynaud’s Disease. Accessed July 18/2021: https://www.asht.org/sites/default/files/docs/2019/raynauds_disease_2019.pdf


Burn MB, Hay DC, Taras JS, & Yao J (2021). Chapter 56: Vascular Disorders of the Upper Extremity in Skirven, Osterman, Fedorczyk, Amadio, Feldscher, & Shin’s Rehabilitation of the Hand and Upper Extremity(7th Edition, pp. 789-791). Philadelphia, PA: Elsevier.


Bonatz E & American Society for Surgery of the Hand (2020, Sept 7). What is Raynaud’s Disease? Accessed July 18/2021: https://www.assh.org/handcare/blog/what-is-raynauds-disease


Raynaud's Association Inc. (2018). The Cold Facts on Raynaud's and Strategies for A Warmer Life. Accessed: July 20/2021: https://www.raynauds.org/wp-content/uploads/2018/02/Raynauds-Guide-PDF-1.pdf


Sloan J – Reviewed by Steinberg PL (2021 Jan 13). Why Are My Hands Always Cold? Accessed July 18/2021: https://www.buoyhealth.com/learn/cold-hands


Splaver, A (2018, Feb 1). Cold hands, warm heart…is there a connection? Accessed July 18/2021: https://www.thedoctorsdr.com/cold-hands-warm-heart-is-there-a-connection/


Sutton, E & Scleroderma Canada, (2019 March). Raynaud’s Phenomenon? Accessed July 18/2021: https://sclerodermabc.ca/wp-content/uploads/2020/04/Raynauds-BC.pdf


UVA – Perry M & Pierce J. (2020 Jan 20). Warming Cold Hands: A New Treatment for Raynaud’s Syndrome. Accessed: July 18/2021: https://blog.radiology.virginia.edu/new-treatment-for-raynauds-syndrome/


Image: Patrick Callahan, Tcal at English Wikimedia, CC BY-SA 3.0. (2008, Oct 6). Montage of Raynaud's Syndrome in 25 yo Male with SLE; Accessed: July 20/2021: <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons https://commons.wikimedia.org/wiki/File:Raynaud_phenomenon.jpg

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