HAND/WRIST
With the mild weather we have been experiencing so far this December, it is hard to imagine that winter officially begins in just a few days. Unfortunately this usually means that we can expect the temperatures to drop outside as we head into January. A few years ago, I started to notice that when I changed environments from warm to cold--for instance, leaving the warm house to get into a cold car--that my fingertips would lose sensation and turn white. After about 10 minutes in front of the heater vents they would warm up again but become very red and throb. So what exactly was happening to my fingers when this occurred?
According to the American College of Rheumatology, when your body is exposed to cold temperatures it limits blood flow to the extremities to preserve core body temperature. In people who have Raynaud’s phenomenon this normal response to a colder temperature is exaggerated.
Raynaud’s phenomenon is a disorder of the small blood vessels in the extremities, mainly the fingers and toes that cause the blood vessels to narrow (vasospasm) and restrict blood flow when the body is exposed to cold temperatures. The affected digits turn white as blood flow is cut-off, and the resulting lack of oxygen can cause the fingers to turn to a bluish color. Once the blood flow returns, the digits turn red and can become very warm, and even swollen. This can also occur in response to emotional stress such as nervousness or excitement.
There are 2 types of Raynaud’s: Primary Raynaud’s and Secondary Raynaud’s.
Primary Raynaud’s is the most common type and is not linked to any underlying medical condition or cause. Primary Raynaud’s does not cause tissue damage and is more of a nuisance than harmful. It is more common in women and usually episodes start to occur between ages 15-30.
Secondary Raynaud’s is associated with a medical condition, typically connective tissue diseases, such as lupus, scleroderma, or RA. It is much more serious and can often times cause associated skin ulcers in the fingertips and nail folds. Secondary Raynaud’s is treated with medications that help the blood vessels relax (vasodilate).
Recommendations to prevent a Raynaud’s episode from occurring:
• Dress in layers and a hat to keep your core temperature warm
• Wear mittens (warmer than gloves) and warm socks and boots when outside
• Reduce stress, practice relaxation techniques
• Limit caffeine intake as caffeine can restrict blood flow
• Avoid air conditioning
• Start your car early to allow to heat up before your drive
• Don’t smoke as this causes blood vessels to narrow
• Run cold vegetables and fruits under warm water prior to preparing, peeling, and cutting to limit cold temperatures on your fingertips
• Use insulated drink containers when drinking beverages with ice
• Regular exercise can be helpful to increase blood flow throughout the extremities and increase your body temperature.
So the next time you hear the expression “cold hands, warm heart” you know that this is because our bodies restrict blood flow to our hands and feet to maintain a warmer temperature in our core, or heart.
