A young complains of one or more fingers going dead suddenly for an hour or more. This occurs symmetrically on both the sides, especially in cold weather. In a long standing case, an ulcer may form at the tip of the finger. The condition is RAYNAUD'S DISEASE.

Raynauds phenomena consists of spasms of arteries supplying the fingers or toes. It is usually precipitated by cold and relieved by heat. When raynauds phenomena occurs without any  underlying causes, it is known as raynauds disease. Numbness and burning of the fingers usually occurs and the pain can be severe. Between the attacks, the pulse and the digits appear normal.

SYMPTOMS OF RAYNAUD'S DISEASE

Signs and symptoms of Raynaud's disease include:

• Cold fingers or toes
• Color changes in your skin in response to cold or stress
• Numb, prickly feeling or stinging pain upon warming or stress relief

During an attack of Raynaud's, affected areas of your skin usually first turn white. Then, they often turn blue and feel cold and numb. As you warm and your circulation improves, the affected areas may turn red, throb, tingle or swell.

Although Raynaud's most commonly affects your fingers and toes, it can also affect other areas of your body, such as your nose, lips, ears and even nipples. After you warm up, the return of normal blood flow to the area can take 15 minutes.

CAUSES OF RAYNAUD'S DISEASE

Blood vessels in spasm

With Raynaud's, arteries of fingers and toes become narrow and briefly limit blood supply when exposed to cold or stress. Over time, these small arteries can thicken slightly, further limiting blood flow.

Cold temperatures are most likely to trigger an attack. Exposure to cold, such as putting your hands in cold water, taking something from a freezer or being in cold air, is the most likely trigger. For some people, emotional stress can trigger an episode.

 Types

• Primary Raynaud's. Also called Raynaud's disease, this most common form isn't the result of an associated medical condition. It can be so mild that many people with primary Raynaud's don't seek treatment. And it can resolve on its own.

• Secondary Raynaud's. Also called Raynaud's phenomenon, this form is caused by an underlying problem. Although secondary Raynaud's is less common than the primary form, it tends to be more serious.

  Signs and symptoms of secondary Raynaud's usually appear around age 40, later than they do for primary Raynaud's.

CAUSES OF RAYNAUD'S DISEASE

• Connective tissue diseases. Most people who have a rare disease that leads to hardening and scarring of the skin (scleroderma) have Raynaud's. Other diseases that increase the risk of Raynaud's include lupus, rheumatoid arthritis and Sjogren's syndrome.
• Diseases of the arteries. These include a buildup of plaques in blood vessels that feed the heart, a disorder in which the blood vessels of the hands and feet become inflamed, and a type of high blood pressure that affects the arteries of the lungs.
• Carpal tunnel syndrome. This condition involves pressure on a major nerve to your hand, producing numbness and pain in the hand that can make the hand more susceptible to cold temperatures.
• Repetitive action or vibration. Typing, playing piano or doing similar movements for long periods and operating vibrating tools, such as jackhammers, can lead to overuse injuries.
• Smoking. Smoking constricts blood vessels.
• Injuries to the hands or feet. Examples include a wrist fracture, surgery or frostbite.
• Certain medications. These include beta blockers for high blood pressure, migraine medications that contain ergotamine and sumatriptan, attention-deficit/hyperactivity disorder medications, certain chemotherapy agents, and drugs that cause blood vessels to narrow, such as some over-the-counter cold medications.

RISK FACTORS OF RAYNAUD'S DISEASE

Risk factors for primary Raynaud's include:

• Sex. More women than men are affected.
• Age. Although anyone can develop the condition, primary Raynaud's often begins between the ages of 15 and 30.
• Climate. The disorder is also more common in people who live in colder climates.
• Family history. A first-degree relative — a parent, sibling or child — having the disease appears to increase your risk of primary Raynaud's.

Risk factors for secondary Raynaud's include:

• Associated diseases. These include conditions such as scleroderma and lupus.
• Certain occupations. These include jobs that cause repetitive trauma, such as operating tools that vibrate.
• Exposure to certain substances. This includes smoking, taking medications that affect the blood vessels and being exposed to certain chemicals, such as vinyl chloride.

COMPLICATION OF RAYNAUD'S DISEASE

If secondary Raynaud's is severe — which is rare — reduced blood flow to your fingers or toes could cause tissue damage.

A completely blocked artery can lead to sores (skin ulcers) or dead tissue, both of which can be difficult to treat. Rarely, extreme untreated cases might require removing the affected part of your body.

PREVENTION OF RAYNAUD'S DISEASE

To help prevent Raynaud's attacks:

• 

  Bundle up outdoors. When it's cold, don a hat, scarf, socks and boots, and two layers of mittens or gloves before you g

  Also use chemical hand warmers. Wear earmuffs and a face mask if the tip of your nose and your earlobes are sensitive to cold.

• o outside. Wear a coat with snug cuffs to go around your mittens or gloves, to prevent cold air from reaching your hands.

• Warm your car. Run your car heater for a few minutes before driving in cold weather.

• Take precautions indoors. Wear socks. When taking food out of the refrigerator or freezer, wear gloves, mittens or oven mitts. Some people find it helpful to wear mittens and socks to bed during winter.

  Because air conditioning can trigger attacks, set your air conditioner to a warmer temperature. Use insulated drinking glasses.

Agaricus muscarius is a prominent remedy for chilblains and frostbite with itching, burning band redness. Sensation as if pierced with ice needles. Gait is uncertain with trembling; itching of the toes and feet feel as if frozen.

Silicea terra has shriveled, mottled, dusky blue, numb skin. Formication. Burning sensation in toes and fingers, better by cold, aversion to heat.

Rhus toxicodendron is for gangrenous ulcers on the legs, running bloody water. Extremities are cold. Red, swollen toes and fingers tips that itch and burn intensely, as if pierced by hot needles; better hot water.

Sepia officianalis has poor circulation and venous stasis. Both these factors predispose to gangrene.