Wintertime is the time to break out the snow boots and the funky socks. Your feet might look like they’re snug and comfy in those fuzzy slippers, but they’re still cold. What gives? Do you need to turn up the heat, or is something else going on?
Here’s a clue: If your toes get super cold in response to either a small drop in temperature, stress or both, it could be Raynaud’s disease.
What Is Raynaud’s Disease?
Raynaud’s disease is a condition marked by poor circulation in the feet, hands and sometimes other areas such as the ears or nose. It is caused by a medical phenomenon called vasospasm.
Vasospasm is a narrowing of the blood vessels—arteries in the case of Raynaud’s. In Raynaud’s, the vasospasm is usually localized to the fingers or toes. When the arteries in these digits narrow, their blood supply drops, and coldness or sometimes numbness is the result. The arteries of people with Raynaud’s seem to overreact to cold and stress, causing the vasospasms and feelings of coldness.
Symptoms of Raynaud’s Disease
Cold toes (and fingers) are the top symptom of Raynaud’s disease. During an attack of Raynaud’s, the affected area may turn white, then blue. Numbness and tingling in the toes is another possible symptom. Advanced or severe cases can cause sores, infection or even gangrene.
Raynaud’s Risk Factors
Risk factors for Raynaud’s disease include:
- Age 15 to 30
- Family history of Raynaud’s
- Female sex
- Living in a colder climate
Raynaud’s Disease vs Raynaud’s Phenomenon
Raynaud’s disease, also known as primary Raynaud’s, is a condition in and of itself. Less common is Raynaud’s phenomenon, or secondary Raynaud’s. Raynaud’s phenomenon is more a symptom of another condition. Causes of Raynaud’s phenomenon can include:
- Connective tissue diseases such as scleroderma, rheumatoid arthritis or lupus
- Atherosclerosis and other arterial conditions
- Smoking, which causes blood vessels to constrict
- Injuries to the feet or toes, such as frostbite or an ankle fracture
- Some medications, such as beta blockers for high blood pressure, migraine medications and those used to treat attention deficit/hyperactive disorder
Diagnosing and Treating Raynaud’s Disease
One of the most important parts of diagnosing Raynaud’s is figuring out if the patient has primary or secondary Raynaud’s. There’s no one test for diagnosing Raynaud’s disease, but some helpful tests may include:
- Cold test: A thermometer is taped to the hands or feet, which are then submerged in cold water. The healthcare provider records how long it takes to return to normal temperature which, in the case of Raynaud’s, may take up to 20 minutes.
- Nailfold capillaroscopy: A healthcare provider puts a drop of oil near the base of the patient’s fingernail or toenail, then examines the nail for abnormal blood vessels.
Treating secondary Raynaud’s is best done by treating the underlying condition itself. Many people with primary Raynaud’s don’t need any treatment beyond warm socks and shoes and keeping out of the cold.
For more severe cases of Raynaud’s disease, medications can help control it. Medications can include:
- Calcium-channel blockers, which allow the blood vessels in your feet to relax.
- Vasodilators, which relax blood vessels in a different way.
Procedures up to and including surgery may be helpful in extreme cases of Raynaud’s. Botox is one such procedure because it can block nerve activity. Surgically cutting or stripping away certain nerves that serve the feet and toes can also reduce the severity of Raynaud’s attacks.
If you are troubled by cold feet, request an appointment with Essex Union Podiatry. We can help determine if you have Raynaud’s, and help you with lifestyle modifications or develop a treatment plan that works for your life.