Raynaud’S Phenomenon
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Definition
Raynaud’s phenomenon is a condition in which cold temperatures or strong emotions cause blood vessel spasms that block blood flow to the fingers, toes, ears, and nose.
Causes, incidence, and risk factors
Raynaud's phenomenon can be associated with other conditions. This is called secondary Raynaud's phenomenon. Most people with the condition are over age 30.
Common causes are:
Drugs that cause narrowing of arteries, such as amphetamines, certain types of beta-blockers, some cancer drugs, ergot compounds, and methysergide
Repeated injury, particularly from vibrations such as those caused by typing or playing the piano
Smoking
Raynaud's phenomenon also occurs without another disease, medication, or cause. This is called primary Raynaud's phenomenon. It most often begins in people younger than age 30.
References
Bakst R, Merola JF, Franks AG Jr., Sanchez M, Perelman RO. Raynaud's phenomenon: pathogenesis and management. J Am Acad Dermatol. 2008;59:633-653.
Ferri FF, ed. Ferri’s Clinical Advisor 2011. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2010.
Review Date: 6/28/2011
Reviewed By: Ariel D. Teitel, MD, MBA, Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY; Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Symptoms
Strong emotions or exposure to the cold causes the fingers, toes, ears, or nose to become white, then turn blue. When blood flow returns, the area becomes red and then later returns to normal color. The attacks may last from minutes to hours.
People with primary Raynaud's phenomenon (no other cause or condition) have problems in the same fingers on both sides, but they do not have very much pain.
People with Raynaud's phenomenon associated with other medical conditions are more likely to have pain or tingling in different fingers. The pain is rarely severe. There may be ulcers on the affected fingers.
Signs and tests
Your health care provider can usually make the diagnosis by examining you and asking questions about your health history. However, vascular ultrasound and a cold stimulation test for Raynaud's phenomenon may be done to confirm the diagnosis.
Different blood tests may be done to diagnose arthritic and autoimmune conditions that may cause Raynaud's phenomenon.
References
Bakst R, Merola JF, Franks AG Jr., Sanchez M, Perelman RO. Raynaud's phenomenon: pathogenesis and management. J Am Acad Dermatol. 2008;59:633-653.
Ferri FF, ed. Ferri’s Clinical Advisor 2011. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2010.
Review Date: 6/28/2011
Reviewed By: Ariel D. Teitel, MD, MBA, Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY; Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Treatment
The following lifestyle changes may help people with Raynaud's phenomenon:
Stop smoking
Avoid caffeine
Stop and avoid medications that cause tightening or spasms of the blood vessels
Keep the body warm. Avoid exposure to cold in any form. Wear mittens or gloves outdoors and when handling ice or frozen food. Avoid getting chilled, which may happen after any active recreational sport.
Wear comfortable, roomy shoes and wool socks. When outside, always wear shoes.
Your health care provider may prescribe medications to relax the walls of the blood vessels. These include topical nitroglycerin, calcium channel blockers, sildenafil (Viagra), and ace inhibitors.
It is important to treat the condition causing Raynaud's phenomenon.
Expectations (prognosis)
The outcome varies depending on the cause and the severity of the condition.
Complications
Calling your health care provider
Call your health care provider if:
You have a history of Raynaud's phenomenon and the affected body part (arm, hand, leg, foot, or other part) becomes infected or develops a sore
Your fingers change color and you do not know the cause
Your fingers or toes turn black or the skin breaks
You have a sore on the skin of your feet or hands
You have a fever, swollen or painful joints, or skin rashes
References
Bakst R, Merola JF, Franks AG Jr., Sanchez M, Perelman RO. Raynaud's phenomenon: pathogenesis and management. J Am Acad Dermatol. 2008;59:633-653.
Ferri FF, ed. Ferri’s Clinical Advisor 2011. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2010.
Review Date: 6/28/2011
Reviewed By: Ariel D. Teitel, MD, MBA, Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY; Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Prevention
Avoid exposure to the cold. Dress warmly when you cannot avoid cold. If you smoke, stop smoking, as it further constricts the blood vessels.
References
Bakst R, Merola JF, Franks AG Jr., Sanchez M, Perelman RO. Raynaud's phenomenon: pathogenesis and management. J Am Acad Dermatol. 2008;59:633-653.
Ferri FF, ed. Ferri’s Clinical Advisor 2011. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2010.
Review Date: 6/28/2011
Reviewed By: Ariel D. Teitel, MD, MBA, Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY; Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 6/28/2011
Reviewed By: Ariel D. Teitel, MD, MBA, Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY; Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.