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What is Raynauds phenomenon? Raynauds phenomenon is where the fingers turn white and become numb and painful. It is due to a narrowing (constriction) of the small blood vessels on exposure to the cold, or to a change in temperature, or to emotional stress. It can sometimes blood vessels in other areas too such as the toes, ears and nose are affected. It is named after Dr Maurice Raynaud, the man who first described it in 1862. Why does it happen? It happens occurs because your blood vessels go into a temporary spasm which blocks the flow of blood. It is this that causes the area to change colour to white, then blue and then finally red as the blood flow returns. What are the symptoms of Raynaud's?
Many people with Raynaud's do not have the full classic colour changes, but develop bouts of uncomfortable, pale, cold fingers. Only the fingers are affected in most cases. Less commonly areas of the body, such as the toes earlobes, nose, nipples or tongue can be affected. Each bout of symptoms can last from minutes to hours. Raynaud's phenomenon is usually mild, with infrequent, brief bouts of symptoms that last just a few minutes. Sometimes it is moderate with more frequent bouts of symptoms that last longer. Rarely, it is severe with repeated frequent bouts, with each bout lasting longer periods of time. What causes Raynaud's? Who gets it? |
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Raynauds is divided into two types:
Primary Raynaud's - when the cause is not known
In most cases there is no known cause (more than 9 in 10 cases). This is called primary Raynaud's. The small blood vessels in the fingers, toes, etc, just appear to be more sensitive than normal to cool temperatures. There is no other underlying disease. Symptoms are triggered more easily in some people than in others. Even mildly cool weather, or getting something out of the freezer, or being in windy conditions can trigger symptoms in some people. Strong emotion may also trigger symptoms in some cases.
Usually, all fingers on both hands are affected in primary Raynaud's.
Secondary Raynaud's - due to an underlying cause
In less than 1 in 10 cases, there is an underlying cause. This is called secondary Raynaud's. Various conditions of blood vessels, joints, muscles, nerves or skin can cause secondary Raynaud's. For example, scleroderma, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus (SLE) and other 'connective tissue' diseases.
If you have secondary Raynaud's you will normally have other symptoms in addition to the symptoms of Raynaud's. The Raynaud's is just one feature of the condition. For example, you may also have joint pains, rashes, joint swelling, etc.
Often the underlying condition is already present, and you may develop Raynaud's as a complication. Sometimes the symptoms of Raynaud's occur first, and other symptoms of the underlying condition develop weeks, months or even years later.
In secondary Raynaud's, symptoms may first begin in just one or two fingers on one hand. This is in contrast to primary Raynaud's when all fingers on both hands are typically affected.
Hand-arm vibration syndrome (vibration white finger) is one common cause of secondary Raynaud's. This is caused by using vibrating tools regularly over a long time. For example, it occurs in some shipyard workers, mine workers, road diggers, etc. It is thought that repeated vibrations over time may damage the small blood vessels or their nerve supply.
Medicines
Secondary Raynaud's can be a side effect of taking certain medicines, including:
The illegal drugs cocaine and amphetamine can also cause secondary Raynaud’s.
Injury and overuse
Raynaud's sometimes results from a physical injury to the affected area. It can also affect musicians, people who type a lot or other people who use their fingers and hands more than usual.
Are tests needed to confirm Raynauds?
Not in most cases. There is no test that confirms primary Raynaud's. The diagnosis of primary Raynaud's is made on the basis of the symptoms described above and there is no abnormality found that may suggest a secondary cause when a doctor examines you.
Blood tests and other tests may be done if secondary Raynaud's is suspected.
What are the complications of Raynauds?
In very severe cases of Raynaud’s the blood supply to an affected body part can become severely diminished, which normally only occurs in secondary, not primary, Raynaud’s. Without a constant supply of blood, the tissue in the body part will begin to die.
Also see: Treatment for Raynauds Phenomenon
- primary: when the condition develops by itself (this is the most common type)
- secondary: when it develops in association with another health condition
Primary Raynaud's - when the cause is not known
In most cases there is no known cause (more than 9 in 10 cases). This is called primary Raynaud's. The small blood vessels in the fingers, toes, etc, just appear to be more sensitive than normal to cool temperatures. There is no other underlying disease. Symptoms are triggered more easily in some people than in others. Even mildly cool weather, or getting something out of the freezer, or being in windy conditions can trigger symptoms in some people. Strong emotion may also trigger symptoms in some cases.
Usually, all fingers on both hands are affected in primary Raynaud's.
- It also tends to run in some families.
- Women are affected much more often than men.
- It usually first develops before the age of 30.
Secondary Raynaud's - due to an underlying cause
In less than 1 in 10 cases, there is an underlying cause. This is called secondary Raynaud's. Various conditions of blood vessels, joints, muscles, nerves or skin can cause secondary Raynaud's. For example, scleroderma, rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus (SLE) and other 'connective tissue' diseases.
If you have secondary Raynaud's you will normally have other symptoms in addition to the symptoms of Raynaud's. The Raynaud's is just one feature of the condition. For example, you may also have joint pains, rashes, joint swelling, etc.
Often the underlying condition is already present, and you may develop Raynaud's as a complication. Sometimes the symptoms of Raynaud's occur first, and other symptoms of the underlying condition develop weeks, months or even years later.
In secondary Raynaud's, symptoms may first begin in just one or two fingers on one hand. This is in contrast to primary Raynaud's when all fingers on both hands are typically affected.
Hand-arm vibration syndrome (vibration white finger) is one common cause of secondary Raynaud's. This is caused by using vibrating tools regularly over a long time. For example, it occurs in some shipyard workers, mine workers, road diggers, etc. It is thought that repeated vibrations over time may damage the small blood vessels or their nerve supply.
Medicines
Secondary Raynaud's can be a side effect of taking certain medicines, including:
- some types of anti-migraine medication, such as sumatriptan and ergotamine
- beta-blockers, which are used to treat high blood pressure and heart disease
- some chemotherapy medications
- decongestants
- the contraceptive pill
- medications used in hormone replacement therapy
- some types of medications used in the treatment of high blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors and clonidine
The illegal drugs cocaine and amphetamine can also cause secondary Raynaud’s.
Injury and overuse
Raynaud's sometimes results from a physical injury to the affected area. It can also affect musicians, people who type a lot or other people who use their fingers and hands more than usual.
Are tests needed to confirm Raynauds?
Not in most cases. There is no test that confirms primary Raynaud's. The diagnosis of primary Raynaud's is made on the basis of the symptoms described above and there is no abnormality found that may suggest a secondary cause when a doctor examines you.
Blood tests and other tests may be done if secondary Raynaud's is suspected.
What are the complications of Raynauds?
In very severe cases of Raynaud’s the blood supply to an affected body part can become severely diminished, which normally only occurs in secondary, not primary, Raynaud’s. Without a constant supply of blood, the tissue in the body part will begin to die.
Also see: Treatment for Raynauds Phenomenon
