Monday, September 27, 2010

Raynaud's Phenomenon

As we eagerly look forward to the fall season and its cooler temperatures, let’s take a look at a condition that could be showing up at the same time. It’s called Raynaud’s and it comes in two forms: a disease and a phenomenon. Raynaud’s is considered a vasospastic disorder, meaning that the smaller blood vessels fluctuate between becoming narrower and then wider. This shows itself as an attack with color changes to the fingers and toes that are usually brought on by stress or the cold. When the blood vessels vasospasm, less blood is getting to the fingers and toes, causing a blueish appearance. When the blood rushes back in, this causes a reddish appearance. And when a normal state returns, this shows a white appearance. Usually pain isn’t associated with this condition.

So what’s the difference between the disease and the phenomenon? Raynaud’s disease occurs more often in females under 40 and shows up on both sides of the body. There is also no ischemic change, or signs of a systemic disease present. Raynaud’s phenomenon occurs more often in males, over 40 and can show up on both sides or just one side of the body. There are ischemic changes and a systemic disease present with the phenomenon. So the phenomenon is a symptom of a bigger disease whereas Raynaud’s disease is a stand-alone condition.

Treatment of this can be difficult. If you are a smoker, then quitting can help due to smoking causing vasoconstriction of vessels. Avoiding stressful situations or the cold can also help this condition. This is less frequent in Texas but I have seen it in several patients every year. This may include wearing gloves and more insulating socks. Medication could also be recommended that would open up the blood vessels in the extremities. This is less frequent in Texas but I have seen it in several patients every year. Evaluation by your podiatrist of this condition is important to determine if it’s a stand-alone disease or a symptom of a more serious condition. Be sure to check with Dr.Grimm or Dr.Pattison for this and any other foot and ankle concern.