Raynaud’s is a disorder that causes blood vessel spasms usually within the hands and feet resulting in discoloration, numbness, pins-and-needles, restricted movement, and skin changes. The associated circulatory spasms lead to decreased blood flow to areas such as the tips of the fingers and toes.
Reynaud’s Phenomenon versus Raynaud’s Syndrome
There are two major types of the Raynaud's condition. The first is called “Raynaud's Phenomenon” which occurs spontaneously or from an obscure cause. The second is called “Raynaud's Syndrome” which is instigated by a pre-existing condition such as bad circulation, cold weather exposure, stress, or problems with connecting tissue near the fingers or toes. Raynaud's is often seen in what is commonly referred to as frost-nip; sometimes regardless of the outside climate or temperature. When the fingers and toes are exposed to varying colder temperatures (typically between 38֯ - 52֯ F) oxygen and blood flow will be much lower. Reduction in oxygen and blood flow can cause discoloration, numbness, and swelling. Raynaud's almost usually results with the return of blood flow to the affected areas over time. When blood and oxygen are not able to quickly return to the fingers and toes, the deprived areas can begin to die and become rotten (gangrenous and/or necrosis). After exposure to extreme cold (e.g. frostnip or frost bite) one may develop a hypersensitivity to touch and to colder environments.
There are two stages of Raynaud’s
Preliminary Raynaud’s which is a result of exposure to varying temperatures and thus spasms, and Secondary Raynaud’s which could be caused a pre-existing condition in the body.
A Triphastic Reaction “White - Blue - Red”: sequentially the skin might first begin to become pale, white, or void of fleshy color; a sign that constriction is occurring. This might be followed by a bluish or purple hue as the amount of oxygen in the tissue begins to lessen, ultimately suffocating the area of oxygen. Finally, as normal blood flow continues, the area will become a throbbing, cold red and dark pink color.
- Numbness and pain in the fingers and toes
- Cold-feeling skin surfaces
- Specific demarcation of color at the joint lines
- Symptoms can occur in the toes and fingers, the tip of the nose, nipples, lips, or earlobes. It can occur in one foot and not the other or randomly around the tips of the body.
Some common and unsuspecting situations where a Raynaud’s attack can happen include:
- Walking from the bread aisle to frozen food aisle
- Going from a cold airconditioned office building to hot car
- Taking a hot shower and then moving to a cold bedroom
Who is at risk?
- Women tend to suffer from Raynaud’s more than men do
- People living in colder climates
- Women on birth control
- Most common in people between the ages of 15-40 years old
- People who work outside during colder months
- Smokers and heavy drinkers
- People suffering from autoimmune disease, scleroderma, lupus, and kidney disease
Why Should I See a Podiatrist?
If the symptoms appear in the toes and feet in addition to the hands and elsewhere, your podiatrist will help treat the cause of the symptoms which are often a sign of something much greater than cold, discolored toes. Your podiatrist will be able to further evaluate which type of Raynaud’s you may have.
Your doctor will know the best treatment for you after a proper diagnosis. The goal is to reduce the number of attacks and prevent any new damage to the tissue.
- Proper evaluation from a medical specialist
- Topical medication
- Exercise practices
- Vascular consultation
- Oral medications
- Daily practices to prevent Raynaud’s attacks