RAYNAUD'S DISEASE: THE COLD FACTS

Raynaud's disease, first described in 1862, is another disorder in which, as in the case of hypertension, the symptoms vary with the presence of stress. Variations in skin temperature seem to occur as a function of changes in emotional states, which, relates to the number and type of stressors in one's life. Typically, the skin temperature of a Raynaud's victim will decrease with the occurrence of heightened stressors. The most commonly affected areas are fingers, toes, nose and earlobes.
When skin temperature drops, Raynaud's sufferers report a variety of symptoms. They may include: progressive skin color changes-- white, blue, and red-- and corresponding feelings of coldness, numbness, burning, tingling and throbbing pain; or any combination of these. These symptoms, which affect five times as many women as men, produce a blanching, mottled and cyanotic appearance of the affected areas. Individuals frequently describe symptom occurrences as, "attacks." Attacks vary in frequency and duration.
There are basically two types of Raynaud's disease: primary and secondary. Primary Raynaud's disease is distinguished from secondary by the absence of gangrene, consistent pain or the presence of organic blood vessel changes. Secondary Raynaud's can be caused by trauma from severe injuries to the arteries, from blood and other diseases; from the use of pneumatic or vibratory tools, and toxic metals such as those in nuclear reactors. When stressed, individuals with Raynaud's disease vary widely in the amount of skin temperature changes. Some have demonstrated lowering their temperatures as much as thirteen degrees!.
In addition to the typical stressors also experienced by most people-- work, marriage, child-rearing, finances-- Raynaud's victims often report: worrying (internal dialogue) about having attacks ahead of time, or places where they occur-- an air-conditioned office, for example; time, as attacks are frequently related to season, month, and so forth, and the availability of proper clothing. Additionally, people with Raynaud's disease may conduct an "inconvenience review", in which they run seemingly endless internal dialogues about the various places and activities that seem prohibitive due to their disease, and then experience increased stress.
There has been an accumulation of evidence in favor of behavioral self-regulation techniques, particularly biofeedback, as the treatment of choice for primary Raynaud's disease. However, the importance of a medical exam prior to partaking in any form of treatment is absolutely essential to establish the diagnosis of either primary or secondary Raynaud’s or the specific physiological and environmental factors associated with the symptoms. The diagnosis is important because there is much more research on the effects of biofeedback and related treatments for primary-- than secondary-- Raynaud's. Furthermore, the symptoms, types of treatment and consequences of secondary Raynaud's are potentially more aggressive and require medical intervention.
Self regulation consists of a variety of factors: Diet, relaxation; guided imagery such as, "autogenic training", and biofeedback. It is useful for someone with primary Raynaud's to avoid consuming products that contain caffeine, nicotine and any other factors that cause vasoconstriction (tightening of the blood vessels), and thus, a reduction in temperature. The object of self-regulation techniques in the treatment of primary Raynaud's is to reduce the peripheral vasoconstriction which causes lowered temperature, and the vasospastic episodes which produce the painful symptoms. In other words, the goal is increased peripheral temperature which occurs with progressively more relaxed states of consciousness. In part, this is accomplished through deep muscle relaxation and a guided imagery procedure. For example, a person is first taught to relax the skeletal muscles of the body by tightening and then letting go and noticing the difference. Then he or she is told to imagine feeling warmth flowing through the blood vessels, or feeling heavy and warm while relaxing at the beach, sitting by a warm fireplace in winter, and so forth. Biofeedback-- both muscle tension and temperature-- provides another dimension in this process by allowing the individual to confirm the physiological changes which are occurring by the visual and auditory signals being "fed-back." Thus, someone is able to discriminate and properly identify thoughts, feelings, and physical sensations which accompany increased muscle relaxation and temperature so that these phenomena can be reproduced at home, in the absence of the biofeedback equipment. And the Raynaud's sufferer can find relief, and come in from the cold.