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RAYNAUDS PHENOMENON TREATMENT

Treating Raynauds

For people who have been diagnosed with primary Raynaud’s they can probably be treated by your doctor.
Those people who have been diagnosed with secondary Raynaud’s due to with an underlying condition, may need to be referred to a specialist in the treatment of that condition.

__Self-Care with Raynauds?

_
  • Smoking can make symptoms worse. The chemicals in tobacco can cause the small blood vessels to narrow. So stopping smoking may ease or even cure the problem.
  • Some drugs (medicines) that are used to treat other conditions sometimes trigger symptoms, or make them worse. The drug may cause the blood vessels to narrow. Such drugs include: beta-blockers, some anti-migraine medicines, decongestants, and, very occasionally, the contraceptive pill. Don't stop a prescribed drug if you suspect it may be making symptoms worse. See your doctor to discuss possible alternatives.
  • Other drugs. Caffeine (in tea, coffee, cola and in some painkillers) triggers symptoms in some people. Cutting out caffeine for a few weeks may help. Amfetamines (amphetamines) and cocaine may also be a trigger.
  • Try to keep warm in cool weather or in cool environments:
  • Keep the hands and feet warm. Warm gloves, socks and shoes are essential when outside in cool weather.
  • Keep the whole body warm, not just the hands and feet. Although hands and feet are the most important, symptoms are less likely to occur if the entire body warm. So, wrap up warmly before going into cooler areas, such as outside on cold days. For example, wear hats and scarves in addition to warm clothes.
  • It is better to put on the gloves before going into colder areas. Ideally, keep gloves, socks and headgear in an airing cupboard or near a radiator so they will be warm when put on.
  • If the symptoms are severe, or symptoms that are easily triggered, then portable heat packs and battery heated gloves and socks are useful. The Raynaud's and Scleroderma Association has a list of suppliers - see below for their details. Your local  pharmacist may also be able to advise.
  • Try not to touch cold objects. For example, use a towel or gloves when removing food from the freezer or working with cold food.
    Regular exercise is recommended by many experts. Exercise the hands and feet frequently to improve the circulation.
    When a bout of symptoms develops, warm the affected hands or feet as soon as possible. Soaking the hands or feet in warm running water is a good way to get warm (but take care that the water does not become too hot, or lose its heat and become cool).


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What treatments can help prevent Raynaud's symptoms?

Keeping warm is the main treatment.

Symptoms are much less likely to occur, and be less severe, if you keep warm (described above).
Other treatments are needed only in some cases.

Medication
Nifedipine may be advised if symptoms are severe. It works by 'opening up' (dilating) the small blood vessels. Some people take nifedipine regularly, each day, to prevent symptoms. Some people take nifedipine just during the winter, or just during cold weather spells. Nifedipine has a list of  possible side-effects and cautions. Most people do not get any side-effects, or only minor side-effects.

Of the side-effects that may occur, the most common are
  • headache,
  • flushing,
  • nausea (feeling sick) and
  • dizziness.
Other medications

Other medications have been used in the treatment of Raynaud’s but their use is controversial as there is limited or insufficient evidence to show that they are effective in most people. However, some people have claimed to benefit from treatment.
The medications include:

  • angiotensin-converting enzyme (ACE) inhibitors
  • fluoxetine (sold under the brand name Prozac), which was widely used in the treatment of depression)
  • sildenafil (sold under the brand name Viagra), which is used to treat erectile dysfunction (inability to get or maintain an erection)

Stress counselling or relaxation techniques
These may be helpful if you have primary Raynaud's and the symptoms are triggered by stress or emotion.

Treatment for an underlying condition
May be needed if you have secondary Raynaud's.

'Nerve blocks' or other hospital-based treatments
May be tried if you have severe Raynaud's which is not helped by other treatments.

A type of surgery called sympathectomy is recommended. It involves cutting the nerves causing the affected blood vessels to go into spasm.
As well as preventing tissue loss, a sympathectomy should help improve any pain you may feel. The results of a sympathectomy are often only temporary and further treatment and possibly more surgery may be required after a few years.

What is the outlook (prognosis)?

Primary Raynaud's
The outlook for people with primary Raynaud's is usually good. Most people have mild symptoms that do not interfere much with daily life. People with more severe symptoms often respond well to treatment with nifedipine. In some cases the condition remits (goes away) in time. In one study that followed up people with primary Raynaud's over seven years, the condition had gone away in nearly 2 in 3 cases at some point over the study period.

Sometimes, someone who is thought to have primary Raynaud's develops other symptoms several months or years later and the diagnosis is changed to secondary Raynaud's. This is thought to occur in about 1 in 10 people who are initially diagnosed with primary Raynauds.

Secondary Raynaud's
There are various underlying conditions that can cause secondary Raynaud's and their severity can vary. In general, symptoms are often more severe than with primary Raynaud's, and tend to respond less well to treatment. In some situations, treating an underlying condition will ease the symptoms of Raynaud's.

Further information and help

The Raynaud's and Scleroderma Association
112 Crewe Road, Alsager, Cheshire, ST7 2JA
Tel (helpline): 0800 917 2494 Web: www.raynauds.org.uk

Arthritis Research UK
Copeman House
St Mary's Gate
Chesterfield
Derbyshire
S41 7TD
United Kingdom
Tel:  +44 (0) 300 790 0400
Fax: +44 (0) 300 790 0401

email: enquiries@arthritisresearchuk.org
web:   www.arthritisresearchuk.org

Also see our page on Raynauds Phenomenon symptoms


Content by Jane Morris - connect with me on Google+



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