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Raynaud's Syndrome

Q: My hands always get really cold in winter, but lately, they feel icy even when I'm indoors, especially at work where they keep the temperature toasty warm. When I put gloves on or rub them together to warm them up, I get a pins and needles sensation. What's going on?

Dr. Donnica:

It sounds like you may have something called Raynaud's syndrome. This condition involves an intermittently decreased blood flow to certain areas of the body (most commonly fingers or toes). Attacks may last anywhere from a few seconds to several hours. Raynaud's is nine times more common in women than men. And you're not alone: estimates are that up to 20% of healthy women ages 21-50 may be affected, while 5 to 10% of the US general population is affected.

The good news is that it is generally treatable. Treatment options include preventing or minimizing cold exposure by wearing gloves or mittens outdoors or holding warm (but not hot) mugs of coffee or tea. While pocket warmers may also help, avoid vigorously rubbing your hands together as this may damage surface cells. You should also avoid substances such as vasoconstrictive drugs or nicotine. Smoking is bad for just about every health issue, but particularly dangerous for people with circulation problems.

Nifedipine, a calcium channel blocker (available by prescription only), has been used to treat Raynaud's phenomenon because of its prompt vasodilatory effects. Two thirds of patients with Raynaud's treated with calcium channel blockers will find relief.

Emotional stress may worsen Raynaud's; develop and practice stress reduction and relaxation techniques that work for you on a regular basis. Daily aerobic exercise is a good choice not only to reduce stress, but also to improve circulation.

While most individuals with Raynaud's syndrome do not have other medical conditions, Raynaud's may be associated with scleroderma, systemic lupus erythematosus ("lupus"), Sjögren's syndrome, obstructive arterial disease, dermatomyositis, and polymyositis. In 1998, a small study in Rome found an association between Raynaud's syndrome and H. phylori, a bacterium in the gut that causes chronic low-level inflammation and is linked to peptic ulcer formation. In this study 36 out of 46 patients with Raynaud's syndrome were found to have H. pylori. After 7 days of antibiotic treatment, the bacterium was eradicated in 83% of patients. Attacks of Raynaud's phenomenon completely disappeared in 17% of the successfully treated patients. Discomfort and the duration and frequency of attacks of Raynaud's phenomenon were significantly reduced in 72% of the remaining patients. If you have bothersome physical symptoms other than those you mentioned, you should consult your physician to be sure that you do not have any of these other conditions; you should also specifically ask to be tested for H. pylori. In addition, depending upon the type of work that you do, your symptoms may flare up because of an association with carpal tunnel syndrome, which may also cause Raynaud's syndrome.

Created: 10/29/2005  -  Donnica Moore, M.D.
Reviewed: 11/14/2008  -  Donnica Moore, M.D.

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