Healthy Living

It’s been a cold winter, and despite some brief warm ups recently we can be assured that it is not over yet.

While there has been a high number of slips, falls and snowblower injuries, there has also been a much quieter result of the cold — Raynaud’s Phenomenon.

Approximately 3% to 5% of the population suffers from Raynaud’s Phenomenon, which is a condition in which some of the body’s blood vessels — commonly in the fingers and toes — constrict in an exaggerated way in response to cold and emotional stress.

This restricts blood flow to the affected areas and causes the skin to change to a white color, then to blue when there are low levels of oxygen, and then back to pink.

Raynaud’s usually occurs on its own and is most common among women, younger age groups and people with family members who also have it. It is sometimes related to an autoimmune illness like lupus or scleroderma, and in these cases can cause a serious decrease in blood flow.

Most often, Raynaud’s affects the blood vessels in the fingers. In a typical attack the fingers become suddenly cold, color changes markedly and become blue or purple. Usually the attack begins in a single finger and then spreads to fingers of both hands.

Symptoms of Raynaud’s generally subside when the cause is removed. The discoloration resolves after 15-20 minutes.

Diagnosis is based on the patient’s description of the attack following cold exposure, and in some cases, particularly when Raynaud’s is related to another disease, consultation with a rheumatologist is needed.

To limit the chances of Raynaud’s, avoid sudden cold exposure and dress in layers. You can help end an attack by placing your hands in your armpit or rotating your arms in a whirling windmill pattern. Avoid smoking and medications such as decongestants, diet pills and some migraine drugs.

Sometimes treatment involves medication, including those that contain calcium channel blockers. Several other medications have been studied including topical nitroglycerine, trental and sildenafil.

In extreme circumstances, hospitalization and surgery may be required.

Sandeep Varma, MD, is a rheumatologist and Medical Director at the Backus Arthritis Center. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Varma or any of the Healthy Living columnists at healthyliving@wwbh.org