Treatments for Raynaud's phenomenon


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Treatment list for Raynaud's phenomenon: The list of treatments mentioned in various sources for Raynaud's phenomenon includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

Treatments of Raynaud's phenomenon discussion: The aims of treatment are to reduce the number and severity of attacks and to prevent tissue damage and loss in the fingers and toes. Most doctors are conservative in treating patients with primary and secondary Raynaud's phenomenon; that is, they recommend nondrug treatments and self-help measures first. Doctors may prescribe medications for some patients, usually those with secondary Raynaud's phenomenon. In addition, patients are treated for any underlying disease or condition that causes secondary Raynaud's phenomenon.

Nondrug Treatments and Self-Help Measures

Several nondrug treatments and self-help measures can decrease the severity of Raynaud's attacks and promote overall well-being.

  • Take action during an attack--An attack should not be ignored. Its length and severity can be lessened by a few simple actions. The first and most important action is to warm the hands or feet. In cold weather, people should go indoors. Running warm water over the fingers or toes or soaking them in a bowl of warm water will warm them. Taking time to relax will further help to end the attack. If a stressful situation triggers the attack, a person can help stop the attack by getting out of the stressful situation and relaxing. People who are trained in biofeedback can use this technique along with warming the hands or feet in water to help lessen the attack.

  • Keep warm--It is important not only to keep the extremities warm but also to avoid chilling any part of the body. In cold weather, people with Raynaud's phenomenon must pay particular attention to dressing. Several layers of loose clothing, socks, hats, and gloves or mittens are recommended. A hat is important because a great deal of body heat is lost through the scalp. Feet should be kept dry and warm. Some people find it helpful to wear mittens and socks to bed during winter. Chemical warmers, such as small heating pouches that can be placed in pockets, mittens, boots, or shoes, can give added protection during long periods outdoors. People who have secondary Raynaud's phenomenon should talk to their doctors before exercising outdoors in cold weather.

    People with Raynaud's phenomenon should also be aware that air conditioning can trigger attacks. Turning down the air conditioning or wearing a sweater may help prevent attacks. Some people find it helpful to use insulated drinking glasses and to put on gloves before handling frozen or refrigerated foods.

  • Quit smoking--The nicotine in cigarettes causes the skin temperature to drop, which may lead to an attack.

  • Control stress--Because stress and emotional upsets may trigger an attack, particularly for people who have primary Raynaud's phenomenon, learning to recognize and avoid stressful situations may help control the number of attacks. Many people have found that relaxation or biofeedback training can help decrease the number and severity of attacks. Biofeedback training teaches people to bring the temperature of their fingers under voluntary control. Local hospitals and other community organizations, such as schools, often offer programs in stress management.

  • Exercise--Many doctors encourage patients who have Raynaud's phenomenon, particularly the primary form, to exercise regularly. Most people find that exercise promotes overall well-being, increases energy level, helps control weight, and promotes restful sleep. Patients with Raynaud's phenomenon should talk to their doctors before starting an exercise program.

  • See a doctor--People with Raynaud's phenomenon should see their doctors if they are worried or frightened about attacks or if they have questions about caring for themselves. They should always see their doctors if attacks occur only on one side of the body (one hand or one foot) and any time an attack results in sores or ulcers on the fingers or toes.

Treatment With Medications

People with secondary Raynaud's phenomenon are more likely than those with the primary form to be treated with medications. Many doctors believe that the most effective and safest drugs are calcium-channel blockers, which relax smooth muscle and dilate the small blood vessels. These drugs decrease the frequency and severity of attacks in about two-thirds of patients who have primary and secondary Raynaud's phenomenon. These drugs also can help heal skin ulcers on the fingers or toes.

Other patients have found relief with drugs called alpha blockers that counteract the actions of norepinephrine, a hormone that constricts blood vessels. Some doctors prescribe a nonspecific vasodilator (drug that relaxes blood vessels), such as nitroglycerine paste, which is applied to the fingers, to help heal skin ulcers. Patients should keep in mind that the treatment for Raynaud's phenomenon is not always successful. Often, patients with the secondary form will not respond as well to treatment as those with the primary form of the disorder.

Patients may find that one drug works better than another. Some people may experience side effects that require stopping the medication. For other people, a drug may become less effective over time. Women of childbearing age should know that the medications used to treat Raynaud's phenomenon may affect the growing fetus. Therefore, women who are pregnant or are trying to become pregnant should avoid taking these medications if possible.

Self-Help Reminders

  • Take action during an attack

  • Keep warm

  • Don't smoke

  • Control stress

  • Exercise regularly

  • See a doctor if questions or concerns develop
1

Patients with primary Raynaud's are taught how to prevent attacks (see below). In patients with secondary Raynaud's, doctors first treat the underlying cause. Vasodilators--drugs that help relax artery walls to improve blood flow--may be prescribed for patients with secondary Raynaud's or primary Raynaud's that resists other forms of therapy.

Are there ways to prevent attacks?

Yes. People suffering from Raynaud's should protect themselves from cold and keep all parts of their body warm--not just their extremities. Outdoors in winter, they should wear scarves, warm socks and boots, and mittens or gloves under mittens because gloves alone allow heat to escape. People with Raynaud's should also wear wristlets to close the space between the sleeve and mitten. Indoors, people should wear socks and comfortable shoes. When taking food out of the refrigerator or freezer, they should wear mittens, oven mitts, or pot holders.

Patients with Raynaud's should guard against cuts, bruises, and other injuries to the affected areas. Activities such as sewing may have to be limited.

Patients who smoke should quit. Doctors may also adjust medications if the drugs appear to be responsible for the symptoms.

After several sessions of training, patients can often prevent or stop attacks using biofeedback, a technique in which patients are taught to "think" their fingers or toes warm.

It is important for persons who suspect they have Raynaud's to talk with their personal physicians. The doctor can give advice on the best ways to manage and treat the problem.2

Treatment is aimed at reducing the number and severity of attacks and preventing tissue damage and loss in the fingers and toes. Most doctors are conservative in treating patients with primary and secondary Raynaudís phenomenon; that is, they recommend nondrug treatments and self-help measures first. Doctors may prescribe medications for some patients, usually those with secondary Raynaudís phenomenon. In addition, patients are treated for any underlying disease or condition that causes secondary Raynaudís phenomenon. 3

Do not ignore an attack of Raynaudís phenomenon. Run warm water over your hands and/or feet. Also, relax. Biofeedback can also be used to minimize length and severity. Preventing attacks is aided by keeping your extremities warm, not smoking, controlling stress and getting more exercise. 3

Footnotes:
1. excerpt from Questions and Answers about Raynaud's Phenomenon: NIAMS
2. excerpt from NHLBI, Raynaud's Phenomenon: NHLBI
3. excerpt from Raynauds Phenomenon: NWHIC

Last revision: June 12, 2003

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