Raynaud’s phenomenon is a condition of the fingers and toes that causes restricted blood flow and colour changes. Raynaud’s classically presents with exposure to cold, whether it is reaching into a freezer, going outside, working in an air-conditioned building or washing your hands in cold water.  You may experience pain, tingling and colour changes in the fingers as blood flow is reduced.

Raynaud’s occurs when there is a sudden reduction in blood supply to the fingers and toes sometimes also affecting the nose and ear lobes. When we are exposed to extreme temperatures our blood flow is naturally either reduced from our extremities and pumped to our vital organs (in the cold) or pumped to the surface of our skin to cool us down (in the heat). With Raynaud’s however, the body exaggerates this response and an attack can be triggered by external temperature changes, stress or even dietary factors like intake of caffeine.

You may notice three stages of colour changes in your hands:

Stage 1: White finger tips and toes (vasoconstriction) is when the blood vessels close and blood flow is rapidly restricted.

Stage 2:  Purple finger tips and toes (reduced oxygen in the blood) when the blood pools in the finger tips and is no longer carrying fresh oxygen to the tissues.

Stage 3: Red finger tips and toes (flushing) when the blood rushes back to the extremities, usually once the hands have warmed up again.

These stages can be painful and require treatment and involvement of your hand therapist, GP and sometimes a rheumatologist.

There are two forms of Raynaud’s; primary and secondary. It is important to work with your team of hand therapist and GP to determine which one is relevant to you in order to guide best treatment.

Primary Raynaud’s is not related to any other disease and occurs in 1 in 5 women. This usually becomes evident before the age of 25.

Secondary Raynaud’s is associated with other conditions such as autoimmune diseases (scleroderma, lupus, rheumatoid arthritis, Sjogren’s disease) and diseases of the arteries. You may have other symptoms, and Raynaud’s is one of them.

Other triggers for Raynaud’s can be occupations that use vibratory tools, drugs that treat the following; high blood pressure, contraceptives, cancer and depression. If you are on any of these medications and experience symptoms in your hands, please consult your doctor.

Written by Caitlin Ring, Occupational Therapist, Riverina Hand Therapy