Advice from a Certified Hand Therapist: What is Raynaud's Disease?

Do your fingers turn pale when taking items out of the freezer? Is there stiffness and pain in your fingers in mildly cold weather, followed by redness and swelling as they warm up?  If so, you may have Raynaud’s Disease, or Raynaud’s phenomenon. But how do you know the difference? Or if you know you have it?

Raynaud’s disease (RD) a symptomatic disease of the digits, or fingers. Raynaud’s “attacks” often occur in three phases: ischemic pallor (paleness), cyanotic coloring (blue or gray or purple coloring) then reactive erythema (redness and swelling) when the digits are exposed to cold or during times of stress.  It is found in 3%-5% of the population, which is more common than Raynaud’s phenomenon.  RD occurs alone without a triggering or traumatic event.  It is considered “idiopathic”, or without a known cause. 

Conversely, Raynaud’s Phenomenon (RP) occurs with a known disease process, often a collagen vascular disorder, and displays the same symptoms.  Females between the ages of 20-40 who live in cooler climates are most affected.  Because RD and RP are so closely related, this can make the understanding slightly confusing, which is why it is often just referred to as “Raynaud’s”. In addition to the color changes, which are present in both RD and RF, there may be other symptoms that occur as well.  These include feelings of “pins and needles”, stiffness, a dull aching and possibly pain – all of which may occur at intermittent times in the digits in response to cold or stress. Those with Raynaud’s demonstrate sensitivity to the mildest temperature drop and do not need to be exposed to freezing temperatures to have these reactive symptoms. This “vasospasm” of the blood vessels in extremely cold temperatures is a normal protective response of the body, but is considered abnormal with mild temperature changes or stress and should be assessed by a physician. 

I Have These Symptoms, Now What?
If you find you have the symptoms of Raynaud’s, a thorough evaluation by a physician is necessary to rule out any underlying medical conditions.  Blood vessel obstruction, scleroderma, rheumatoid arthritis, or lupus conditions, though rare, can be present in those with symptomatic Raynaud’s.  Diagnostic testing can assist the physician in determining if it is Raynaud’s Phenomenon or Raynaud’s Disease.  Once a proper diagnosis is given, referral to a Certified Hand Therapist can be made.

How Will Hand Therapy Help Me?
Referral to a certified hand therapist (CHT) can assist you in management of your Raynaud’s symptoms and the modification of the activities which may trigger them.  The CHT will perform a complete evaluation which includes an extensive history, physical assessment and behavioral profile to determine frequency and duration of attacks, severity of symptoms, and the impact these have on your daily activities.  A plan of care will be developed and may include suggestions for activity modifications or adaptations, strategies to decrease behavioral triggers, and biofeedback training.  Conservative management of Raynaud’s symptoms is the first step in treatment and management of Raynaud’s Disease and Raynaud’s Phenomenon and collaborating with a CHT can be the first step.

Learn more about the causes of cold hands.