Raynaud’s Disease

Symptoms of Raynaud’s occur when the person is cold or feels stressed or anxious, and affect the extremities e.g. finger tips and toes usually, but also hands, feet, ears, nose, lips, tongue and nipples. Raynaud’s symptoms may include:

• Skin colour changes to white, blue or red (or all three)

• Extremities feeling painful, numb or stiff

• Pins and needles

• Throbbing feeling

• Sensitivity to temperature changes

The colour change that often occurs with Raynaud’s is due to blood flow being restricted to the affected areas, which makes the skin turn white usually, then blue because oxygen in that area of the skin is low, then red when blood starts to flow back into the area again. The sensations (such as numbness) and pain symptoms of Raynaud’s occur due to the blood vessels contracting or being in spasm, and the lack of initial blood flow, then the rush of blood back to the area.

People with severe Raynaud’s, usually secondary Raynaud’s that is caused by another underlying condition, often experience the symptoms more intensely, for example:

• Extreme cold and heat when circulation comes and goes

• Constantly swollen hands

• Difficulty gripping or holding small items

• Extreme sensitivity to even slight temperature change i.e. moving from a warm room to one that is slightly cooler

• Ulcers due to tissue damage may develop if Raynaud’s spasms are regular

If you are concerned you may have Raynaud’s symptoms, it is advisable to visit your GP, who may be able to diagnose Raynaud’s straight away if they think you have the condition. They may recommend you have some blood tests to rule out secondary Raynaud’s – the most serious type which has underlying causes.

There are two types of Raynaud’s:

• Primary Raynaud’s – the most common type of Raynaud’s, with no underlying medical condition. Nobody knows why this occurs, but it can cause lots of discomfort and pain, consequently making it difficult to carry out some household or daily tasks that require gripping or walking

• Secondary Raynaud’s – less common, this type is caused by a health condition such as scleroderma, lupus or rheumatoid arthritis. These are autoimmune diseases. Raynaud’s symptoms may be the first symptoms to occur. A person with secondary Raynaud’s is likely to have more complications which could include skin ulcers and long-term blood vessel damage

If you think you may have Raynaud’s, you may wish to take this online test to find out if your symptoms are likely to be associated with the condition.

The main treatments for Raynaud’s which may be recommended to you by a GP include:

• Keeping warm as much as possible i.e. wrapping up in cold weather, wearing extra pairs of gloves/socks, using heat pads, keeping your house warm

• Exercise to help circulation

• Avoiding stress or learning to de-stress using techniques like mindfulness and activities such as yoga

• Avoiding smoking and drinking alcohol as they affect circulation

• Avoiding too much caffeine

• Medication called nifedipine, which may be prescribed if your symptoms are getting worse

• Eating a healthy, balanced diet

Many people try pain relief medication such as paracetamol or ibuprofen during a Raynaud’s attack, which works for some people and not others.

There is a surgical operation called cervical sympathectomy that was once used as a Raynaud’s treatment, but is rarely used now as it did not always reduce the symptoms.

For people who have severe Raynaud’s symptoms of the feet, a procedure called a lumbar sympathectomy can be carried out, which works well for some people to relieve pain.

Some people are finding relief from Botox injections, but this is an emerging area that still needs to be researched.

Acupuncture and reflexology are natural treatments that some people find helpful to reduce their symptoms. Some people swear by Epsom salt baths, lavender essential oil, and other natural products that they feel brings relief.

Everyone will respond differently to Raynaud’s treatment and different things help different people. If you have Raynaud’s and you feel your condition is getting worse, to the point where it’s really affecting your life, you may need to visit your GP to discuss this further or be referred to a rheumatologist.

How well you are able to live with Raynaud’s will depend upon the severity of your symptoms and how effective treatment is for you.

Many people with Raynaud’s find colder weather particularly difficult and need to wear multiple pairs of gloves and socks, thick lined boots or thermal insoles, and use portable heating devices such as hand warmers. However, some people may be sensitive to even slight temperature changes, whatever the season.

This video shows what it is like for someone living with primary Raynaud’s, and highlights how much it can affect daily life.

This video shows what it is like to live with secondary Raynaud’s as a result of scleroderma, and shows that some people with severe Raynaud’s symptoms have great difficulty doing everyday tasks such as going shopping or using money.

If Raynaud’s symptoms are making it difficult to use your hands or feet, you may wish to explore daily living aids. These are products designed to help you with mobility, such as getting around the home, getting around outside, getting ready and doing chores around the house.

At NRS Healthcare, we are experts in daily living aids. If you have Raynaud’s, you may find the following daily living aids useful:

• Comfort when sitting – if your feet are affected by Raynaud’s, you may find it more comfortable to raise your legs when sitting by using a foot rest

• Food preparation aids – if there are times when you find it difficult to grip objects, these food preparation devices may help

• Dressing aids – if your Raynaud’s sometimes makes it hard to fasten buttons, put shoes on etc, these dressing aids may be useful

• Writing and gripping aids – if your Raynaud’s symptoms cause difficulty gripping, you may find these items useful for holding pens, cutlery, paint brushes, etc:

o Foam Tubing

o Pen Grippers

• Eating and drinking aids – if your Raynaud’s causes difficulty gripping cutlery or cups, you may wish to use large handled cutlery or large handled mugs:

o Kura Care Cutlery

o Good Grips Cutlery

o Thermo Mug

• Aids for household chores – you may find that your symptoms affect your ability to do things around the home such as carry trays/meals or stand for long periods (for example on a cold kitchen floor). These items may help:

o Household trolley

o Perching stool

You may also be interested in heat remedies to provide pain relief and comfort; this Wheat Warmer is ideal for use indoors and outdoors.

NRS Healthcare has a team of occupational therapist product advisors who can advise what products may be useful to you. Feel free to contact them on 0345 121 8111 or email productadvice@nrshealthcare.co.uk.

Diet for Raynaud’s

There is no ‘Raynaud’s diet’ you should follow if you have the condition, but you should aim to eat a healthy, balanced diet such as The Eatwell Plan.

Some people take vitamins and minerals as supplements for Raynaud’s, but there is little evidence to suggest these have an effect. You should always check with your GP before taking Raynaud’s supplements.

Exercise for Raynaud’s

Exercise helps improve circulation and reduce stress, so it’s important to exercise if you have Raynaud’s. You may wish to explore options for stress reduction such as yoga. The NHS provides more advice about how to get fit for free.

Raynaud’s and employment

It’s unlikely that someone’s primary Raynaud’s would be so severe that they were unable to work, but it may present a problem depending on what job a person has, for example, someone who works in a very cold environment or outside may have difficulty doing their job.

There are some options for Raynaud’s help that are available to you. Some people find it helps to talk to other people who are affected by Raynaud’s and below, we list some online Raynaud’s support groups. We also include links to other online resources with information and advice. If you are concerned about anything you have read in this guide, please discuss with your GP.

Communities

Scleroderma and Raynaud’s UK online community – a forum for people affected by Raynaud’s, or the associated health condition scleroderma, to share experiences

Raynaud’s Syndrome Facebook Group – a public group of people with Raynaud’s and their families to discuss treatments, symptoms and experiences

NHS Inform – Scottish website providing information on Raynaud’s

NHS – source of official medical information about causes, symptoms and treatments for Raynaud’s and related conditions

Raynaud’s Association – US charity supporting people with Raynaud’s with online information about the condition and how to live well

Scleroderma and Raynaud’s UK – a charity providing support and information to the millions of people with Raynaud’s, and associated condition scleroderma, with an online community and lots of online information about living with these conditions

Autoimmune diseases

– conditions where the immune system attacks the body, mistaking it for an invading virus/bacteria

Blood vessels

– tubes in the body that carry blood around i.e. a vein, artery or capillary

Cervical sympathectomy

– surgery that takes out some of the nervous system around the spinal cord, rarely used now for Raynaud’s

Lumbar sympathectomy

– a procedure involving injecting medication into the nerves to increase blood circulation

Lupus

– an autoimmune disease that causes inflammation in joints, skin, blood cells and other organs

Nifedipine

– a calcium channel blocker medication that relaxes blood vessels and can be used to treat Raynaud’s symptoms

Rheumatologist

– a doctor specialising in conditions affecting the musculoskeletal system e.g. bones and tissues

Scleroderma

– a rare condition that causes skin thickening problems, which can have complications affecting the organs and blood vessels

Sjogren’s syndrome

– usually part of an auto-immune condition such as lupus, but can develop on its own, causing dry eyes, dry mouth, dry skin, joint pain, muscle aches, swelling and rashes