About a year ago when I was out for an evening walk, I noticed that the tip of my right index finger began to feel unusually cold. When I looked at it, I noticed it was very white at the top. Within minutes, its color changed to blue and then to red, at which time I felt a burning and tingling sensation alerting me that the circulation was returning. I didn’t think much of this, even though it happened a few more times in the next several weeks. Three months later, I was with a friend near the starting line of a race in which we were about to compete. It was chilly and rainy outside, and she made a comment about her fingers being cold and numb. She told me her doctor diagnosed her with Raynaud’s phenomenon. As she described her symptoms, I realized they closely paralleled mine. Although I have yet to be officially diagnosed with Raynaud’s, I feel confident that what I continue to experience, even with just that one finger, is of this category.
Raynaud’s phenomenon causes a series of discolorations of the fingers and/or the toes after they are exposed to changes in temperatures, either hot or cold. It can also be triggered by emotional events. The discoloration of the skin occurs due to an abnormal spasm of the blood vessel, which creates a decrease in the flow of blood to the local tissues.
Much like my finger does, the digit(s) affected turn white at first because of lack of blood supply. Then, it will turn blue due to prolonged lack of oxygen, and it will finally become red and the blood vessels reopen. This is precisely what my one index finger does, and I experience this phenomenon at least three times a week. It can happen when I am outside in the cold or even when I have just momentarily run my hands under cool water from the tap.
Raynaud’s affects women more frequently than men, especially those in their 20s, 30s, and 40s. Raynaud’s can present as a stand-alone issue or as a part of other rheumatic diseases. Occurring alone, it is known as Raynaud’s disease. When it happens in conjunction with other diseases, it is referred to as secondary Raynaud’s phenomenon.
The causes of Raynaud’s phenomenon are not known. However, abnormal nerve control of the blood vessel diameter and sensitivity of the nerve to cold exposure are under the microscope as contributing causes.
Raynaud’s has been seen with a variety of conditions, such as scleroderma, rheumatoid arthritis, hormone imbalance, trauma (from frostbite or vibrating tools), and certain medications, such as Inderal and Bleoxane.
Actual symptoms all depend on the severity, frequency and duration of the blood vessel spasm. Most individuals affected are only bothered with a slight discoloration of the skin upon exposure to cold temperatures. They may also notice mild tingling and numbness of the affected finger(s). However, when the spasms of the blood vessel last for an appreciable amount of time, the sensory nerves can cause pain in the finger(s) due to lack of oxygen. In rare instances, continued lack of oxygen can lead to an ulcerated finger, which can become infected and result in gangrene. Although not as common, Raynaud’s phenomenon can also affect the nose, the ears, and the tongue.
As for treatment options for Raynaud’s, the milder cases usually only require simple prevention methods, such as keeping the body warm, especially in the extremities. Sadly, for me, even wearing two pairs of gloves outdoors still does not keep that one finger from exhibiting the discoloration process and the related tingling and pain.
Wearing warmer clothing in cold environments is necessary. The use of cotton gloves while getting into the freezer is recommended. Room temperatures should not be too cold. When washing dishes, rubber gloves can prevent the hands from becoming too cold. Keep barefoot walking to a minimum, and avoid wearing tight-fitting wrist bands, rings, and footwear. Additionally, keep emotional stress to a minimum and avoid using tools that vibrate the hand to reduce the frequency of the spasms.
Several medications may also exacerbate Raynaud’s. These include over-the-counter cold and weight medicines, beta blockers, and medicines used for high blood pressure and heart disease, such as Tenormin, Lopressor, and Corgar.
For those who suffer from persistent symptoms, oral medications that serve to open the blood vessels may provide relief. Medications that thin the blood are also sometimes helpful.
It is important to note that severe Raynaud’s phenomenon can lead to gangrene and the loss of the affected finger(s). For the most severe and rare cases, a surgical procedure called “sympathectomy” may be done. In this procedure, the nerves that cause the constriction of the blood vessels are surgically interrupted.
If you suspect you are experiencing Raynaud’s, please be sure to consult your physician for further evaluation. And yes, I'll be making that call too to my physician!
Sources:
http://www.medicinenet.com/raynauds_phenomenon/article.htm http://www.mayoclinic.com/health/raynauds-disease/DS00433
http://www.arthritis.org for more information