What is the treatment for Raynaud's (Raynaud's disease or Raynaud's phenomenon) of the fingers?

From the Guidelines

Treatment for Raynaud's phenomenon should start with lifestyle modifications, including keeping hands and body warm, avoiding triggers, and using gloves and hand warmers, as these measures can help prevent attacks and reduce their severity. According to a recent study 1, practical advice to people with systemic sclerosis suffering from Raynaud’s phenomenon may include the use of gloves and heating devices for the hands, avoidance of direct contact with cold surfaces, and a thorough drying of the skin.

Some key lifestyle modifications include:

• Wearing gloves in cold weather
• Using hand warmers when necessary
• Avoiding triggers like cold temperatures, emotional stress, and smoking
• Performing gentle arm windmills to increase circulation when an attack occurs
• Warming fingers by placing them in warm water or moving to a warmer environment

If symptoms are severe, medications may be prescribed, including calcium channel blockers like nifedipine (10-30mg daily) 1, which relax blood vessels, or topical nitroglycerin ointment applied to affected fingers. In severe cases, medications like sildenafil or losartan may be considered, as they work by dilating blood vessels to improve blood flow to the extremities.

It's essential to seek medical attention if you develop sores or infections on your fingers, as these can be complications of Raynaud's requiring prompt treatment. Regular exercise and stress reduction techniques like meditation can also help improve circulation and prevent stress-triggered episodes 1. Severe cases that don't respond to medication might require procedures like sympathectomy, which blocks nerves that cause blood vessels to narrow.

From the Research

Treatment Options for Raynaud's Finger

• Calcium channel blockers are a commonly prescribed treatment for Raynaud's phenomenon, including primary and secondary types 2, 3, 4, 5
• Nifedipine, a type of calcium channel blocker, has been shown to be effective in reducing the frequency and severity of vasospastic attacks in patients with Raynaud's phenomenon 2, 3, 4, 5
• The efficacy of calcium channel blockers in reducing the frequency of attacks is moderate, with a weighted mean difference of -6.13 attacks per week compared to placebo 4
• The efficacy of calcium channel blockers in reducing the severity of attacks is also moderate, with a weighted mean difference of -0.62 cm on a 10-cm visual analogue scale 4
• Higher doses of calcium channel blockers may be more effective than lower doses, and dihydropyridine calcium channel blockers may be more effective for primary Raynaud's phenomenon than for secondary Raynaud's phenomenon 4
• Common side effects of calcium channel blockers include headache, dizziness, nausea, palpitations, and ankle edema, but no serious adverse events have been reported 4

Comparison of Treatment Outcomes

• A meta-analysis of 18 randomized controlled trials found that calcium channel blockers reduced the frequency of attacks by an average of 2.8 to 5.0 fewer attacks per week and reduced the severity of attacks by 33% 5
• Another study found that calcium channel blockers reduced the frequency of attacks by 1.72 fewer attacks per week and reduced the severity of attacks by 0.2 on a 10-cm visual analogue scale 3
• The efficacy of calcium channel blockers may vary depending on the type and dose of the medication, as well as the individual patient's response to treatment 2, 3, 4, 5

Patient Response to Treatment

• Patients with primary Raynaud's phenomenon may respond more favorably to treatment with calcium channel blockers than patients with secondary Raynaud's phenomenon 2, 4
• Individual patient response to treatment may vary, with some patients showing marked improvement and others showing no improvement at all 2
• Patient-preference scores and physiological measurements may also be used to assess the efficacy of treatment, but the results may be limited by small sample sizes and variable data quality 3