Raynaud’s (‘Ray-nose’) is an oversensitivity of the small blood vessels to changes in temperature which affects the extremities, particularly the fingers and toes. Symptoms The fingers and/or toes may turn white (indicating restricted blood flow), red (indicating return of blood flow), purple and blue (blood vessel reaction) in response to cold or when the individual is under stress. The extremities may feel deathly cold, and the condition can be acutely painful, or you may just feel some numbness and tingling and find it a little trickier to button up your coat. The symptoms vary widely from person to person.
In very severe cases, necrosis (gangrene) can occur. This is uncommon, and certainly in the cases that I have seen the patient is much less interested in their multicoloured fingers and toes than I am! It is a common condition, estimated to affect up to 10 million people in the UK alone. Two Subtypes Primary Raynaud’s is more common and less serious. Secondary Raynaud’s tends to be related to a concurrent autoimmune disease such as Scleroderma or Lupus, and is more serious.
Treatment * Endeavour to maintain a constant, warm temperature and do not expose your extremities to big changes in temperature
* Exercise regularly to improve circulation
* Nifedipine can be prescribed by your GP to dilate your blood vessels * Try to reduce stress (easier said than done! You could try an app such as Headspace; inner peace brought about by a 3-5 minute meditation practice) * Do not smoke. Smoking furs your arteries, restricting blood flow. Differential Diagnoses * CHILBLAINS - similar mechanism, but it’s not the same * GOUT - totally different symptoms and aetiology If I had a penny for every time I tell a patient “no, it’s not gout.
Trust me, you’d KNOW if it was gout”. I’ll post about this another time!
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