Raynaud's Phenomenon

NOTICE: This health information was not created by the University of Michigan Health System (UMHS) and may not necessarily reflect specific UMHS practices. For medical advice relating to your personal condition, please consult your doctor. Complete disclaimer

Raynaud's Phenomenon

Topic Overview

Picture of the skin (cross section) What is Raynaud's phenomenon?

Raynaud's (say "ray-NOHZ") phenomenon is a problem with blood flow. Your body doesn't send enough blood to your hands and feet, so they feel very cold and numb. In most cases, this lasts for a short time when your body overreacts to cold temperatures.

There are two kinds of Raynaud's phenomenon. Primary Raynaud's is also known as Raynaud's disease. It occurs on its own and is the most common form. Secondary Raynaud's is also called Raynaud's syndrome. It most often forms as part of another disease.

People may not talk to a doctor about symptoms of Raynaud's. For most people, it is more of a nuisance than a disability.

What causes Raynaud's phenomenon?

Primary Raynaud's has no known cause. Secondary Raynaud's may be a symptom of another disease such as lupus, scleroderma, rheumatoid arthritis, or atherosclerosis. Taking certain medicines, using vibrating power tools for several years, smoking, or having frostbite may also cause Raynaud's.

Certain things, such as stress and taking certain medicines, can trigger an attack. But the most common trigger is exposure to cold. In the cold, it's normal for the body to narrow the small blood vessels to the skin and to open the blood vessels to the inside parts of the body to keep the body warm. But with Raynaud's, the body overreacts and restricts blood flow through the small vessels to the skin more than necessary.

What are the symptoms?

During an attack of Raynaud's, the body limits blood flow to the hands and feet. This makes the fingers or toes feel cold and numb and then turn white or blue. As blood flow returns and the fingers or toes warm, they may turn red and begin to throb and feel painful. In rare cases, Raynaud's affects the nose or ears.

An attack most often lasts only a few minutes. But in some cases it may last more than an hour.

How is Raynaud's phenomenon diagnosed?

To diagnose Raynaud's, your doctor will ask you questions about your symptoms and past health. He or she will also do a physical exam. Since Raynaud's attacks are so sudden and brief, your doctor probably won't get to see you have an attack. So your doctor will want you to describe what happens to you during an attack.

There are no simple tests that your doctor can use to see if you have Raynaud's. You may have a blood test or other tests to rule out certain diseases that may be causing your symptoms.

How is it treated?

If you have secondary Raynaud's that is caused by another disease, your doctor can treat that disease. This may relieve your symptoms.

There is no cure for primary Raynaud's, but you may be able to control it by avoiding the things that trigger it. These triggers include cold temperatures, stress, smoking, caffeine, cold medicines with pseudoephedrine, and beta-blockers. But don't stop taking prescribed medicines unless you talk to your doctor first.

You may be able to prevent Raynaud's attacks with these home treatment tips:

  • Remember to keep your body warm at all times.
  • Wear mittens or gloves when it is cold outside.
  • Use potholders or oven mitts when you get something from the refrigerator or freezer.
  • Keep your feet warm by wearing wool or synthetic socks rather than pure cotton socks.
  • Try running warm water over your hands. It can increase blood flow to them.

If you can't control your symptoms with home treatment, your doctor may give you a medicine called a calcium channel blocker. This may increase blood flow to your hands and feet and relieve symptoms.

Frequently Asked Questions

Learning about Raynaud's phenomenon:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with Raynaud's phenomenon:

Symptoms

Areas affected by Raynaud's phenomenon may:

  • Feel cold or numb, as if they have fallen asleep.
  • Turn white or blue.
  • Turn blue, then red with warming. As colors develop, the affected areas may throb, ache, tingle, or feel cold or numb.

The hands, feet, nose, and ears can be affected by Raynaud's phenomenon. Raynaud's may affect one finger or several. Even nipples may be affected.

Exams and Tests

Because an attack of Raynaud's phenomenon typically ends quickly, your doctor most often will determine whether you have Raynaud's phenomenon by your description of your symptoms. Your doctor will review your medical history, perform a physical exam, and do blood tests or other tests to rule out a secondary cause of Raynaud's phenomenon. If possible, you may want to take a color photograph of your hands when you are having symptoms. Then you can bring the photo to your appointment.

A rheumatologist or dermatologist may examine the small blood vessels (capillaries) at the base of your fingernails using a small magnifying lens. Known as "capillaroscopy," this simple examination may help distinguish between primary Raynaud's and secondary Raynaud's that is part of a connective tissue disease such as lupus, scleroderma, or rheumatoid arthritis.

Treatment Overview

There is no cure for primary Raynaud's phenomenon, although the condition often can be effectively controlled. You may be able to limit or reduce the severity of attacks by keeping warm; managing emotional stress; and avoiding medicines or other substances that affect blood flow, such as nicotine, caffeine, or cold medicines that contain pseudoephedrine. Avoiding beta-blockers, which are often used to treat high blood pressure and fast or irregular heart rates, is also advised. Beta-blocker medicines slow the heart rate and decrease how forcefully the heart contracts, causing even less blood to flow through your capillaries and making symptoms of Raynaud's worse. Do not stop taking medicines your doctor has prescribed, such as beta-blockers, without talking with your doctor.

If Raynaud's phenomenon can't be effectively controlled with home treatment and it interferes with your daily activities, your doctor may prescribe medicines that help increase blood flow and relieve symptoms. These medicines might include a high blood pressure medicine such as a calcium channel blocker, a nitroglycerin ointment, or an erection-enhancing medicine such as sildenafil (Viagra).

Some alternative treatments have shown promise in treating Raynaud's phenomenon. But they have not been shown to work for everyone. Examples of alternative treatment include herbal supplements and biofeedback training.

If the condition is related to another disease, a drug, or a specific activity (secondary Raynaud's), treating the disease or stopping the drug or activity may also reduce the symptoms of Raynaud's phenomenon.

Home Treatment

Symptoms of Raynaud's phenomenon can often be relieved by home treatment.

To prevent or relieve symptoms that affect your hands or feet:

  • Wear mittens or gloves anytime it is cool outside. Mittens are warmer than gloves, because they keep your fingers together. Gloves underneath mittens will keep your hands warmer than gloves alone.
  • Wear mittens or gloves or use pot holders or oven mitts when getting something from the freezer or refrigerator.
  • Drink hot liquids. This helps maintain your internal body temperature.
  • When drinking from a cold container such as a can or bottle, use an insulated cover.
  • Warm your hands by running warm water over them or rubbing them together. This often will increase blood flow to your hands, relieving an attack of Raynaud's phenomenon. Be careful not to burn your hands under water that is too hot.
  • Wear wool, synthetic, or cotton-blend socks rather than pure cotton socks. They keep your feet drier and warmer by pulling moisture away from your skin.
  • Use foot powder to help absorb moisture from your feet. When your feet are damp, they are more easily chilled.
  • Swing your arms rapidly in a circle at the sides of your body ("windmilling"), which can temporarily increase blood flow into your fingers.

To keep your whole body warm:

  • Wear layers of warm clothing. The inner layer should be made of a material such as polypropylene that pulls moisture away from your body.
  • Wear a hat. You lose more body heat from your head than from any other part of your body.
  • Do not wear clothing that is too tight. Tight clothing can decrease or cut off circulation.
  • Try to stay dry. Choose waterproof, breathable jackets and boots. Being wet makes you more likely to become chilled.
  • Keep rooms at the same temperature.

In general:

  • Quit smoking, and avoid caffeine (in coffee, some soft drinks, and nonherbal teas). Nicotine and caffeine can cause blood vessels to become narrower (constrict). These drugs may trigger an attack of Raynaud's phenomenon or make an attack worse.
  • Avoid taking certain medicines that may cause or aggravate Raynaud's phenomenon, such as drugs that affect blood flow, including cold medicines that contain pseudoephedrine; some heart and blood medicines; and migraine headache medicines. Do not stop taking medicines your doctor has prescribed, such as beta-blockers, without talking with your doctor. Talk to your doctor about other steps you can take to reduce the effect of Raynaud's phenomenon while still taking these medicines.
  • Drink plenty of liquids to prevent dehydration, which can lower the amount of blood moving through the blood vessels and help bring on an attack of Raynaud's phenomenon or make an attack worse.
  • Try eating a hot meal before going outside. Although there is no proof that this will help, some people believe that eating raises your body temperature and helps keep you warm.

Other Places To Get Help

Organizations

Arthritis Foundation
P.O. Box 7669
Atlanta, GA  30357
Phone: 1-800-283-7800
Web Address: www.arthritis.org
 

The Arthritis Foundation provides grants to help find a cure, prevention methods, and better treatment options for arthritis. It also provides a large number of community-based services nationwide to make living with arthritis easier, including self-help courses; water- and land-based exercise classes; support groups; home study groups; instructional videotapes; public forums; free educational brochures and booklets; the national, bimonthly consumer magazine Arthritis Today; and continuing education courses and publications for health professionals.


National Heart, Lung, and Blood Institute (NHLBI)
P.O. Box 30105
Bethesda, MD  20824-0105
Phone: (301) 592-8573
Fax: (240) 629-3246
TDD: (240) 629-3255
Email: nhlbiinfo@nhlbi.nih.gov
Web Address: www.nhlbi.nih.gov
 

The U.S. National Heart, Lung, and Blood Institute (NHLBI) information center offers information and publications about preventing and treating:

  • Diseases affecting the heart and circulation, such as heart attacks, high cholesterol, high blood pressure, peripheral artery disease, and heart problems present at birth (congenital heart diseases).
  • Diseases that affect the lungs, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema, sleep apnea, and pneumonia.
  • Diseases that affect the blood, such as anemia, hemochromatosis, hemophilia, thalassemia, and von Willebrand disease.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health
1 AMS Circle
Bethesda, MD  20892-3675
Phone: 1-877-22-NIAMS (1-877-226-4267) toll-free
Phone: (301) 495-4484
Fax: (301) 718-6366
TDD: (301) 565-2966
Email: niamsinfo@mail.nih.gov
Web Address: www.niams.nih.gov
 

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is a governmental institute that serves the public and health professionals by providing information, locating other information sources, and participating in a national federal database of health information. NIAMS supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases and supports the training of scientists to carry out this research.

The NIAMS website provides health information referrals to the NIAMS Clearinghouse, which has information packages about diseases.


References

Other Works Consulted

  • Pope J (2008). Raynaud's phenomenon (primary), search date May 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
  • Zaghloul SS, et al. (2010). Raynauld's disease and phenomenon. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 650–653. Edinburgh: Saunders Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Stanford M. Shoor, MD - Rheumatology
Last Revised June 30, 2010

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

© 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.