What is Raynaud's (Raynaud's disease or Raynaud's phenomenon) syndrome?

From the Guidelines

Raynaud syndrome is a condition characterized by the excessive constriction of blood vessels in response to cold temperatures or stress, leading to reduced blood flow to the fingers and toes, and is typically managed by avoiding triggers and using medications such as calcium channel blockers. This disorder typically causes affected areas to turn white, then blue due to lack of oxygen, and finally red as blood flow returns, often accompanied by pain, numbness, or tingling. There are two types: primary Raynaud's, which occurs on its own and is usually milder, and secondary Raynaud's, which develops due to underlying conditions like autoimmune disorders, particularly scleroderma or lupus. Some key points to consider in the management of Raynaud syndrome include:

• Avoiding triggers like cold exposure by wearing gloves and warm clothing, reducing stress, and avoiding smoking and caffeine which can worsen symptoms 1
• Using medications such as calcium channel blockers (like nifedipine 30-60 mg daily) to help dilate blood vessels, as supported by a meta-analysis pooled findings from 38 RCTs that included 554 patients with secondary Raynaud phenomenon 1
• Considering other options like topical nitroglycerin, alpha blockers, or vasodilators like sildenafil in resistant cases
• The importance of physical exercise in improving health-related quality of life in people with SLE and SSc, as recommended by the EULAR guidelines 1 The condition occurs because the blood vessels overreact to cold or stress by releasing chemicals that cause excessive narrowing, disrupting normal blood flow regulation to the extremities. According to the most recent and highest quality study, the use of gloves and heating devices for the hands, avoidance of direct contact with cold surfaces, and a thorough drying of the skin are practical advice for people with SSc suffering from Raynaud’s phenomenon 1. Additionally, physical exercise should be considered for people with SLE and SSc to improve patient outcomes, as supported by several studies 1. Overall, the management of Raynaud syndrome should prioritize avoiding triggers, using medications, and promoting physical exercise to improve health-related quality of life.

From the Research

Definition of Raynaud Syndrome

• Raynaud syndrome, also known as Raynaud's phenomenon, is a common condition characterized by an exaggerated vasospastic response to cold or emotion, resulting in the digits (fingers and toes) turning white, then blue, then red 2, 3, 4.
• It is a vasospastic disease that can occur as a primary condition or secondary to an underlying disease, such as connective tissue disorders like systemic sclerosis, systemic lupus erythematosus, and mixed connective tissue disease 4.

Symptoms and Characteristics

• The symptoms of Raynaud syndrome include digital pallor, cyanosis, and extremity pain 4.
• The frequency, duration, and severity of attacks can vary, and the condition can be triggered by cold temperatures or emotional stress 2, 3.
• The condition can also cause pain, disability, and affect the quality of life of those affected 4.

Treatment and Management

• Calcium channel blockers are the most commonly prescribed drugs for people with primary Raynaud's phenomenon and are also used to treat secondary Raynaud's phenomenon 2, 3, 4.
• These medications promote vasodilation and can help reduce the frequency and severity of attacks, as well as improve blood flow to the affected areas 2, 3, 4.
• Other treatments, such as iloprost, losartan, felodipine, amlodipine, fluoxetine, and sildenafil, have also been studied, but more research is needed to confirm their effectiveness 5, 4.