Cold Hands – Raynaud’s Phenomenon

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If your fingers turn white and start to hurt when you are out in the cold, you may have a condition called Raynaud’s phenomenon. When your body temperature starts to drop, your brain sends signals along nerves to shut blood flow to your hands and the skin turns white. When the temperature drops to 59 degrees, your body tries to save your skin by opening the blood vessels and the skin turns red and starts to itch and burn. This is called the “Hunting Response” and is normal. People who have Raynaud’s phenomenon do not have the normal “Hunting Response” so the blood vessels in their hands that do not open when the skin temperature reaches 59 degrees. Smoking, using vibrating equipment, or various diseases can cause Raynaud’s phenomenon.

A treatment for Raynaud’s phenomenon was developed by Dr. Murray Hamlet at the Army’s Research Institute of Environmental Medicine (Ann Intern Med, 1982 Nov;97(5):706-9).  He had sufferers sit out in the cold with their hands immersed in warm water six times a day. This caused blood vessels in their hands to open while those elsewhere in the skin closed down. All people who were tested were able to be out in the cold without feeling pain in their hands after eight sessions done every other day. However, this treatment is so cumbersome that it is not recommended today.

The easiest treatment is inexpensive single-use hand warmer packets that can keep you from being miserable when you want to stay outside. They are available in sporting goods stores, ski shops and online. Wear two or more layers of gloves or mittens, with the warmer packets tucked inside.

If your fingers still feel cold, swing your arms rapidly about your shoulder with your elbow straight. This will drive blood, like a centrifuge, into your fingers and warm them.

If you are still bothered by cold hands, the blood pressure drugs called calcium channel blockers, such as Nifidipine, can help to treat and prevent Raynaud’s phenomenon (Rheumatology, November 2005). Another option is nitroglycerin ointment that is used to treat angina (J Rheumatol, 1985 Oct;12(5):953-6; Lancet, November 13, 1999;354:1670-1675). When applied to the forearm, it opens blood vessels leading to the hands. Check with your doctor to see if these prescription medications might be appropriate for you.

People with Raynaud’s phenomenon may not have the usual warning signs of frostbite and so are in danger of permanent damage if they ignore their cold hands. See my report on Cold Weather Exercise Tips