Diagnosis
Your healthcare professional asks about your symptoms and medical history and does a physical exam. You also might have tests to rule out other medical problems that can cause the same symptoms.
Tests
A test called nailfold capillaroscopy can tell the difference between primary and secondary Raynaud's. During the test, the professional uses a microscope or magnifier to look for anything unusual on the skin at the base of a fingernail. This might include swelling of the blood vessels.
Blood tests can help find out whether another condition, such as an autoimmune condition or a connective tissue disease, is causing Raynaud's. Blood tests for Raynaud's might include:
- Antinuclear antibodies test, also called an ANA test. A positive test result often means that your immune system is mistakenly attacking body tissue. This is called an autoimmune reaction. Such immune system activity is common in people who have connective tissue diseases or other autoimmune disorders.
- Erythrocyte sedimentation rate. This test shows the rate at which red blood cells fall to the bottom of a tube. A faster than typical rate might signal an inflammatory or autoimmune disease.
No one blood test can diagnose Raynaud's. Other tests, such as those that rule out diseases of the blood vessels, can help find a condition that can be related to Raynaud's.
Treatment
Dressing for the cold in layers and wearing gloves or heavy socks usually can help mild symptoms of Raynaud's. Medicines can treat more-serious symptoms. The goals of Raynaud's treatment are to:
- Reduce the number of attacks and how bad they are.
- Keep tissue damage from happening.
- Treat the underlying disease or condition.
Medications
Depending on the cause of symptoms, medicines might help. Medicines used to treat people with Raynaud's disease may include:
- Calcium channel blockers. These medicines relax and open small blood vessels in the hands and feet. These drugs also can help heal sores on fingers or toes. Examples include nifedipine (Procardia), amlodipine (Norvasc), felodipine and isradipine.
- Vasodilators. These medicines relax blood vessels. They include the high blood pressure medicine losartan (Cozaar), the erectile dysfunction medicine sildenafil (Viagra, Revatio), the antidepressant fluoxetine (Prozac) and a class of medicines called prostaglandins.
Surgeries and medical procedures
Surgery or shots might be needed to treat serious Raynaud's.
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Nerve surgery. Nerves in the hands and feet control opening and narrowing of blood vessels in skin. Cutting these nerves stops those responses.
Through small cuts in the affected hands or feet, a health professional strips tiny nerves around the blood vessels. This surgery, if successful, might lead to fewer and shorter attacks.
- Chemical injection. Shots of numbing medicines or onabotulinumtoxinA (Botox) can block nerves in affected hands or feet. Some people need to have this more than once if symptoms remain or return.
Lifestyle and home remedies
You can take steps to reduce Raynaud's attacks and help you feel better.
- Avoid smoke. Smoking, vaping or breathing in someone else's smoke tightens blood vessels. This causes skin temperature to drop.
- Exercise. Exercise increases blood flow. And it has many other health benefits. If you have secondary Raynaud's, talk to your healthcare professional before exercising outdoors in the cold.
- Manage stress. Stress can trigger Raynaud's symptoms. Find ways to help reduce emotional stress. Getting more exercise, practicing mindfulness and joining support groups are some ways to reduce and manage stress.
- Avoid rapidly changing temperatures. Try not to go quickly from heat to air conditioning.
What to do during an attack
Warm your hands, feet or other affected areas. Do the following to gently warm your fingers and toes:
- Get indoors or to a warmer area.
- Wiggle your fingers and toes.
- Place hands under armpits.
- Make wide circles with your arms.
- Run warm — not hot — water over your fingers and toes.
- Massage your hands and feet.
If stress triggers an attack, get away from the stress and relax. Practice a stress-relieving technique that works for you. Warm your hands or feet in water to help lessen the attack.
Alternative medicine
Certain practices and supplements that help blood flow better might help manage Raynaud's. However, alternative medicine practices need more study to know how much they can help Raynaud's. If you're interested, talk to your healthcare professional about:
- Fish oil. Taking fish oil supplements could increase blood flow.
- Ginkgo. Ginkgo supplements could help lessen the number of Raynaud's attacks.
- Acupuncture. This practice seems to improve blood flow, so it may help Raynaud's attacks.
- Biofeedback. Using the mind to control body temperature might help Raynaud's. Biofeedback includes guided imagery to raise the temperature of hands and feet, deep breathing, and other exercises for relaxing. Your healthcare professional may be able to suggest a therapist who can help you learn biofeedback techniques. There are books and videos on the subject.
Talk to your healthcare professional if you're thinking of trying alternative treatments. Your health professional can warn you if there are possible side effects.
Preparing for your appointment
Your primary health care provider will likely be able to diagnose Raynaud's based on your symptoms. You may be referred to a provider trained in disorders of the joints, bones and muscles. This type of health care provider is called a rheumatologist.
Here's information to help you get ready for your appointment.
Make a list of:
- Your symptoms, when they began and what seems to trigger them.
- Other medical conditions you and your family have, particularly connective tissue or autoimmune disorders.
- All medicines, vitamins and other supplements you take, including doses.
- Questions to ask your provider.
Take a family member or friend along, if possible, to help you remember the information you receive.
Questions to ask your provider include:
- What is likely causing my symptoms?
- If I have Raynaud's, is it primary or secondary?
- What treatment do you recommend, if any?
- How can I reduce the risk of a Raynaud's attack?
- I have other health conditions. How can I manage them together?
Don't hesitate to ask other questions.
What to expect from your doctor
Your provider is likely to ask you questions, including:
- During a Raynaud's attack, do your fingers or toes change color or feel numb or painful?
- Has anyone else in your family been diagnosed with Raynaud's?
- Do you smoke?
- How much caffeine, if any, do you have daily?
- What do you do for a living and for recreation?
Nov. 16, 2024