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Raynaud's Disease - Cold, Numb, Foot Pain |
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Definition
Episodic vasospasm (constriction of small arteries) of the digits. It is characterized by digital blanching, cyanosis(blue), a feeling of numbness or dulled sensory response and rubor (red) after cold exposure and rewarming. It can also be induced by anxiety or stress. This condition is primarily confined to the fingers and toes but can affect areas of the body such as your nose, cheeks, ears and even tongue.Primary Raynaud's phenomenon is also called Raynaud's disease. Criteria for Raynaud's disease include episodic digital ischemia (sequence of color changes in the skin in response to cold or stress), a numb, prickly feeling or stinging pain upon warming or relief of stress, absence of arterial occlusion, bilateral distribution, absence of symptoms or signs of other diseases that also cause Raynaud's phenomenon, and duration of symptoms for 2 years or longer. Most people with Raynaud's disease develop symptoms before they reach 40 years of age. It can occur in young children. Raynaud's disease affects women three to five times more frequently than men. The prevalence is lower in warm climates than in cold climates. |
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Etiology
The mechanisms postulated to cause Raynaud's phenomenon include increased sympathetic nervous system activity, heightened digital vascular reactivity to vasoconstrictive stimuli, circulating vasoactive hormones, and decreased intravascular pressure. The sympathetic nervous system mediates the digital vasoconstrictive response to cold exposure and emotional stress but has been discounted as a primary mechanism. Some investigators have suggested that increased sensitivity, increased numbers of postsynaptic alpha2-adrenergic receptors, or both enhance the vasoconstrictive reactivity to sympathetic stimulation. In some cases of Raynaud's phenomenon, endogenous vasoactive substances (e.g., angiotensin II, serotonin, and thromboxane A2) and exogenous vasoconstrictors (e.g., ergot alkaloids and sympathomimetic drugs) may cause digital vasospasm. Many patients with Raynaud's phenomenon have hyperhidrosis (sweaty palms). |
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