Raynaud’s syndrome

Overview

Raynaud's syndrome is a condition in which a restricted blood supply causes the fingers, toes and earlobes to go white, numb and painful. The skin turns first blue and then red. Primary Raynaud's syndrome presents with episodes of vasospasm in which the blood vessels tighten. Various factors are involved in secondary Raynaud’s syndrome. The symptoms should be investigated.

Symptoms

• Three-phase attacks
• Tricolour phenomenon (colours of the French flag)
• Duration: a few minutes to 1 hour

Phases

• Painful whitening of the skin
  • Narrowing of the arteries, blood flow is blocked
  • Numbness
  • Prickling
  • Stiffness
  • Discomfort
  • Pain
• Cyanosis (blue skin) caused by a lack of oxygen
• Rewarming of fingers (reddened skin)
  • Blood flows to fingers again
  • This phase is often missing
  • Swelling
  • Heat
  • Pain
  • Tingling

Tissue death is possible if the blood supply is reduced for too long

Causes and treatment

Causes

Triggers

• Cold: winter, putting your hand into the fridge, touching cold items
• Stress

Primary Raynaud’s syndrome

• No discernible cause
• Spastic constriction of blood vessels in the fingers
• Most common form (approx. 70%)
• Women are affected up to 10 times more often

Secondary Raynaud’s syndrome

• Impaired circulation caused by
  • Damage to vascular walls
  • Blocked blood vessels
  • Medication (beta blockers, chemotherapeutic agents)
• Underlying problems
  • Rheumatoid or autoimmune disorders (scleroderma, lupus, etc.)
  • Arteriosclerosis
  • Diseases with abnormal blood proteins
  • Poisoning (e.g. heavy metals, cocaine)
  • Vibration trauma: many years of working with vibrating equipment (pneumatic hammer, power saw, but also piano playing)

Further treatment by your doctor / in hospital

Possible tests

• Physical examination
• Clinical tests
  • Making a fist
  • Cold provocation test
• Capillary microscopic examination
• Blood test (inflammatory markers, blood count, etc.)

Possible therapies

• Primary Raynaud’s syndrome
  • Medication only for severe impairment and frequent attacks
• Secondary Raynaud’s syndrome
  • Medication primarily if the course of the disease is severe (defects to fingers and/or toes)
  • Treatment of the underlying disease

What can I do myself?

• Topical measures
  • Protect against cold (e.g. warm gloves and shoes)
  • Good skin care
• During a Raynaud’s attack
  • Warm the hands and feet
  • Hand and finger exercises
  • Acupuncture and other methods of alternative medicine
  • Relaxation exercises (e.g. autogenic training)
• Don’t use drugs or tobacco

When to see a doctor?

• For Raynaud's attacks
  • Pain, numbness and stiffness in the fingers/toes
  • Changes in skin colour (white, blue, maybe red)
  • Attacks when it’s cold and wet, or if stressed
• Search for an underlying disease as trigger

Synonyms

Raynaud's syndrome, Raynaud's phenomenon, Raynaud’s disease, dead finger, Reil's finger