Raynaud’s disease or Raynaud’s syndrome
Is a relatively uncommon disorder of the blood vessels. While it’s typically seen in the fingers it can occur in the toes as well. Symptoms include an increased sensitivity to cold and the blanching (whitening) of the affected digits. They may also take on a bluish color. In nearly all cases symptoms appear when the skin is exposed to cold temperatures or the patient becomes stressed.
These physical symptoms are caused by the action of the many tiny vessels which feed the fingers and toes. When triggered, these vessels start begin to contract and become more narrow. This is known as vasoconstriction, and greatly reduces the total circulation these digits receive. When taken as a whole this sequence of events is known as Raynaud’s phenomenon.
There is no single cause of Raynaud’s disease. It is, however, often seen in patients with autoimmune disorders such as lupus (systemic lupus erythematous) and scleroderma. The condition can also occur alongside several connective tissue disorders.
Raynaud’s can’t be cured yet it’s symptoms can be managed successfully. Treatments can be broken down into oral medications, chemical injections, and various lifestyle changes. For many patients a combination of treatments provides the most relief. Also note that Raynaud’s syndrome is almost never dangerous. This leads some patients to choose no treatment at all.
The most popular medication prescribed “off label” to treat Raynaud’s syndrome is the calcium channel blocker Procardia (nifedipine). When used as a compounded cream formulation and applied topically when needed, this drug causes blood vessels in the toes to relax and dilate or widen.
The most popular oral medications used to treat Raynaud’s syndrome are known as calcium channel blockers. This makes sense, since these drugs cause blood vessels throughout the body to relax and dilate or widen. This is known as vasodilation. A good example is Procardia (nifedipine). This drug is normally prescribed to treat the chest pains associated with coronary artery disease.
Drugs in the prostaglandin class have proven themselves effective as well. These drugs are used to treat a variety of conditions ranging from glaucoma to stomach ulcers. As with calcium channel blockers, prostaglandins are sometimes prescribed “off label” to treat Raynaud’s.
The drugs listed above are typically a doctor’s first choice in the treatment of Raynaud’s. When oral medications fail, however, injectable botulinumtoxin type A drugs may prove useful. The world famous cosmetic injectable Botox is the best example. It’s only serious competitor, Dysport, has proven equally effective.
Botox injections smooth out facial wrinkle by temporarily paralyzing the facial muscles which cause them. These are usually the “frowning” muscles of the forehead and between the eyes. In the case of Raynaud’s, Botox blocks the nerves which cause the small vessels of the toes to spasm. Other off-label uses for Botox include relieving tension headaches and preventing excessive foot sweating. When used correctly, botulinum A injections provide up to 5 symptom-free months.
Several simple lifestyle changes can also greatly improve the symptoms of Raynaud’s disease. These do-it-yourself approaches can also improve a person’s overall health and include:
- Quitting smoking. Nicotine is a potent vasoconstrictor. Since vasoconstriction is the direct cause of Raynaud’s syndrome so it’s no surprise that smoking can make symptoms worse. Note that exposure to secondhand smoke can trigger this effect as well.
- Exercise. A sensible exercise program can greatly improve an individual’s circulation. While there’s no cure for Raynaud’s, exercise can reduce a patient’s symptoms to the point that they’re barely noticeable.
- Stress reduction. It’s no secret that stress has the potential to make almost any medical condition worse. Raynaud’s disease is no exception. Diverse methods of controlling stress include yoga, meditation, Tai-Chi, and many others. Simple activities such as talking to a friend or walking a dog can also help. It’s simply a matter of finding what works for you.
- Temperature control. Dress for the weather and avoid sudden changes in temperature. A good example is avoiding the frozen-food section at the grocery store.
Managing a sudden attack. Observe the following common sense measures during a flare-up:
- Move your fingers and toes to stimulate circulation.
- If you’re outside get indoors as soon as possible.
- Warm your hands by placing them against your torso or under your armpits.
- Run warm water over the affected fingers or toes. This water should be warm, not hot.
- Move the arms in wide circles in a “windmill” motion.
- Massage the affected fingers or toes.
- Remember to breathe. If stress precipitated the attack this simple advice can make all the difference. Alternately, simply remove yourself from the stressful situation if possible.
Only a trained podiatrist or similar specialist can accurately diagnose Raynaud’s disease. At the Beaver Valley Foot Clinic our podiatrist treats patients with Raynaud’s on a daily basis and knows what works. We offer all of the above treatments—and several others—and have helped thousands of patients find relief. Raynaud’s is treatable, so there’s no reason to keep suffering. Call us today at 878-313-FEET (3338) to book an appointment.