Raynaud's syndrome

Raynaud's syndrome is a condition when blood flow to certain parts of the body is reduced due to narrowing of the arteries. This condition is common and is usually not a serious condition.

In Raynaud's syndrome, cold temperatures, anxiety, or stress can trigger the narrowing of blood vessels. The condition makes the skin change color to pale and blue. Although it generally affects the fingers or toes, Raynaud's syndrome sometimes also occurs in the ears, nose, lips, and nipples.

Raynaud's syndrome generally does not cause serious complications, but it can affect the sufferer's quality of life. For example, sufferers will find it difficult to do simple things, such as buttoning a shirt.

Type of Raynaud's Syndrome

Raynaud's syndrome is divided into two, namely:

Primary Raynaud's syndrome (Raynaud's disease)
Primary Raynaud's syndrome is not caused by another medical condition. This type occurs most often and is usually mild and does not need to be treated.
Secondary Raynaud's syndrome (Raynaud's phenomenon)
Secondary Raynaud's syndrome is caused by another medical condition, such as an autoimmune disease or an arterial vessel disorder. This secondary type is more serious, and requires further examination and handling in the hospital.

Causes of Raynaud's Syndrome

Raynaud's syndrome is caused by the narrowing of arterial blood vessels that make blood circulation in the fingers or toes less. This condition is triggered by several risk factors that are differentiated based on the type of syndrome, namely:

Primary Raynaud's syndrome

The cause of narrowing of the arteries in primary Raynaud's syndrome is not known for sure, because this condition occurs without any underlying disease. However, there are several factors that are thought to increase the risk of primary Raynaud's syndrome, namely:

Aged 15–30 years
Female sex
Having a family member suffering from primary Raynaud's syndrome
Living in a cold area.
Experiencing stress

Secondary Raynaud's syndrome (Raynaud's phenomenon)

Secondary Raynaud's syndrome can be caused by a number of the following factors:

Autoimmune diseases, such as lupus, rheumatoid arthritis , and Sjögren's syndrome
Arterial vessel disorders, including atherosclerosis, Buerger's disease , and pulmonary hypertension
Viral infections in the blood, such as hepatitis B and hepatitis C
Cancer of the blood, bone marrow or immune system, such as acute lymphoblastic leukemia , lymphoma, and multiple myeloma
CTS ( carpal tunnel syndrome ), which is a condition caused by pressure on the nerves in the hand
The habit of smoking, because it can cause narrowing of blood vessels
Activities that involve repetitive movements over a long period of time, such as typing, playing musical instruments, and operating machines with strong vibrations
Medicines, such as beta-blockers, migraine medicines containing ergotamine or sumatriptan, cancer medicines ( cisplatin and vinblastine), birth control pills, and pseudoephedrine
Injuries to the hands or feet, for example a broken wrist, complications from operations on the hands or feet, and frostbite
Exposure to certain chemicals, such as nicotine and vinyl chloride

Symptoms of Raynaud's Syndrome

Symptoms of Raynaud's syndrome occur in three stages, namely:

Stage 1
Fingers or toes turn pale due to reduced blood flow.
Stage 2
Fingers or toes turn blue due to lack of oxygen supply. At this stage, the fingers will feel cold and numb.
Stage 3
The fingers or toes turn red again because the blood flow is faster than normal. At this stage, the fingers or toes will feel tingling, throbbing, and may experience swelling.

The above symptoms initially occur in one finger or toe, then spread to other fingers. Sometimes, only one or two fingers are affected by this disease.

In some cases, Raynaud's syndrome is accompanied by other symptoms, such as pain and burning when the blood flows quickly. These symptoms will slowly disappear when blood flow returns to normal. The symptoms can last less than 1 minute to several hours per day or per week.

When should you go to the doctor?

Immediately contact a doctor if you experience symptoms of Raynaud's syndrome, especially if symptoms:

Getting worse
Interferes with daily activities
Appears only on one side of the body
Accompanied by joint pain, skin rash, and muscle weakness
Occurs in people over 30 years old for the first time
Occurs in children under 12 years old

Diagnosis of Raynaud's Syndrome

Diagnosis of Raynaud's syndrome begins by asking the patient's symptoms and risk factors. Next, the doctor will perform a physical examination by examining the fingers or toes to see the condition of the skin, nails, and blood flow, as well as signs of secondary Raynaud's syndrome.

The doctor will also perform other examinations, such as:

Cold stimulation test

This test aims to trigger symptoms of Raynaud's syndrome. In this test, the doctor will attach a temperature gauge to the patient's finger, then put the patient's hand in ice water for a few minutes.

Once the hand is removed, the device will measure how quickly the temperature in the patient's fingers returns to normal. Raynaud's syndrome sufferers usually need more than 20 minutes for the temperature in their fingers to return to normal.

Nailfold capillaroscopy

This test aims to find out the type of Raynaud's syndrome experienced by the patient. The test is performed by inserting a drop of liquid or oil into the bottom of the nail, to see the condition of the arteries under the nail through a microscope.

Blood test

The blood test aims to detect disorders or medical conditions related to secondary Raynaud's syndrome. The types of blood tests performed include:

Complete blood count, to detect signs of infection or the presence of cancer cells in the blood
Antinuclear antibody (ANA) test, to check the presence of antibodies that arise as a result of autoimmune diseases
Blood sedimentation rate test, to detect the presence of inflammation or infection

Treatment of Raynaud's Syndrome

Until now, there is no method to overcome Raynaud's syndrome. However, doctors can provide treatment to relieve symptoms and reduce severity, prevent tissue damage, and address the underlying cause of Raynaud's syndrome.

The following is the treatment of Raynaud's syndrome based on its type:

Primary Raynaud's syndrome

Primary Raynaud's syndrome generally does not require specific medical action. The way to deal with it is enough to stop the symptoms when there is an attack of primary Raynaud's syndrome.

If primary Raynaud's syndrome occurs due to cold temperatures, some efforts that can be made are:

Immediately enter or move to a warmer room
Warm your hands or feet by placing your hands under your armpits or soaking your feet in warm water.
Finger or toe massage.
Make twisting movements or shake the legs.
Wear gloves or socks.

While in Raynaud's syndrome caused by stress, efforts that can be made include:

Do relaxation techniques , such as yoga and meditation
Listening to music or shifting focus to other things that can calm and relieve stress
Doing physical activity

Secondary Raynaud's syndrome

Secondary Raynaud's syndrome requires medical treatment by a doctor. Some actions that can be done in patients with secondary Raynaud's syndrome are:

Medicines

The doctor will give the type of medicine adapted to the patient's condition and the cause of the symptoms, among others:

Calcium antagonist
This drug works to facilitate blood flow in the small blood vessels in the hands and feet so as to reduce the frequency and severity of the symptoms experienced. Examples of calcium antagonist drugs are nifedipine and amlodipine.
Vasodilator
This drug is used to widen blood vessels. Examples of vasodilator drugs given are isoxsuprine , nitroglycerin, antidepressant drugs, antihypertensive drugs, and drugs to overcome erectile dysfunction ( sildenafil ).

Botulinum toxin injection

Botulinum toxin or botox is useful to paralyze nerves so that they do not respond excessively to cold temperatures. Botox injections will be given repeatedly.

Nerve surgery

The doctor will recommend surgery if the symptoms of Raynaud's syndrome worsen and the drugs are no longer effective. The operation is performed by making a small incision and cutting the nerve to reduce sensitivity. Thus, the frequency and duration of symptom attacks decreases.

Complications of Raynaud's Syndrome

There are several complications that can be caused by Raynaud's Syndrome, namely:

Gangrene
A totally blocked artery can cause tissue death. In some rare cases, gangrene can result in amputation of the affected body part.
Changes in finger shape
Affected fingers can become thin and pointed, with shiny skin and slow-growing nails. This condition occurs due to blood that does not flow well to the part.
Scleroderma
Scleroderma is an autoimmune disorder that causes thickening or hardening of the skin and connective tissue. This condition occurs when the body produces too much collagen.

Prevention of Raynaud's Syndrome

There are several efforts that can be made to prevent the occurrence of Raynaud's syndrome, namely:

Wear gloves, a hat, a jacket or thick clothing, and boots when traveling to cold places.
Use earplugs and a face mask, if the tip of the nose and ears are sensitive to the cold.
Wear socks even indoors or when sleeping, especially if you live in an area that has winter.
Avoid sudden temperature changes, for example from warm air to an air-conditioned (AC) room.
Use protection or hand covering when taking something from the freezer .
Avoid heavy stress by doing meditation or yoga.
Avoid too much caffeinated drinks.
Do not smoke or be around smokers.
Limit the use of tools that produce a lot of vibration, such as a mixer , because the vibration can trigger a relapse of Raynaud's syndrome.

In addition to the methods above, consult a doctor before consuming any medicine. This is because there are types of drugs that can trigger the occurrence of Raynaud's syndrome, among others: