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Raynaud’s Syndrome

Cold feet can be a protective mechanism and not always a bad thing.  When you are cold your autonomic system redirects blood flow away from your extremities, ears and nose. Your body wants to maintain your core temperature. This is how your auto pilot system is intended to work.

But what if your body’s temperature regulation overreacts. Cold temperatures will make your feet and hands grow cold. This may also occur when temperatures are absolutely comfortable and your toes and fingers go frozen. What if the same thing happens when you’re stressed out? Or if it happens to cause pain or numbness as well?

If any of the symptoms above describe you in any way, you should absolutely come to see us for an examination. Raynaud’s syndrome (or a related condition) could be involved.

What is Raynaud’s Syndrome?

Raynaud’s syndrome (also referred to as Raynaud’s phenomenon or Raynaud’s disease – they’re all the same thing) is a condition where the body overreacts to certain changes. Ambient temperature is the most significant influence but stress, emotions, and some drugs will turn the switch on. You can think of it as the body’s natural thermostat set a little different than everyone else. It can be a beautiful 68 degree evening and your family and friends are in hog heaven. Someone with Raynaud’s will be shivering and with their hands stuffed in their armpits or between their legs wishing for warm gloves and stockings.

In very cold conditions, the body should shift into “survival mode”. The peripheral blood vessels will constrict in the extremities so the warmer blood stays in the center of your body. This is a life protective response. But people with Raynaud’s may have this response when the body is not actually in danger.

    Even minor changes in temperature can cause an episode of blood vessel constriction. Sometimes, temperature doesn’t have to change at all.   Factors such as stress can be the culprit.

    Symptoms of Raynaud’s can include:

    • Cold toes, fingers, ears, and nose.
    • Color changes in the skin. The skin color will be pale, deathly white from lack of blood, to blue from lack of oxygen, and then red as blood flow is restored. A very patriotic look. 
    • Numbness, potentially followed by a prickly feeling, or tingling sensation, that will become a stinging pain once your toes and fingers warm back up.

    Raynaud’s can be quite uncomfortable and be damaging in certain situations. It can present with a wide spectrum of symptoms. Although it is rare, an extreme case can stop blood flow like a tourniquet that is tightly applied. However, even milder cases can increase your risks of frostbite if you are in actual cold conditions.

    You can expect to see these changes on the right and left sides as well as in the hands and feet. There can be a very selective area of vessel constriction that can be limited to just several digits. The end of the 3rd, 4th, and 5th fingers can turn white while the 1st and 2nd flingers appear more normal in color.


    Raynaud's Syndrome

    One, Two, Three…

    These changes are limited to the very smallest of arteries and capillaries. If you lightly squeeze the tip of your toes or fingers for 3-5 seconds and then release the color should quickly return. This is called capillary fill time. You should see the toe change from a pale to a normal appearance in 2 -3 seconds. When the small vessels constrict it may take 5- 10 seconds for color to return.

    The Body’s Mood Ring

    Do you remember the mood rings of the …..well …a while ago? The body will make these same changes if you know what to watch for. If a person with Raynaud’s is warm and happy their nose and toes will be red and rosy. If you see blue or a dusky color- RUN AWAY. The person is angry, upset, or cold.

    What Causes Raynaud’s?

    Unfortunately, the medical community is not fully certain. We understand that cold and stress can start the reaction, but we don’t fully understand why this happens in some people.

    We do know that Raynaud’s tends to be more common in:

    • Women
    • People who live in colder climates (obvious temperature influence)
    • People who have a parent, sibling, or child who also has the disease, indicating a potential hereditary factor
    • People with certain neuromuscular conditions, such as lupus or multiple sclerosis
    • People that use nicotine
    • People that have other vascular problems may appear with the same symptoms but over a larger area.
    • People that cannot afford Mood rings

    There is no real age limit on this condition, either, although most people will have their first episode between the ages of 15 to 30. In my experience it is a consistent and repeatable event but the literature says it can be hit or miss problem like altitude sickness.

    cold toes

    How to Treat Cold Feet from Raynaud’s

    Since we do not fully understand Raynaud’s, there is no standard treatment. But that doesn’t mean there is nothing we can do. We can help you manage symptoms and prevent complications!

    The first line of treatment is protective and supportive.

    A management plan means taking steps to prevent and protect feet and hands from exposure. This may include:

    • Using warm moisture-wicking socks made from Merino wool (aka Smart Wool). It’s wise to never go anywhere – especially in winter – without an emergency kit. Take out the umbrella and sunscreen from the car and replace it with this kit.
    • Limiting or ceasing anything that may further constrict your blood flow. This includes nicotine and caffeine. It does not matter whether it comes from cigarettes, a patch, or vaping.
    • Using biofeedback treatment to intentionally override the autonomic system. You can mentally condition yourself to adjust to stress and temperature changes. Channel the Yogi inside of you
    • Using certain supplements or drugs, such as niacin, magnesium, or prescription calcium channel blockers to improve symptoms.

    Getting Cold Feet When You Shouldn’t? Comes See Us!

    Cold feet on a winter’s day that improve with slippers are usually fine, but unexpected episodes certainly aren’t. If you have concerns, don’t hesitate to give our Indianapolis office a call at (317) 545-0505, or fill out our online contact form.

    If you are experiencing pain from any of these toe deformities, or have noticed the development of claw, mallet, or hammertoes, schedule an appointment with Jeffrie C. Leibovitz, D.P.M. for the effective treatment you need. You can connect with our office by calling (317) 545-0505.


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