10 Cold Weather Tips for Managing Raynaud’s During Winter

For some of us, cold winter months can be bothersome, especially when the weather outside is frightful. But if you have Raynaud’s syndrome, cold weather can be particularly painful.

Raynaud’s causes tiny blood vessels in your fingers, toes, ears or nose to constrict during exposure to cold weather, emotional stress, anxiety and other triggers. When these blood vessels are constricted, they reduce blood supply to those areas. This, in turn, makes your skin in those areas turn white or blue. And once blood flow resumes, these areas can then redden and become extremely painful or numb and tingly.

In most cases, Raynaud’s requires a little extra attention to keep your hands and feet warm and dry during winter months. But if your Raynaud’s becomes severe enough, it can lead to ulcers or tissue injury.

“If there is such low blood flow to the tissue that it doesn’t get the necessary nutrients it needs to survive, some people can get gangrene, and the tissues of the fingertips and toes can even die,” says Benjamin Abraham, MD, a pain management specialist who treats people with severe Raynaud’s.

But is there anything you can do to quell some of your triggers? And are there treatments available that can help reduce the severity of Raynaud’s?

Dr. Abraham, along with vascular medicine specialist Meghann McCarthy, DO, share some tips to keep you warm this winter without exacerbating your Raynaud’s triggers. Plus, they cover some treatment options you may want to consider when you’re feeling left out in the cold.

What causes Raynaud’s?

For many people who experience Raynaud’s, attacks can be painful, but they generally pass quickly and don’t cause long-term challenges. This is called primary Raynaud’s. It’s often seen in younger women and people assigned female at birth (AFAB) — though it isn’t exactly clear why, says Dr. McCarthy.

Sometimes, the blood vessel conditions that cause Raynaud’s are the result of other underlying autoimmune conditions like:

• Scleroderma.
• Connective tissue disease.
• Lupus.

Certain medications can also lead to blood vessel constriction that triggers Raynaud’s. If Raynaud’s is a result of this or other underlying conditions, it’s diagnosed as secondary Raynaud’s syndrome.

“More severe symptoms such as ulcers and skin sores are very rare with primary Raynaud’s but may be seen more often with secondary Raynaud’s,” notes Dr. McCarthy.

10 tips for managing Raynaud’s during the winter

Just because you have Raynaud’s doesn’t necessarily mean you have to avoid all of your favorite cold weather activities. These tips are designed to reduce the severity and length of your Raynaud’s flare-ups by minimizing your triggers and helping you respond to triggers more quickly:

1. Keep your hands and feet warm and dry. Raynaud’s directly affects your extremities where your blood vessels are thinnest, so wear gloves, mittens or mitten caps and make sure feet warmers and hand warmers are items you keep around at all times.
2. Keep the rest of your body covered, too. Raynaud’s can be triggered when any part of your body gets cold, so layer your clothing and wear a hat to keep heat inside your body.
3. Avoid handling cold objects. Frostbite can happen in minutes — and if you have Raynaud’s, it could set in even faster with more severe effects. Avoid shoveling snow if you can or wear hand warmers. And try not to hold ice-cold drinks for too long.
4. Reduce your stress levels by doing yoga or practicing self-care. The cold isn’t your only trigger. Raynaud’s can also be triggered by anxiety, excitement or emotional stress. By focusing on your mental health with the help of yoga, meditation, mindfulness and other self-care techniques, you can reduce the likelihood of Raynaud’s flaring up.
5. Drink a warm drink. Nothing warms your insides faster than a nice hot cup of tea (or cocoa!). If you’re going to be outside or you’re coming in for the first time, drinking a nice hot drink can help raise your internal temperature more moderately.
6. Stay hydrated. In general, you should stay hydrated because water helps your blood maintain its temperature and gets your blood flowing (which helps when you have Raynaud’s). On average, you should drink a few glasses of water every day and avoid excess caffeine when possible.
7. Run warm water over your hands and feet. When Raynaud’s strikes, running your hands and feet under warm water can get your blood flowing and help your internal temperatures catch up to speed.
8. Don’t smoke. Smoking restricts your blood vessels naturally over time, so if you have Raynaud’s, smoking can actually worsen your symptoms. If you’re looking to quit smoking, these tips can help you kick the habit.
9. Stay active. People living with Raynaud’s can always benefit from exercise because it gets their blood circulating faster and more efficiently. On average, you should aim for 30 minutes of moderate-intensity aerobic exercises five days a week.
10. Avoid quick temperature changes. A sudden shift in temperatures — like coming in from out of the cold, or taking a cold shower after a sweaty, intense workout — can trigger Raynaud’s, too. To avoid this, allow your body to acclimate to room temperature naturally and don’t rush your next activity if you can avoid it.

“Keeping your hands and feet warm is one of the mainstays in the management of Raynaud’s and one of the most effective ways to keep the blood vessels open,” says Dr. McCarthy. “In many cases, simple lifestyle changes and warming strategies are adequate enough to manage Raynaud’s symptoms and prevent any damage to the skin, even in the long-term.”

What other treatments help with Raynaud’s?

Beyond lifestyle changes, if you need treatment for Raynaud’s symptoms, your physician may refer you to someone who specializes in vascular medicine.

“The goal of treatment is to eliminate pain and prevent complications,” explains Dr. McCarthy.

There are several different oral medications that you can take and other topical solutions you can use on your skin to help open your narrowed blood vessels. You may hear your doctor call them calcium channel blockers, phosphodiesterase inhibitors or topical nitrates.

Still, each person’s experience with Raynaud’s is unique. What may be mild to some may end up feeling extreme for others. If your symptoms don’t respond, or if you don’t tolerate traditional treatment with medication, a pain medicine specialist may be able to offer some additional solutions that can help you manage how you’re feeling when flare-ups happen.

“When the usual treatments fail, we can often help,” Dr. Abraham reassures.

Some of the potential pain management options you may be offered include:

• Sympathetic nerve blocks. During this procedure, a healthcare provider injects an anesthetic medication into a portion of your sympathetic nervous system, which controls the way blood vessels open or close. “This tricks your body into opening up the blood vessels and facilitates blood flow into certain tissues,” Dr. Abraham explains. The relief from nerve block injections is likely temporary, but for some people, it can offer benefits with lower risk than having a surgical treatment.”
• Botox®. Some studies have found that Botox may work for a longer period of time than a nerve block, according to Dr. Abraham. But this treatment is experimental and hasn’t been extensively studied yet in people with Raynaud’s.
• Surgical sympathectomy. During this procedure, a surgeon cuts through a group of sympathetic nerves to prevent nerve signals from passing through. This procedure isn’t always effective in the long-term, but it could be a potential option.
• Spinal cord stimulation. This treatment, which is used for several other pain conditions, delivers electricity onto specific nerve areas using a device that’s implanted near your spine. This is thought to act by altering the activity of the sympathetic nervous system to keep blood vessels open and allow more blood flow to the affected areas. An external controller allows you to turn the device on, off, up or down.

“While these treatments are not 100% effective for everyone,” notes Dr. Abraham, “small studies suggest they are a great option when the pain is severe and there is ongoing tissue damage.”

New research is being done every day to find new, more effective solutions for treatment-resistant Raynaud’s. If you feel your treatment options aren’t working effectively enough, or if you’re interested in other potential solutions, make an appointment with your healthcare provider who can discuss which options are available and best for your unique case.

“While many mild cases of Raynaud’s are responsive to lifestyle changes and warming techniques, we have many other treatments available to help manage symptoms in more severe or refractory cases — from topic creams to oral medications, injections and surgical procedures,” encourages Dr. McCarthy.

“There are numerous options and combinations of options that can be tailored to fit each individual’s need to provide symptomatic relief.”