Woowhee, It’s Cold Out There

We’ve already seen sub-zero temperatures in Connecticut, and winter is barely half over (Groundhog’s Day was February 2nd). If you work or recreate outdoors, you have to take extra precautions. If you dress for the cold, wearing multiple layers and properly covering your head, hands and feet, it’s uncomfortable but tolerable. However, for five percent of Americans suffering from Raynaud’s Disease, dressing warmly still may not be enough to avoid extra discomfort, chaffing and pain from exposure to extreme cold.

Raynaud’s Disease causes some areas of our body — such as fingers and toes — to feel numb and cold in response to cold temperatures or stress. In Raynaud’s Disease, smaller arteries that supply blood to our skin narrow, limiting blood circulation to affected areas. Women are more likely than men to have Raynaud’s disease, also known as Raynaud or Raynaud’s phenomenon or syndrome. It appears to be more common in people who live in colder climates, and often occurs prior to the age of 30.

Treatment of Raynaud’s Disease depends on its severity and whether you have other health conditions. For most people, Raynaud’s Disease isn’t disabling, but it can affect quality of life. Signs and symptoms of Raynaud’s Disease include:

  • Cold fingers or toes
  • Color changes in your skin in response to cold or stress
  • Numb, prickly feeling or stinging pain upon warming or stress relief

With Raynaud’s, arteries to fingers and toes go into vasospasm when exposed to cold or stress, narrowing vessels and temporarily limiting blood supply. Over time, these small arteries can thicken slightly, further limiting blood flow.

Cold temperatures are most likely to trigger an attack. Exposure to cold, such as putting hands in cold water, taking something from a freezer or being in cold air, is the most likely trigger. For some people, emotional stress can trigger an episode.

During an attack of Raynaud’s, affected areas of the skin usually first turn white. Then, they often turn blue and feel cold and numb. As you warm and circulation improves, the affected areas may turn red, throb, tingle or swell. Although Raynaud’s most commonly affects fingers and toes, it can also affect other areas of the body such as our nose, lips, ears and even nipples. After warming, it can take 15 minutes for normal blood flow to return to the area.

There are two main types of the condition. Primary Raynaud’s, the most common form, can be so mild that most people don’t seek medical treatment. It often resolves by itself. However, Secondary Raynauld’s typically is a side effect of another underlying cause; though less common, it tends to be more serious.

Recognizing and Mitigating Symptoms

Causes of Secondary Raynaud’s include:

  • Connective tissue diseases.Most people who have a rare disease that leads to hardening and scarring of the skin (scleroderma) have Raynaud’s. Other diseases that increase the risk of Raynaud’s include lupus, rheumatoid arthritis and Sjogren’s syndrome.
  • Diseases of the arteries.These include a buildup of plaques in blood vessels that feed the heart (atherosclerosis), a disorder in which the blood vessels of the hands and feet become inflamed (Buerger’s disease), and a type of high blood pressure that affects the arteries of the lungs (primary pulmonary hypertension).
  • Carpal tunnel syndrome.This condition involves pressure on a major nerve to hands, producing numbness and pain that can make the hand more susceptible to cold temperatures.
  • Repetitive action or vibration.Typing, playing piano or doing similar movements for long periods and operating vibrating tools, such as jackhammers, can lead to overuse injuries.
  • Smoking constricts blood vessels.
  • Injuries to the hands or feet.These include wrist fracture, surgery or frostbite.
  • Certain medications.These include beta blockers, used to treat high blood pressure; migraine medications that contain ergotamine or sumatriptan; attention-deficit/hyperactivity disorder medications; certain chemotherapy agents; and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications.
  • Family history.A first-degree relative — a parent, sibling or child — having the disease appears to increase your risk of Primary Raynaud’s.

There are specific tests for helping physicians diagnose Reynaud’s Disease, and a variety of medications and treatments, typically aimed at treating the underlying causes. For the most part, common sense prevails. Avoiding rapidly changing temperatures (indoors and outdoors) when possible and dressing properly are the most obvious preventative measures. Stop smoking, which causes skin temperatures to drop by constricting blood vessels. Exercise increases circulation, and learning to recognize and control stress may limit attacks.

Getting outdoors in the winter is important for our physical and mental health. Enjoy it responsibly, and remember – the days are already getting longer and spring will be here before we know it!

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!