Cold or numb fingers and toes may signal more than just winter. It could be a sign of Raynaud’s. Dr Mel Wynne-Jones advises
Raynaud’s is a blood-vessel disorder which affects around 10 million of us in the UK and produces a sudden reduction in blood flow to the hands and other extremities, which then temporarily turn cold, white and become numb/painful.
In extremely cold conditions, this is a normal reaction designed to conserve body heat, but in Raynaud’s it can be triggered by even a mild drop in temperature, as well as by stress, anxiety and other emotional changes.
It often starts at a young age, and is slightly more common in women.
Raynaud’s usually occurs for no obvious reason (‘primary’) but around one in 10 cases is linked to other diseases (‘secondary’), including immune-system disorders such as rheumatoid arthritis, lupus and scleroderma, which affect the skin, joints and other tissues.
Smoking, work that involves vibrating tools (‘vibration white finger’), hand injuries, infections, some cancers, migraine or a family history of the condition can also increase your risk of developing Raynaud’s.
Many prescribed medicines can trigger it, too, including beta blockers and ACE inhibitors (used to treat heart conditions and high blood pressure), oestrogen hormones (the contraceptive pill and hormone replacement therapy) and chemotherapy.
Raynaud’s produces spasm in tiny skin surface arteries; fingers, toes, noses and ears, and even nipples may suffer. They typically go white and cold initially.
You may even see a dividing line between affected and unaffected areas. Lack of oxygen produces pain and numbness, and changes skin colour to blue until the blood supply returns, turning skin red and warm again.
Attacks may be frequent, mild, or severe, but the skin appears normal in between. However, in secondary Raynaud’s, particularly scleroderma, the spasm may be longer-lasting and, like frostbite, can cause permanent tissue damage such as ulcers, scarring or even gangrene, so needs to be taken seriously.
Depending on any other linked symptoms and what other medical conditions you have, you may need blood tests, a heart tracing (ECG) or scan (echocardiogram), or other X-rays, ultrasound or CT scans.
Your GP may also suggest changing your medication, or referring you to a rheumatologist or other specialist if she suspects you have secondary Raynaud’s.
If your symptoms are mild or infrequent, you may already have found ways to cope (see self-help tips, left) and primary Raynaud’s often eventually improves by itself.
Nifedipine is a heart/blood-pressure tablet that effectively dilates blood vessels and relieves the spasm. You can take it regularly or only when needed (for example, if you have to spend time outside on a cold day).
In severe cases, specialists sometimes prescribe other medicines not licensed for Raynaud’s (such as Viagra), or advise surgery, such as sympathectomy, which cuts nerves in the neck and/or back that control blood-vessel spasm.
7 ways to help your circulation
1. Keep warm with layered clothing and stay in warm environments whenever you can.
2. Wear thick gloves (even to remove food from the freezer if necessary), socks, a hat and fur-lined boots when you go out in the cold. Outdoor activity shops sell hand-warmers.
3. Find out more, and/or buy heated gloves/socks/insoles from Scleroderma & Raynaud’s UK (helpline, 0800 311 2756; sruk.co.uk).
4. Brisk exercise improves circulation and can relieve stress. Also try mindfulness, relaxation techniques or lifestyle changes to minimise the effects of stress triggers.
5. Don’t smoke as it damages arteries. Visit nhs.uk for help if you want to stop.
6. You may be entitled to workplace changes (speak to your employer) or disability benefits if your condition is work-related.
7. See your doctor quickly if you notice any skin damage.