Understanding Raynaud’s Phenomenon

Things to remember | Symptoms | Primary Raynaud’s phenomenon | Secondary Raynaud’s phenomenon | Diagnosis | Treatment | Prevention | Complications | Where to get help | How we can help | More to explore | Download PDF

Things to remember

• Raynaud’s phenomenon is the short-term interruption of blood flow to your extremities
• It can occur on its own or as the result of another condition
• Management options include avoiding cold weather and sudden temperature changes.

Raynaud’s phenomenon is a condition that can cause discomfort as the blood supply to your extremities becomes reduced. In general fingers and toes are affected, but other parts of your body such as nose, lips and ears can be affected too.

It can happen in cold temperatures or when you’re in an emotionally stressful situation.

Raynaud’s phenomenon can occur on its own (primary Raynaud’s phenomenon), or it can be linked to another disease or condition (secondary Raynaud’s phenomenon). It can last from just a few minutes to many hours.

Raynaud’s phenomenon doesn’t usually cause permanent damage. However it can be a symptom of a more serious underlying illness, so it’s important to see your doctor if you experience it.

Symptoms

Your body protects your internal organs (your core) from heat loss in cold weather by redirecting your blood away from your extremities such as the fingers and toes.

With a Raynaud’s attack, this reaction is exaggerated. Blood vessels in your extremities narrow, starving the tissues of blood and causing the characteristic blue or white colour change.

When this happens you may experience stinging pain, tingling and numbness in your fingers or toes.  When blood flow returns, the skin turns from blue to red and finally back to the normal pink colour.

Circulation to the rest of the body is generally normal.

Primary Raynaud’s phenomenon

Primary Raynaud’s phenomenon (or Raynaud’s disease or just Raynaud’s) is the most common form of Raynaud’s phenomenon. It affects more women than men, generally under the age of 30. If you have a family member with primary Raynaud’s, you’re more at risk of developing it.

Secondary Raynaud’s phenomenon

The most common causes of secondary Raynaud’s are underlying autoimmune disorders such as rheumatoid arthritis, scleroderma and systemic lupus erythematosus (lupus).

Other common causes are:

• mechanical vibration – such as using a power tool for long periods
• carpal tunnel syndrome
• atherosclerosis – narrowing of the arteries caused by a build-up of fatty plaques that can hamper blood flow to the extremities
• smoking – constricts blood vessels
• some medication – e.g. beta blockers, some chemotherapy agents and medication that causes blood vessels to narrow
• frostbite.

Diagnosis

It’s not hard to diagnose Raynaud’s phenomenon, but it is sometimes hard to tell the difference between the primary or secondary form of the condition.

Your doctor may use a range of methods to work out which form you have including:

• taking a complete medical history
• a physical examination
• blood tests
• examining fingernail tissue with a microscope.

Treatment

For most people, Raynaud’s phenomenon is a nuisance rather than a disabling condition.

Keeping your body and extremities warm is helpful to prevent attacks. You should also dress appropriately for the cold with gloves, thick socks and warm layers.

If you’re outside and you experience an attack, go indoors and soak your fingers or toes in warm (not hot) water. If you can’t go indoors, try to warm your fingers or toes by wiggling them. You could also place your hands under your armpits, make circles with your arms or try to massage your hands or feet. If a stressful situation triggers the attack, try to remove yourself from the situation and relax.

Talk with your doctor if your Raynaud’s isn’t controlled by these simple measures. You may need to be prescribed medications that widen your blood vessels and improve circulation.

For secondary Raynaud’s phenomenon, it’s also important that the underlying condition (e.g. lupus or rheumatoid arthritis) is treated effectively.

Prevention

There’s no cure for Raynaud’s phenomenon. Managing the condition means that you need to try to avoid triggers, especially exposure to cold temperatures and stressful situations.

Things you can do to prevent an attack:

• avoid prolonged exposure to cold weather or sudden temperature changes, such as leaving a warm house on a cold day or air conditioned rooms in hot weather.
• be aware that even holding something cold, such as a can of drink, can trigger symptoms.
• make sure your whole body is kept warm, using several layers of clothing to trap body heat. Keep your extremities warm with gloves and woollen socks. Hand warmers are also helpful.
• don’t smoke cigarettes or drink caffeinated beverages, as nicotine and caffeine constrict blood vessels.
• review your medications with your doctor. If your medications are causing the problem you may need to find alternatives.
• learn to recognise and avoid stressful situations. Stress and emotional distress can trigger an attack, particularly for people with primary Raynaud’s phenomenon. Relaxation may decrease the number and severity of attacks you experience.
• keep a journal of when attacks happen. This will help you work out what triggers an attack.
• look after your hands and feet. Dry hands and feet can develop skin cracks, so it’s important to moisturise them to prevent dryness. Protect your hands when in water with barrier creams and/or rubber gloves.
• exercise regularly to maintain blood flow and skin condition. Physical activity can also help increase your energy levels, control your weight, improve your cardiovascular (heart) fitness and help you sleep better. Talk to your doctor before starting any exercise program.
• eat a healthy and well balanced diet for general good health.

Complications

In most cases, Raynaud’s phenomenon is harmless and has no lasting effects. However in severe cases loss of blood flow can permanently damage the tissue.

Complications of severe Raynaud’s include:

• ulcers
• tissue loss
• scarring

Talk with your doctor if you notice any of these problems or if you notice other changes to your symptoms.

Where to get help

• Your doctor
• Musculoskeletal Australia.
  National Arthritis and Back Pain+ Help Line 1800 263 265

How we can help

Call our Help Line and speak to our nurses. Phone 1800 263 265 or email helpline@msk.org.au.

We can help you find out more about:

• Raynaud’s phenomenon and other musculoskeletal conditions
• ways to live well with these conditions
• managing your pain
  • read our A-Z guide to managing pain
  • watch our excellent videos on pain, your brain and how you can retrain your pain system.
    • Pain, the brain and your amazing protectometer – Lorimer Moseley
    • Treating pain using the brain – David Butler
• upcoming webinars, seminars and other events.

More to explore

• Better Health Channel betterhealth.vic.gov.au
• Versus Arthritis UK versusarthritis.org 
• Occupational Therapy Australia otaus.com.au

Download this information sheet (PDF).

The whole or part of this material is copyright to the State of Victoria and the Better Health Channel. Reproduced with permission of the Victorian Minister for Health. Users are permitted to print copies for research, study or educational purposes.

This information has been produced in consultation with and approved by: Musculoskeletal Australia.