Cold hands warm heart
With the onset of colder weather you may notice a worsening of problems with your circulation. In most people this is a relatively minor symptom but a proportion of the population have a more significant condition called Reynauds Phenomenon.
Typically patients with Raynauds will notice three different phases of the condition with their hands or feet going white first of all then blue and then red. The symptoms are often accompanied by pain and tingling in the hands which can last for some time.
Raynauds is very common and affects 1 in 20 people and is more common in women. Most people have primary Raynauds which is not associated with other conditions but 1 in 10 of those with Raynauds will have associated autoimmune diseases.
If you have joint pain, dry eyes, mouth ulcers or skin rash then other more serious conditions need to be excluded such as Sjogrens Syndrome, Lupus or Rheumatoid Arthritis. This is usually done following clinical evaluation and assessment by a Rheumatology Specialist.
Figure 1 : The typical appearance of Raynauds
Raynauds is caused by spasm of the small blood vessels within the peripheries and is typically worse in cold weather and other situations such as the freezer department in a supermarket or the use of vibrating tools at work.
Raynauds cannot be cured but the symptoms can be improved by simple lifestyle measures such as stopping smoking, hand warmers, and gloves. Keeping your whole body warm also reduces the number of attacks.
There are a number of drugs that can be helpful all of which act by dilating up the blood vessels and should therefore be used with caution if you have a low blood pressure.
Medication that can be used includes drugs such as Nifedipine, Losartan or Sildenafil (Viagra). In very severe cases patients may have to have drip treatment using a drug called Iloprost.
In summary the majority of patients with Raynauds will not have significant disability but if you have other associated symptoms or would like to consider drug treatment then review by a rheumatologist is recommended.
Dr Tom Walton
If you would like to book an appointment with our Consultant Rheumatologist Dr Tom Walton call our friendly team on 01245 474070 or e-mail firstname.lastname@example.org.