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When Cold Hands Won't Warm Up

Dec 07, 2018
 No one likes to have cold hands. But imagine if your hands got cold and then couldn't warm up? This is what happens to people dealing with Raynaud's phenomenon. In response to cold stimuli blood vessels in their fingers spasm, decreasing blood flow. "Fingers can turn purple, blue, white, and often individual fingers have different colors," said Shaun Mendenhall, MD, a hand and wrist surgeon with University of Utah Health. "Another symptom is pain. It can be pretty uncomfortable when this happens."

There are two types of Raynaud's: primary and secondary. People with the primary form of the disease do not report any other health complaints that could be an underlying cause. Those with the secondary form also suffer from another illness, usually an autoimmune condition like lupus or rheumatoid arthritis. "In most cases, Raynaud's patients will see a rheumatologist first to go through a whole work up of autoimmune diseases," said Mendenhall. "That's kind of where [we start] to try to get to the bottom of it."

Preventing attacks is the primary treatment for those with Raynaud's. Wearing gloves and avoiding cold stimuli are important. Hand warmers are essential for some. Others will even avoid placing their hands in cold water or use oven mitts to remove items from the fridge or freezer. People with Raynaud's are also advised to quit smoking since that can constrict blood vessels. "Sometimes patients are put on medications that are calcium channel blockers that kind of help dilate the blood vessels a little bit," said Mendenhall. "When it gets really bad, they may seek out surgical options."

There are two surgeries that can be done to help those with severe Raynaud's. The first is called a sympathectomy and involves removing sympathetic nerves from the blood vessel walls. This helps open the blood vessels. The other is a bypass operation. "We take a little vein from somewhere else and we bypass little areas of their hand arteries that are, for whatever reason, permanently clamped down or clotted off," said Mendenhall.

Another surprising treatment proving effective for Raynaud's is Botox. The medication commonly used to paralyze facial muscles to prevent wrinkles is also being used to keep blood vessels from going into spasm. "Botox has really revolutionized treatment for Raynaud's," said Mendenhall. "There have actually been a number of randomized trials now that are showing that it's beneficial."