About Raynaud's phenomenon
What is Raynaud's phenomenon?
Raynaud's phenomenon is a condition in which there is a narrowing of blood vessels in response to cold or emotional stress. It most often affects the fingers, but sometimes the toes, ears, or the end of the nose1.
The main symptoms of Raynaud's phenomenon
The narrowing of blood vessels in Raynaud's phenomenon is called vasospasm (vaso=blood vessel, spasm=constriction). With vasospasm, the fingers turn white and cold, then blue with dilated veins. When the stressor is removed, the blood vessels go back to normal blood flow causing a red 'flushing' and a “pins and needles” sensation1.
Who can develop Raynaud's phenomenon?
There are two types of Raynaud’s phenomenon, referred to as “primary” and “secondary”.
Primary Raynaud’s phenomenon refers to those without underlying disease. It usually has an age of onset between 15 and 30 years and is more common in women10. Even though these patients experience uncomfortable symptoms of Raynaud’s phenomenon, there is no damage to the body. Approximately 10% of the general population has Primary Raynaud’s phenomenon1,2.
Secondary Raynaud’s phenomenon refers to Raynaud’s in patients who have an associated disease. The onset of secondary Raynaud’s phenomenon is typically later in life – usually after the age of 301,2. The most common rheumatic diseases associated with Raynaud’s include scleroderma and lupus. However, it can be associated with other rheumatic diseases1. For example, up to 35% of people with Sjögren's syndrome are also affected by Raynaud's phenomenon3. It can also be associated with drug use and other blood or hormone related disorders2,8.
Getting a diagnosis of Raynaud's phenomenon
Raynaud's phenomenon has several warning signs, which may be present at onset. These include4,5:
Your primary care provider may order comprehensive blood tests to examine blood count, metabolism, muscle enzymes, rheumatoid factor and a variety of other values9.
Treatment for Raynaud's phenomenon
Once a doctor has diagnosed Raynaud's phenomenon, there are several simple, effective methods to help manage the symptoms. While there is no known cure for Raynaud's phenomenon, people with the disease are usually able to manage their symptoms by being mindful of triggers and modifying their behaviour.
Protection against the cold6
There are a number of strategies to treat the symptoms of Raynaud’s phenomenon. Most importantly, protecting the core body (hat, scarf, layered clothes) as well as the hands and feet from cold temperatures will help prevent discomfort. Wearing gloves and heavy socks in winter is a simple yet tried and true protection strategy. Heat packs are helpful as well. Some people with Raynaud’s phenomenon even find it helpful to wear oven mitts when reaching into freezers.
Avoid stimulants6
People with Raynaud’s phenomenon should not smoke or be exposed to second-hand smoke, as smoking restricts blood vessels and can worsen the condition. Recreational substances or ‘stimulants’ may make Raynaud’s phenomenon worse and should be avoided. Learn more about this here.
Exercise6
Exercise, even low impact or gentle movements can boost circulation and may improve Raynaud’s. Why? Exercise improves blood flow to the working muscles, improving circulation. Next time you are on a walk in the cold, try swinging your arms in circle. Other activities such as swimming, cycling or yoga may also be recommended by your health care professional. The most important thing is that you enjoy what you are doing and exercise within your limits.
Medications2,7,8
If conservative strategies such as protecting against the cold and exercise are not helping, there are several medications which are sometimes used to treat Raynaud’s phenomenon. These work to relax the walls of the blood vessels and increase blood flow:
Key take-aways
References
| ACE is committed to using inclusive language that is free from words, phrases and tone that reflect discriminatory or stereotyped views of underrepresented people or groups. In our attempt to avoid bias or using language that appropriates other cultures as it relates to Indigenous Peoples health and wellness, ACE consults with Indigenous advisors to ensure its website and other written materials use terms and expressions that align with Indigenous identities and are culturally appropriate. |
Raynaud's phenomenon is a condition in which there is a narrowing of blood vessels in response to cold or emotional stress. It most often affects the fingers, but sometimes the toes, ears, or the end of the nose1.
The main symptoms of Raynaud's phenomenon
The narrowing of blood vessels in Raynaud's phenomenon is called vasospasm (vaso=blood vessel, spasm=constriction). With vasospasm, the fingers turn white and cold, then blue with dilated veins. When the stressor is removed, the blood vessels go back to normal blood flow causing a red 'flushing' and a “pins and needles” sensation1.
Who can develop Raynaud's phenomenon?
There are two types of Raynaud’s phenomenon, referred to as “primary” and “secondary”.
Primary Raynaud’s phenomenon refers to those without underlying disease. It usually has an age of onset between 15 and 30 years and is more common in women10. Even though these patients experience uncomfortable symptoms of Raynaud’s phenomenon, there is no damage to the body. Approximately 10% of the general population has Primary Raynaud’s phenomenon1,2.
Secondary Raynaud’s phenomenon refers to Raynaud’s in patients who have an associated disease. The onset of secondary Raynaud’s phenomenon is typically later in life – usually after the age of 301,2. The most common rheumatic diseases associated with Raynaud’s include scleroderma and lupus. However, it can be associated with other rheumatic diseases1. For example, up to 35% of people with Sjögren's syndrome are also affected by Raynaud's phenomenon3. It can also be associated with drug use and other blood or hormone related disorders2,8.
Getting a diagnosis of Raynaud's phenomenon
Raynaud's phenomenon has several warning signs, which may be present at onset. These include4,5:
- Fingers, toes, ears, and/or nose turning white or blue when they are exposed to cold, or at times of emotional distress
- Pain in the fingers or toes when they are exposed to changes in temperature
- Tingling in extremities when they have been exposed to cold and when warming up
Your primary care provider may order comprehensive blood tests to examine blood count, metabolism, muscle enzymes, rheumatoid factor and a variety of other values9.
Treatment for Raynaud's phenomenon
Once a doctor has diagnosed Raynaud's phenomenon, there are several simple, effective methods to help manage the symptoms. While there is no known cure for Raynaud's phenomenon, people with the disease are usually able to manage their symptoms by being mindful of triggers and modifying their behaviour.
Protection against the cold6
There are a number of strategies to treat the symptoms of Raynaud’s phenomenon. Most importantly, protecting the core body (hat, scarf, layered clothes) as well as the hands and feet from cold temperatures will help prevent discomfort. Wearing gloves and heavy socks in winter is a simple yet tried and true protection strategy. Heat packs are helpful as well. Some people with Raynaud’s phenomenon even find it helpful to wear oven mitts when reaching into freezers.
Avoid stimulants6
People with Raynaud’s phenomenon should not smoke or be exposed to second-hand smoke, as smoking restricts blood vessels and can worsen the condition. Recreational substances or ‘stimulants’ may make Raynaud’s phenomenon worse and should be avoided. Learn more about this here.
Exercise6
Exercise, even low impact or gentle movements can boost circulation and may improve Raynaud’s. Why? Exercise improves blood flow to the working muscles, improving circulation. Next time you are on a walk in the cold, try swinging your arms in circle. Other activities such as swimming, cycling or yoga may also be recommended by your health care professional. The most important thing is that you enjoy what you are doing and exercise within your limits.
Medications2,7,8
If conservative strategies such as protecting against the cold and exercise are not helping, there are several medications which are sometimes used to treat Raynaud’s phenomenon. These work to relax the walls of the blood vessels and increase blood flow:
- Calcium channel blockers: nifedipine (Procardia®, Adalat®), diltiazem (Cardizem® and Dilacor®), amlodipine (Norvasc), nicardipine (Cardene®), nifedipine (Procardia®, Adalat®).
- Phosphodiesterase type 5 inhibitor: sildenafil (Viagra), tadalafil (Cialis).
- Other vasodilator medications used for pulmonary hypertension can be considered in severe cases.
Key take-aways
- Raynaud’s causes decreased blood flow to the fingers, and sometimes, toes, ears, or the end of the nose.
- Raynaud’s is usually triggered by cold temperatures, anxiety, or stress.
- There is no known cure but people can manage their symptoms by protecting against the cold, avoiding stimulants, participating in regular exercise, and taking medications as prescribed and recommended by your doctor.
References
| 1 | ACR website |
| 2 | Clinical manifestations and diagnosis of Raynaud phenomenon – UpToDate. Accessed March 16, 2023. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-raynaud-phenomenon?search=raynaud&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H536557134 |
| 3 | Garner et al. (2015). Prevalence, risk factors and associations of primary Raynaud’s phenomenon: systematic review and meta-analysis of observational studies. https://pubmed.ncbi.nlm.nih.gov/25776043/ |
| 4 | Wigley & Flavahan (2016). Raynaud’s Phenomenon. https://www.nejm.org/doi/10.1056/NEJMra1507638 |
| 5 | Patient education: Raynaud phenomenon (Beyond the Basics) - UpToDate. Accessed September 2, 2022. https://www.uptodate.com/contents/raynaud-phenomenon-beyond-the-basics |
| 6 | Goundry et al. (2012). Diagnosis and management of Raynaud’s phenomenon. https://doi.org/10.1136/bmj.e289 |
| 7 | Devgire, V., & Hughes, M. (2019). Raynaud's phenomenon. https://doi.org/10.12968/hmed.2019.80.11.658 |
| 8 | Khouri et al. (2016). Drug-induced Raynaud's phenomenon: beyond β-adrenoceptor blockers. https://doi.org/10.1111/bcp.12912 |
| 9 | Temprano (2016). A Review of Raynaud's Disease. 113(2), 123–126. https://pubmed.ncbi.nlm.nih.gov/27311222/ |
| 10 | LeRoy & Medsger (1992). Raynaud's phenomenon: a proposal for classification. Clinical and experimental rheumatology, 10(5), 485–488 https://pubmed.ncbi.nlm.nih.gov/1458701/ |
Arthritis Consumer Experts
ACE thanks Arthritis Research Canada (ARC) for its scientific review of ACE and JointHealth™ information and education programs.