Cold Feet? It Could Be Raynaud’s

Do your feet feel icy in bed or when you’re barefoot? Does one toe change to a completely different colour? It may be Raynaud’s phenomenon. 

This is a condition which goes by a few different names; be that Raynaud’s phenomenon, disease or syndrome. It is caused by excessive constriction of the blood vessels supplying the extremities, in response to cold or emotional stress. 

• It usually affects the fingers and toes, but may affect the ears and nose 

• It occurs among women more than men 

• Usually develops before the age of 40, often as teenagers, and progresses slowly 

What causes Raynaud’s?

Raynaud’s can be genetic and is usually mild. It can occur for no known reason without any other underlying medical condition. This type is called primary Raynaud’s syndrome or Raynaud’s disease and accounts for about 80% of cases. 

Secondary Raynaud’s can occur alongside other conditions. 

Stress and anxiety can also cause an attack. Smoking further constricts the blood vessels, therefore increasing the severity of the condition. 

What are the symptoms of Raynaud’s?   

An attack is caused by the constriction of the blood vessels, resulting in the fingers/toes becoming white and feeling numb in severe cases. This can lead to a phase where the digits turn blue, followed by red as blood flow returns, which can cause a burning sensation, stinging, pain, numbness or tingling. These symptoms may vary in severity from a minor discomfort to strong pain. 

How is Raynaud’s diagnosed?

Raynaud’s does not have a straightforward medical test. It is diagnosed by the presence of the three phases of white, blue and red.  As it may not be possible to reproduce these symptoms during a medical appointment, it is strongly advised to take photos of the fingers or toes during an attack so the podiatrist can assess what is happening. 

Podiatrists can check pulses in the feet and perform a circulation test with a Doppler ultrasound, which listens to blood flow in the blood vessels. 

How is Raynaud’s treated?

The goals of treatment are to: 

• Treat the underlying condition 

• Reduce the amount and severity of attacks 

• Prevent tissue damage  

Medication may help, depending on the cause, after thoroughly discussing the condition with your GP. To promote circulation, your doctor could prescribe vasodilators or calcium channel blockers- which relax and open small blood vessels in your hands and feet, reducing the number and severity of attacks.  

Tips for managing Raynaud’s:

• Avoid triggers. If emotional stress is the cause, relaxation techniques may be useful. 

• It is advised to keep the whole body warm by wearing layers of clothing to prevent heat loss. An electric blanket can be used to keep warm at night. 

• Smoking should be avoided as this can constrict blood flow, worsening the condition. 

• Regular exercise is advised as it improves circulation and can reduce stress levels. 

• Insulated and waterproof wellingtons/boots are recommended for farmers and people exposed to lower temperatures and wet conditions when outdoors. 

• Warm gloves/mittens and thermal socks should be worn, especially when during cold weather, when in contact with cold surfaces or objects, such as fridges or frozen food.

• Exposure can also lead to chilblains. To prevent these, extremities should be gently warmed up, by putting hands and/or feet into lukewarm water and adding warmer water gradually . 

For more information on chillblains, read our blog here. 

When should I get help for Raynaud’s?

Many people learn to live with and adapt to the condition by following the steps above but you should see a podiatrist or a GP if you have severe Raynaud’s and develop a wound and/or infection in one of the affected toes.