Raynauds Syndrome

Raynaud’s syndrome, or white finger, is a blood circulation disorder that causes numbness in the extremities when they’re exposed to cold. Blood circulation to the fingers, toes, nose, ears and lips is severely compromised.

Raynaud’s syndrome gains its alternate name, white finger, from the whiteness of the fingers when blood circulation is reduced. White finger can also be triggered by emotional stress.

Raynaud’s Syndrome Statistics

Raynaud's SyndromeWomen comprise the majority of Raynaud’s syndrome cases. Estimates of white finger prelevance vary. Some estimates suggest five to ten percent of the US population have Raynaud’s syndrome. Other studies claim that white finger affects as much as one fifth of the US adult population.

Not surprisingly, Raynaud’s is more common (or at least more noticeable) in cold climates. People with Raynaud’s syndrome in warmer climes tend to have more frequent attacks of white finger when exposed to cold, and more severe symptoms.

A White Finger Attack

Raynaud’s syndrome attacks may be triggered by cold or emotional stress. In either case, blood circulation to the extremities slows. Reduced blood circulation causes arteries in the extremities to collapse. The fingers may turn white or blue due to the loss of blood circulation and oxygen depletion.

A white finger attack may last only a few minutes, or may persist for several hours. As the attack ends, the extremities may throb painfully and redden as blood circulation returns.

Types of Raynaud’s Syndrome

Raynaud’s syndrome has been classified into several types with varying causes.

Primary Raynaud’s Syndrome: Primary Raynaud’s cannot be traced to another condition. Generally milder than other types of white finger, 75 percent of primary Raynaud’s syndrome cases occur in women between the ages of fifteen and forty.

Secondary Raynaud’s Syndrome: Secondary Raynaud’s syndrome is less common and tends to produce more severe symptoms than primary Raynaud’s syndrome. Only nine percent of white finger cases are traced to secondary causes.

Connective tissue disorders are the most common cause of secondary Raynaud’s syndrome. Blood circulation problems are seen in approximately one third of systemic lupus erythematosus cases, and up to 95 percent of sclerodema patients report white finger attacks.

Other causes of white finger include:

  • carpel tunnel syndrome
  • certain chemotherapy agents
  • dermatomyositis
  • ergotamine medications for migraines
  • frostbite
  • obstructive arterial disease
  • polymyositis
  • Sjörgen’s syndrome
  • vasoconstrictive medications.

Workplace White Finger

Workplace white finger is actually a subtype of secondary Raynaud’s syndrome, and is caused by work-related blood circulation damage. Plastics workers exposed to the chemical vinyl chloride have a high rate of white finger.

Regular use of vibrating tools can damage blood circulation in the hands and cause white finger: 45 to 58 percent of rock drillers develop Raynaud’s syndrome.

Long-term use of the following tools has also been link to white finger:

  • chainsaws
  • chipping hammers
  • grinding wheels
  • impact wrenches
  • jackhammers
  • pavement breakers
  • pneumatic drills
  • riveting tools.

Workplace Raynaud’s syndrome gets progressively worse the longer such tools are used.

Diagnosing Raynaud’s Syndrome

A medical history and physical exam are often enough to diagnose Raynaud’s syndrome. The examining physician may perform a nailfold capillaroscopy. A drop of oil is placed on the nailfold (the skin flap at the bottom of the nail) and the nailfold is examined under a microscope. Abnormalities in nailfold blood circulation can indicate a connective tissue disease.

Antinuclear antibody testing is a blood test for specific antibodies produced in response to autoimmune or connective tissue diseases. This test may also be used for diagnosing white finger.

White Finger Treatment

In cases of secondary Raynaud’s syndrome, treating the underlying condition helps reduce the frequency of attacks and the severity of symptoms. In general, however, white finger treatment is preventive and based on the following guidelines:

  • If possible, avoid air conditioning.
  • Keep hands and feet warm.
  • Soak hands in warm water.
  • Stay indoors in cold weather.
  • Use gloves to handle frozen food.
  • Use insulated drinking glasses.
  • Wear hats to reduce heat loss.
  • Wear multiple layers of clothing in cold weather.

Quitting smoking can help alleviate Raynaud’s syndrome. Stress management and relaxation techniques prove helpful to many people with primary Raynaud’s syndrome. Biofeedback can teach people to voluntarily control the temperature of the extremities.

Medication for Raynaud’s Syndrome

Severe cases of Raynaud’s syndrome can be treated with medication; secondary Raynaud’s syndrome is more likely to be treated with medication than primary Raynaud’s syndrome. None of the medications prescribed for white finger should be used while pregnant.

Calcium channel blockers cause blood vessels to relax, improving blood circulation. Calcium channel blockers reduce the severity of symptoms and the frequency of attacks in two thirds of cases, and they also promote the healing of skin ulcers, a complication of severe white finger.

Alpha blockers prevent blood vessel constriction and promote proper blood circulation, so they’re sometimes used to treat white finger. Topical application of nonspecific vasodilators may be used to aid skin ulcer healing.

White Finger Complications

The presence of white finger increases a person’s risk of an autoimmune or connective tissue disorder. People with Raynaud’s syndrome have a higher than normal chance of rheumatoid arthritis, systemic lupus erythromatosus and scleroderma.

Secondary Raynaud’s syndrome can cause skin ulcers due to impaired blood circulation. In severe, rare occasions blood circulation is restricted so severely that gangrene develops in the fingers or toes. Heartburn and difficulty swallowing are also associated with white finger, and may indicate the presence of an underlying tissue disorder.

Undetected or untreated Raynaud’s syndrome can result in permanent blood circulation damage that impairs finger function. The damage to blood vessels can be severe enough to result in physical disability and increases the risk of gangrene.

Resources

Canadian Centre for Occupational Health and Safety. (updated 1998). What is Raynaud’s syndrome?

Life Extension Foundation. (updated 2003). Raynaud’s syndrome.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2001). Questions and answers about Raynaud’s phenomenon.

Walling, A. (2000). Topical treatment for patients with Raynaud’s syndrome.