In this condition, the small arteries in the fingers, and sometimes the toes, suddenly constrict in response to cold or emotional stress. The fingers/toes turn white and feel numb. When the blood returns, there’s an uncomfortable burning, tingling sensation. Swelling may also occur. These ‘vasospasm’ attacks can last from a few minutes to hours.
Raynaud’s syndrome (or disease) tends to strike women aged 20-40. Left uncontrolled, it can lead to brittle, deformed nails and slow-healing ulcers at the fingertips or around the nails. In severe cases, the blood vessels can collapse and die, leading to gangrene.
What causes it?
The exact cause of Raynaud’s is unknown. One theory suggests that the abnormal blood vessel constriction could be due to infection by Helicobacter pylori (a cause of stomach cancer). Raynaud’s patients with H. pylori had a complete recovery or a reduction of vasospasms once the bacteria were eradicated (Dig Dis Sci, 1998; 43: 1641-5; Int J Angiol, 1998; 7: 307-9).
Raynaud’s can also be secondary to other conditions such as scleroderma, lupus and rheumatoid arthritis. Such cases are considered to be more serious as patients are more likely to develop skin ulcerations and tissue death.
Certain drugs can also induce Raynaud’s, including over-the-counter cold and weight-control medications, and beta-blockers, which decrease blood flow.
People who work with vibrating tools are also at risk of a similar condition known as ’vibrating white finger’.
What doctors tell you
An effective cure for Raynaud’s remains elusive. Calcium-channel blockers, which open up the arteries, are prescribed to control the vasospasms. But effectiveness is limited - and come at the cost of a raft of side-effects such as dizziness, headaches, nausea, oedema, hot flushes, abnormal heartbeats, sleep disturbances, psychosis and jaundice.
Other drugs for Raynaud’s include blood-thinners (like aspirin) and vasodilators (such as reserpine and guanethidine).
Surgery is often the final option, such as a sympathectomy, where the nerves controlling vascular constriction in the fingers are cauterised. However, this is rarely done as it is invasive and unpredictable in outcome.
An experimental treatment is H-O-U therapy (heat, ozone, ultraviolet light). Patients are reinjected with their own blood, pretreated with H-O-U (Int Angiol, 1997; 16: 250-4).