Raynaud’s syndrome and Rheumatoid Arthritis

Raynaud’s Syndrome is a disorder of the blood vessels that supply the skin.  It usually affects the fingers and toes, but rarely also the tip of the nose, ears and lips.

During an attack, the smaller arteries that supply the skin narrow and constrict, limiting blood supply to affected area. As a result the skin will turn white and look ‘bloodless’, then turn blue.  As the blood flow returns, the affected areas turn red, and throb painfully, or tingle, burn or feel numb.

There are two types of Raynaud’s – Primary (usually called Raynaud’s Disease) and Secondary (usually called Raynaud’s Syndrome).  With Primary Raynaud’s, the cause isn’t known.  It is usually milder, and nothing more than an inconvenience.

Secondary Raynaud’s, however, is caused by another disease or condition.  It is associated with autoimmune diseases such as Lupus, Scleroderma or Rheumatoid Arthritis.

Even mild or brief changes in temperature can cause an attack of Raynaud’s.  Something as simple as getting something out of the freezer, or hanging out washing on a cold day, can cause the fingers to react and turn blue.  Emotional stress can also cause this reaction.

Treatment depends on the severity of the condition.  Where Raynaud’s Syndrome is present with Rheumatoid Arthritis, rheumatologists generally focus on treating the underlying disease (RA) and the Raynaud’s will also improve.

Self care is often all that is required, and focuses on keeping the extremities warm.  Wearing gloves outdoors is essential, as are thick socks and warm footwear.  Some people even need to wear gloves when getting items out of the freezer.  Avoid smoking, as nicotine causes blood vessels to constrict.  Try to control stress, because stressful situations can also trigger an attack.

For more severe cases, there are drug treatments, including:

calcium channel blockers, which relax and open up the small blood vessels.

Alpha blockers which counteract norepinephrine, a hormone that shrinks blood vessels.

Vasodilators, which relax blood vessels.

I have had Raynaud’s Syndrome for many years.  I had no idea it was related to RA, it was just co-incidental that I had an attack in the cold waiting room on the day I was seeing my GP to discuss my ongoing joint pain.  She took one look at my blue hands and immediately started thinking Lupus or RA, and referred me to a Rheumatologist.  So in that respect, Raynaud’s has been my friend.