Raynaud’s Disease: Why Your Hands and Feet Hurt So Badly When They’re Cold

Winter is terrible for many reasons, seasonal affective disorder, treacherous slicks of ice, and the infinite quest for moisturized skin among them. But for people with Raynaud’s disease (sometimes called Raynaud’s phenomenon or syndrome), winter can also make their hands and feet go numb, then ache, and even turn every color of the American flag in the process. It would be an impressive party trick if it weren’t so painful.
Raynaud’s symptoms are painfully distinct.
It’s not just that your fingers feel cold when you trudge through the snow (or frolic, depending on your opinion of winter). “It’s impressive, this change,” vascular surgeon Daiva Nevidomskyte, M.D., assistant professor in the Department of Surgery at Duke University School of Medicine, tells SELF. “Within a couple of minutes, people’s fingers turn pale, then blue, and once they’re reheated, they turn red. It’s a pretty dramatic response.”
Beyond the visible changes, when someone is having a Raynaud’s attack, the lack of blood flow will lead to numbness and pain in the affected body part as it turns white and blue. When the blood flow returns, the body part starts to redden, and nerves reacting to the renewed circulation will cause tingling, throbbing, or burning, Mounir Haurani, M.D., vascular surgeon and assistant professor at The Ohio State University Wexner Medical Center, tells SELF.
Of course, almost everyone has experienced a mild version of these symptoms. If you forgot gloves and had to walk a mile in the freezing cold, it would be normal for your fingers to feel frigid and numb while you’re outside, then even hurt and turn red as you start warming up, Dr. Haurani says. But a person with Raynaud’s would experience these symptoms more quickly and intensely, and they would also experience them in milder situations that wouldn’t affect people without Raynaud’s, he explains.
Raynaud’s is a disorder of the blood vessels, and there are actually two types of this health condition.
“The underlying reason Raynaud’s happens is that small arteries, predominantly in the digits—fingers and toes—will spasm,” Dr. Haurani says. Your sympathetic nervous system, which causes blood vessels to narrow, is the source of this mechanism. The result is that little or no blood flow will get to those parts of the body, according to the National Heart, Lung, and Blood Institute (NHLBI). These Raynaud’s attacks typically affect the hands and feet, but they can also affect the nose, ears, lips, or even nipples.
Primary Raynaud’s has no known cause, while secondary Raynaud’s is linked with health conditions that can affect the blood vessels, like lupus, rheumatoid arthritis, and the connective tissue disease scleroderma. “If you notice you have Raynaud’s accompanied by things like malaise, achy joints, unusual rashes, and unexplained fevers, that might hint that there’s a more systemic problem,” Dr. Haurani says.

Secondary Raynaud’s may also be connected with repetitive physical actions over long periods of time (like typing or using a jackhammer), injuries to the hands or feet, and medicines like migraine medications with ergotamine, which causes arteries to narrow, according to the NHLBI.
Around 5 percent of people in the United States have some form of Raynaud’s, the NHLBI says, noting that the primary form is more common, less severe, and really more of a nuisance than a serious illness you need to worry about. On the other hand, in extreme cases, secondary Raynaud’s can lead to such diminished circulation that a person develops skin ulcers or tissue damage.
No matter whether someone has primary or secondary Raynaud’s, the attacks typically have one of two triggers.
Exposure to cold is the number one provocation of a Raynaud’s attack, Dr. Haurani says. When you get cold, your body wants to preserve heat, especially around the important organs in the center of your body. To do this, it diverts blood from extremities back to your core, Dr. Haurani explains. This is why people in colder climates are most at risk for Raynaud’s, though an attack can even happen when people wander through the frozen food aisle at the grocery store, Dr. Haurani adds.
Although Raynaud’s is most likely to affect your digits, it can happen if other areas are cold, too. “You may have perfectly well-insulated, warm hands and feet, but if your whole body takes on a chill, it can cause those vasospasms,” Dr. Haurani says.
It’s a similar story with stress. When you’re feeling tense, your sympathetic nervous system activates your fight or flight response, so more blood gets directed toward your heart and large muscles instead of areas like your fingers and toes. So, although the experts note that stress is the less common trigger for Raynaud’s, you can indeed experience painful, discolored fingers and toes just because you’re stressed.
Many people with Raynaud’s can take small measures to stave off attacks.
No, you shouldn’t just stay inside all winter long. You should, however, prepare for cold exposure as well as possible, Dr. Nevidomskyte says. “It’s not just about wearing gloves—you should also keep your core temperature warm,” she notes. If that means bundling up until you’re the human version of the Michelin Man, so be it. You may also want to look into hand and foot warmers.
If those options don’t work and you feel a Raynaud’s attack coming on, you can try moving to a warmer spot, warming your hands and feet by putting your hands under your armpits or soaking your hands and feet in warm water, says the NHLBI. You can also try moving, shaking, or wiggling your appendages to get the blood flowing. If you think the attack is due to stress, you can try relaxation techniques, like deep breathing.
If your Raynaud’s is causing severe pain, or if you think it’s happening because of a health issue or medication, talk to your doctor.
Although it’s less common, Raynaud’s does sometimes progress from a bother to a real concern, especially if it’s secondary. In these cases, your doctor may recommend medicines to increase blood flow into your extremities, or, in the rarest of instances, surgery to make the nerves in the hands and feet less responsive to triggers, says the NHLBI.
If you think you have Raynaud’s and it’s really affecting your quality of life, see your primary care physician, Dr. Nevidomskyte says. Depending on your symptoms and medical history, they may recommend you to either a vascular specialist or rheumatologist to rule out secondary causes, figure out a treatment plan, and give you one fewer reason to hate winter.

Source: https://www.self.com/story/raynauds-cold-hands-feet

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