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Cold Hands, Cold Feet?

Who would you recommend seeing for Raynaud's disease and what treatment do you recommend? I have this condition, as well as other problems that I believe are related (skin rashes, poor sleeping, stiffness, and a sore lower back and hip).

If you have Raynaud's disease, your hands blanch on exposure to cold, becoming numb and possibly painful for minutes to hours. This is a common condition, particularly in young women. Raynaud's can occur by itself, or it can accompany more serious problems, such as lupus, scleroderma, and other autoimmune conditions. It's been associated with migraine and carpal tunnel syndrome, too. Given your other symptoms, I would suggest that you see a doctor to determine whether there is any underlying disease.

The root of the problem in Raynaud's disease is an instability in the nerves that control the blood vessels in the hands and feet. In a recent article in Lancet, researchers traced the mechanism to a shortage of nerve fibers in the skin that contain calcitonin-gene related peptide, which acts on the blood vessels to open them up.

When your fingers start to turn white, the first thing to do is try and warm them up. You can dip your hands in warm water for a few minutes, or put on woolen gloves. But you might get better results by triggering warmth from within. My relaxing breath exercise can help you relax the autonomic nervous system, including the nerves that control small arteries in the hands. Another possibility is a course of biofeedback to learn to warm your hands, followed by practice on your own.

If you smoke, quit smoking! Nicotine really constricts arteries in the extremities. Also eliminate other stimulants from your life, including caffeine, as these make Raynaud's worse. Beta blocker drugs also may trigger the condition. On the positive side, niacin may be useful as a supplement. Niacin will dilate the blood vessels in the skin, causing a wave of heat from your head to your toes. I would start with 100 milligrams a day of plain niacin, then go up to a maximum of 200 or 300 milligrams a day.

An article in Physician and Sports Medicine suggested a conditioning procedure that should train your body to respond more appropriately to cold weather. Dress lightly for indoors and immerse both hands in water that's 120 Fahrenheit for two to five minutes, then go to a cold room or outside. There, immerse your hands in the same temperature water for 10 minutes. Go back inside and do the immersion again. The article suggests repeating this procedure three to six times a day for a total of 50 times.

 

 
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