With the weather turning chilly (sometimes) at the moment, I am brought to thinking once again about a surprisingly common complaint amongst my patients – Raynauds phenomenon or syndrome.  Another frequent winter irritant is chilblains.  But what are these two conditions, how are the triggered and what can be done about them?

Raynaud’s phenomenon

A lot of people will have come across this, may know someone with it or indeed suffer it themselves.  It is most easily recognised when the fingers and toes turn a deathly white, in a very clear “cut-off” line, and it then takes forever for the normal colour to return.  Raynaud’s can be triggered by a number of factors – most commonly it is cold, but there can also be factors such as vibration or (in my case) damp.  The small blood vessels of the digits spasm, causing the blood flow to cease.  There are actually two variations: the first, where the fingers or toes turn totally white, is caused by just the arterial capillaries (those supplying blood TO your digits) shutting off; the second is less noticeable as the digits turn a very strange, dusky purpley-blue as a result of both the arterial and venous capillaries (vessels supplying and taking blood away from the digits) clamping shut, trapping de-oxygenated blood in your digits.  Often, Raynaud’s  is just really  irritating, making your hands totally numb or giving you the feeling of walking on cobbles if it’s affecting your toes, but it can be very painful or give you the sensation of tingling or pins and needles.

So what can be done? The obvious answer is…avoid the triggers!  If you know it is set off by cold, invest in several good pairs of gloves and socks and make sure you keep your hands and feet as warm as possible. There may be other factors which are making it worse, such as smoking, and again the answer is an obvious case of “stop doing it, then!”.  Raynaud’s can also be secondary to other conditions such as Rheumatoid Arthritis, in which case correctly managing these conditions will help.  If all else fails, there is a medication which can be tried, but usually this is not needed.

Chilblains

Oh they are truly evil.  The itching, the pain, the bright red, shiny, inflamed fingers and toes which drive you nuts.  Yep, been there done that – in fact, sufferers of Raynaud’s quite often find themselves doubly afflicted with Raynaud’s AND chilblains.  Not fair.

Anyway, chilblains are small, itchy swellings that usually appear on the fingers and toes.  They are a reaction to the blood vessels in your extremities constricting when they get cold, and then rapidly expanding when you warm up again.  This frequent change from constricted to expanded causes irritation in the surrounding tissue.  That’s why it’s more common in people with poor circulation, such as those with Raynaud’s – they get cold that much more easily!

There are other risk factors for developing them: spending a lot of time out in the cold, damp weather; family history of chilblains; poor diet or low body weight; and smoking.

Generally, chilblains will get better on their own and need little intervention, although there are soothing creams available and if you get them a lot your GP may recommend medication to help improve your circulation.  However, you are once again  better off just trying to avoid situations where they may arise.  Stay warm and dry, keep active, eat well with at least one hot meal a day, avoid tight or constricting shoes, and (of course) stop smoking.

So there we go – a few helpful bits of information about two common and exceptionally irritating winter ailments.  Nothing Chiropractic can do about them, I’m afraid, but it’s still useful to know how best to handle them.  Bring on the summer!