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Cold feet and fingers?

Paoli Hospital December 22, 2016 General Wellness

Have you ever noticed in cold environments—like winter weather or when you’re holding a cold drink—that the color changes in your toes, fingers, and/or nose? If it’s accompanied by numbness or a freezing sensation, you may be one of the estimated 28 million people in the United States with Raynaud’s Syndrome.

Approximately five to 10 percent of all Americans have some form of Raynaud’s Syndrome with varying severity, but—according to The Raynaud’s Association—only one in 10 seek treatment.

If the above symptoms sound familiar to you and you haven’t previously sought treatment for Raynaud’s Syndrome, read on to find out more about the disease from Christopher Hood, Jr., DPM, Premier Orthopaedic & Sports Medicine foot and ankle surgeon at Paoli Hospital, part of Main Line Health.

Skin changes due to Raynaud’s Syndrome

Raynaud’s is a condition that causes the skin on your nose, fingers, or toes to become cold and numb in response to decreased temperatures or stress. This response can be visual, like a change in skin color from pink to pale white, blue, and—finally—red. Sometimes, these skin changes can be accompanied by a throbbing feeling, as well. These changes, which are called ‘attacks,’ can last about 15 minutes before circulation and skin color return to normal.

Types of Raynaud’s Syndrome

There are two forms of Raynaud’s Syndrome: primary, called Raynaud’s disease; and secondary, called Raynaud’s phenomenon.

Primary Raynaud’s is the more common form of the disease. Risk factors for Raynaud’s disease include:

  • Gender: Women are nine times more likely to be diagnosed than men
  • Age: Patients are typically young, between 15–30 years of age
  • Geographic location: Individuals who live in colder geographic locations are at higher risk
  • Family history: One-third of patients have a family member with a form of Raynaud’s

Secondary Raynaud’s is usually diagnosed in adults 40 years of age and older, and its episodes can be more severe. Raynaud’s phenomenon is typically caused by something else, including:

  • An underlying medical condition, like rheumatoid arthritis, scleroderma, lupus, Sjogren’s Syndrome, connective tissue disorder, arterial disease, or thyroid disorders
  • Specific occupations, like a construction worker or typist, that require using your hands or could cause vibration to your hands
  • Trauma, including extremity fractures and carpal tunnel syndrome
  • Exposure to certain substances. Smoking and certain medications—like migraine medicine, beta-blockers, ADAH, and chemotherapy drugs—can cause Raynaud’s.

Unfortunately, there is no single test to diagnose Raynaud’s. To determine whether you have Raynaud’s phenomenon, you will likely require blood work to be performed and a referral to a rheumatologist.

Treating Raynaud’s Syndrome

Unfortunately there is no cure for Raynaud’s. Instead, treatment is focused on controlling the severity and frequency of episodes. This includes appropriate cold weather protection—like gloves, heavy socks, and insulated boots—and medications that prevent blood vessels from narrowing.

Other steps to control the symptoms of Raynaud’s Syndrome include smoking cessation, exercise, stress control, and avoiding rapidly changing temperatures. During an attack, it is recommended that individuals get to a warm location and attempt to slowly warm the affected area. Some strategies include warm water soaks, arm circles to promote circulation, and foot or hand massage. If conservative measures fail, some patients even elect to relocate to a warmer climate.

Raynaud’s Syndrome is often viewed as more of an annoyance rather than a dangerous condition. However, Raynaud’s has the potential to progress into a fully-blocked artery and result in skin sores or delayed wound healing. We have seen this delayed wound healing in patients with Raynaud’s during the winter and prefer to surgically treat these patients during times of warmer weather.

If you have been dealing with any of the symptoms described, schedule an appointment with a foot and ankle specialist to discuss your treatment options. There are multiple other conditions that can mimic Raynaud’s and collaboration with a Rheumatologist may be necessary. Your foot and ankle doctor will work with you to determine the best course of action for your situation.