Raynaud’s syndrome, a response to both cold environments and stress, causes fingers and toes of affected individuals to turn white or blue, then red and painfully swollen. While not a life-threatening disease, Raynaud’s presents itself as more of a disconcerting inconvenience. Only in rare instances does this phenomenon cause significant problems. Still, for clients who exercise year-round, whether indoors or out, Raynaud’s often puts a crimp in their abilities to grasp weights or move handles on fitness machines. This article explores the manifestation and etiology of Raynaud’s syndrome as well as homeopathic ways of alleviating its ensuing discomfort.
A Unique and Challenging Problem
Raynaud phenomenon, often described as a transient and peripheral vasoconstrictive response, can occur upon exposure to cold temperatures and/or emotional stress. Maurice Raynaud first recognized this phenomenon in 1862; Sir Thomas Lewis picked up interest in the topic in 1930 and conducted many further studies.
When facing very cold temperatures or periods of high emotional stress, the body adapts by restricting blood flow to the skin. This thermoregulating mechanism enables the body to prevent further heat loss while also allowing it to maintain its core temperature. Specifically in Raynaud phenomenon, one can observe evidence of vasoconstriction of the digital arteries and cutaneous arterioles.
Raynaud’s phenomenon generally limits presentation to fingers and toes; however, some individuals also experience spasms of diminished blood flow to the ears, nipples, knees, and/ or nose. Raynaud’s syndrome currently affects 5-10% of the American population. Healthcare providers do not always agree on the exact etiology of Raynaud’s. Some professionals believe that a blood disorder may elicit Raynaud’s by increasing the blood thickness, perhaps as a result of extra platelets or red blood cells in the circulation system. Others feel that it comes about as a result of extra sensitivity of the receptors in the blood responsible for narrowing of the blood vessels.
Variations on a Theme
Raynaud’s syndrome occurs with two variations:
Primary Raynaud’s
A milder and more common version of Raynaud’s, this presentation appears in the absence of a connection to any other illness. Raynaud’s affects more women than men, with its onset typically between the ages of 15 and 25. While causing minor discomfort, the majority of individuals living with primary Raynaud’s disease find their symptoms quite manageable without any professional medical intervention.
Secondary Raynaud’s
Although this form of the phenomenon occurs with much less frequency than primary Raynaud’s, it tends to confer much more severe symptoms. In addition to the general aforementioned symptoms, this form may lead to skin infections or ulcers brought on by insufficient blood flow. The diseases most often linked with Raynaud’s tend to fall into the categories of either autoimmune or connective tissue diseases, such as lupus and rheumatoid arthritis.
Recognizing Raynaud’s
As previously mentioned, symptoms of Raynaud’s syndrome can vary greatly. Commonly observed symptoms include the following:
- Fingers that turn pale or white, and then blue, accompanied by numbness upon exposure to cold, or during stress or emotional upset. Once the extremities get re-warmed, they turn red as blood flow returns
- Hands/fingers/toes that may feel swollen and painful when re-warmed
- In severe cases, one can witness sores on the finger pads
- In rare cases, gangrene in the fingers sets in, leading to infection or the need for amputation
Easy Treatment Options
Each individual’s treatment of Raynaud’s syndrome depends upon the severity of the symptoms, as well as one’s age and general health. Flare-ups tend to occur more during the winter months. Dr. Benjamin Abraham, a pain management specialist whose practice focuses on treating individuals with Raynaud’s, along with vascular medicine specialist Dr. Meghann McCarthy, offer the following tips to minimize overt discomfort during these very cold days.
- Keep hands and feet warm/dry: Raynaud’s directly affects the body’s extremities, where blood vessels thin out. Wearing gloves, mittens or mitten caps, and tucking hand warmers and feet warmers inside outerwear helps protect these body parts.
- Keep as much as of the body covered as possible: Raynaud’s can flare up when any part of the body gets cold, so wearing layers of clothing helps; a hat, too, keeps body heat from dissipating through the top of the head.
- Avoid handling cold objects: Frostbite poses a threat to anyone in the winter; individuals with Raynaud’s syndrome can develop even faster and with much more serious effects. If possible, avoid shoveling snow, and handle ice-cold beverages as little as possible.
- Reduce stress levels with meditation, yoga or other methods of self-care: Raynaud’s often accompanies periods of great anxiety or emotional stress. Blood vessels naturally constrict in response to stress. By focusing on mental health, one can possibly lessen the likelihood of a Raynaud’s flare-up. Ways to manage stress include meditating, exercising, and breathing deeply from your belly. Studies show that coloring or doing an art project can decrease stress hormones. Meditation and deep breathing have been shown to raise the temperature in hands and feet.
- Prioritize hydration: Water intake will help circulating blood maintain its temperature and continue flowing easily, while also aiding the body in holding onto internal heat. When a body gets too dehydrated, it limits blood flow to the skin, causing one to feel chilled faster in a cold environment. In addition, many professionals recommend avoiding caffeinated beverages, to minimize the possibility of vasoconstriction.
- Run warm water over hands and feet: When Rayna flare-up does occur, running hands and feet under warm water can get the blood flowing and help restore homeostasis to the internal body temperature. Keep in mind that this re-warming often comes with redness, swelling and pain, but it does not last too long.
- Cease smoking: Over time, smoking cigarettes will tend to naturally restrict blood vessels, worsening any Raynaud’s symptoms.
- Engage in physical activity: For individuals suffering with Raynaud’s, participating in any form of physical exercise will help their blood circulate faster and more efficiently. Typically aim for 30 minutes of moderate-intensity aerobic exercises at least 4-5 days/week.
- Avoid rapid temperature changes: Any sudden shift in temperatures — like coming in from the outside on a cold day, or taking a cold shower after a sweaty, intense workout — can likewise trigger Raynaud’s. To keep this problem at bay, allow the body to acclimate to room temperature naturally and try not to rush into the day’s next activity if possible.
Ice Baths: Ally or Antagonistic?
Stress in the form of shocks to one’s system can also trigger an attack, since the phenomenon will trigger the body’s “fight-or-flight” response. This, in turn, will lead to constriction of the blood vessels. However, cold exposure poses a greater threat for Raynaud’s flare-ups. Given these considerations, cold therapies for the treatment of Raynaud’s, such as ice baths, remain somewhat controversial. Prior to embarking on such a therapy, one must critically understand how exactly it can influence this condition.
Ice baths, often known as cold water immersion (CWI), enjoy much popularity as a recovery method for elite athletes. The rationale behind this assumes that submerging the body in cold water causes blood vessels to contract, lowering inflammation and aiding in the elimination of metabolic waste. Upon stepping out of the ice bath, the blood vessels dilate, improving blood flow and returning oxygen to the muscles, which helps with recuperation.
It may appear counterintuitive to propose ice bath immersion as a treatment for Raynaud’s symptoms, since exposure to cold can instantly elicit the appearance of symptoms and discomfort. Some theories suggest that regular exposure of the body to cold temperatures could desensitize it to cold, which may in turn reduce the severity of Raynaud’s disease. We must state that this theory remains speculative, with little scientific evidence to support positive outcomes. If trainers wish to suggest this to clients suffering from Raynaud’s, they must preface it with a cautionary note.
Taking a Natural Treatment Path
Many herbal and natural remedies claim to alleviate Raynaud’s symptoms, and one can purchase them without a prescription from a physician. Still, before committing to a homeopathic method, individuals may wish to consult with their physician just to make sure nothing will cause a dangerous drug interaction with medications currently taken. Once again, as we have mentioned in previous articles, limited scientific data conclusively support the use of herbal remedies, so proceed with caution and with eyes open.
Gingko biloba, the best-researched natural remedy for Raynaud’s, produces a significant reduction in symptoms for many sufferers. Both vitamins C and E contain antioxidants, which go a long way towards protecting blood vessels.
Gamma Linoleic Acid, or omega-6 (GLA), recently garnered attention for management of Raynaud’s phenomenon and its symptoms. One can ingest GLA as a supplement. In addition, it occurs naturally in the following:
- evening primrose oil
- starflower oil
- linseed/flaxseed oils
Many people find GLA consumption highly effective, but it may take up to eight weeks to appreciate and notice the full benefit.
In addition to herbal remedies, some nutritional changes may prove helpful as well. Warming foods, or those which create a heat-related sensation in the body upon ingestion, may help with the circulation problems commensurate with Raynaud’s. Ginger, hawthorn, cayenne, magnesium, horse chestnut, chili peppers and prickly ash often get recommended for treatment.
New and Novel Potential Treatment Modalities
Currently, no definitive cure exists for Raynaud’s syndrome. However, as with many other conditions, scientists continue to explore cutting-edge therapies.
Recent research has focused on the role that alpha-2 adrenergic receptors play in the presentation of Raynaud’s. These specific receptors cause blood vessels to constrict when exposed to cold. Researchers seem optimistic about future medications that can selectively block these receptors. They have observed promising results in some clinical trials, yielding fewer side effects than current modes of treatment.
Another potential area to tap involves nitric oxide, a known blood vessel dilator that greatly improves blood flow. Current research endeavors seek ways to increase nitric oxide levels in individuals living with Raynaud’s. Among these we may see medications that enhance nitric oxide production; by making use of creative and novel delivery methods, such as transdermal patches or creams, patients can apply nitric oxide directly to affected areas.
Though more commonly used for purely aesthetic reasons, Botox injections show promise in severe cases of Raynaud’s. New and ongoing research also aims to tap into the potential use of stem cell therapy for vascular regeneration.
Genetic Solution
While scientists cannot say for certain whether or not Raynaud’s phenomenon qualifies as an inherited condition, they continue to study the genetic factors involved in developing this condition. Gene therapy may prove helpful in the future. Some compelling new investigative studies have looked at ways to modify the expression of genes specifically related to blood vessel constriction. Eventually scientists hope that such an approach could provide a long-term solution for individuals suffering from a more severe form of Raynaud’s.
The Vascularity Issue
The best-studied mechanisms in Raynaud’s phenomenon involve the blood and vascular endothelium (lining). Microcirculatory flow may actually get slowed down by activated platelet clumps, rigid red and white blood cells and damaged endothelium, as they also release vasoactive/vasoconstrictive compounds which may trigger the clotting cascade and thrombosis. Initial management for mild forms of Raynaud’s syndrome could soon see a focus on medical advice regarding a patient’s purposeful avoidance of known precipitating factors, including vasospastic drugs.
Final Thoughts
As one who suffers from Raynaud’s, I can assure readers that, while frustrating and painful at times, this condition does not have a huge impact on everyday life. However, when it does flare up, along with the rheumatoid arthritis, weightlifting can get compromised. Grip strength diminishes when fingers refuse to work properly! For clients presenting with either of these conditions, personal trainers may consider having a few alternative options lined up when designing programs and exercise selection.
References
https://pubmed.ncbi.nlm.nih.gov/28985172
https://pubmed.ncbi.nlm.nih.gov/4087271
https://www.ncbi.nlm.nih.gov/books/NBK499833
https://www.assh.org/handcare/blog/advice-from-a-certified-hand-therapist-cold-weather-tips-for-raynauds
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https://www.nhs.uk/conditions/raynauds
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