Managing Raynaud's

Although there is no cure for Raynaud's, it can be treated. The key to managing Raynaud's symptoms is to try to prevent an attack - planning ahead is vital. Here are some ways you can manage Raynaud's phenomenon symptoms and live as normal a life as possible.

Webinar on Raynaud’s

Click here to watch our webinar on Understanding & Managing Raynaud's. Dr John Pauling shares key information, including who is at risk, symptoms, getting tested, prevention and treatments, as well as giving some practical tips and advice. We hope you find this useful. 

There were lots more of your questions that were answered after the session - click here to download the comprehensive list.

General measures

• Avoidance of repeated trauma to the fingertips and avoidance of vibrating tools.
• Control or limitation of emotional stress - stress plus cold exposure is an especially potent trigger for RP
• Avoidance of vasoconstricting drugs — avoid medications known to worsen vasospasm, when possible.

Several classes of drugs known to be associated with vasospasm include the following:

• Over-the-counter nasal decongestants(eg, phenylephrine, pseudoephedrine)
• Amphetamines, diet pills, and herbs with ephedra
• Agents used to treat attention deficit hyperactivity disorder (ADHD) (methylphenidate and dextroamphetamine)
• Some medications used for migraine headaches, including serotonin agonists (e.g, sumatriptan) or ergotamine

Keep warm

Do all you can to avoid cold environments, touching cold items or spending time in areas where temperatures fluctuate. Even a slight change in temperature can cause an attack. What you can do to keep warm:

• Wear warm clothes in cold temperatures
• Wear lots of thin layers and loose clothing in order to remain as warm as possible.
• Use hand warmers, feet warmers, gloves and thick socks to keep cold fingers and toes comfortable on chilly days.
• There are some more products to help keep warm in our online shop such as thermal shoe insoles and fleece blanket.

Relax and pace yourself

Try to steer clear of stressful situations as stress and anxiety can trigger an attack. Take rests when you can to avoid getting too fatigued. The Pulmonary Hypertension Association (PHA UK) describes a good way of helping to focus on your breathing, called controlled breathing, (also known as diaphragmatic breathing) which uses your diaphragm and lower chest muscles. To try this technique, follow the steps below:

• Get into a comfortable position where your neck, shoulders and back are well supported, such as in an upright chair with armrests or by leaning against a wall.
• Relax your shoulders, neck and arms.
• Place your hands on your tummy, just above your belly button.
• Give a little cough- the muscle you feel under your hand is your diaphragm.
• As you breathe in, allow your tummy to swell- you'll feel your hands rising and being pushed out by your diaphragm and tummy muscles.
• As you breathe out, relax and let your tummy fall.

Complementary therapies

Complementary therapies can bring relief from symptoms for some. These are listed within our treatments section.

Speak to your doctor about treatments

One drug, Nifedipine, a calcium channel blocker, is licensed for Raynaud's, and there are drugs that are prescribed commonly for Raynaud's too. Nifedipine doesn't cure Raynaud's, but can help to relieve symptoms. Other medications have been used to treat Raynaud's, with mixed results, and more can be found on our treatments page.

• Iloprost is available for extreme cases.
• Angiotensin II receptor blocker — Angiotensin II receptor blockers (ARBs) may be used for patients with uncomplicated RP who may benefit from the use of an ARB for other indications (eg, hypertension, heart failure, proteinuric chronic kidney disease).
• Selective serotonin reuptake inhibitor — Fluoxetine may be used in patients with uncomplicated RP
• PDE5 inhibitors e.g sildenafil
• Topical GTN
• Endothelin-1 receptor antagonist e.g. Bosentan
• Botox is an experimental Raynaud's treatment, which may reduce blood vessel spasm and block pain nerves. Increasing amounts of research is emerging for it, but it is only used in selected cases and usually only in specialist centres.
• Some Raynaud's sufferers have found acupuncture alleviates symptoms.

Take action to prevent ulcers

People with secondary Raynaud's are at risk of ulcers. These can become infected and take some time to heal, so it's important to avoid them if possible. Here are some ways to keep ulcers at bay:

• Look after your skin and cover any broken areas with a clean plaster, Inadine or Mepilex.
• Keep an eye out for signs of infection in broken skin – yellow discharge, redness, swelling, pain and failure to heal.
• If you see any of these signs, contact your GP or local rheumatology team immediately.
• Keep a diary of where your ulcers appear – this will help your doctor to monitor and treat the problem.

Eat a healthy diet

Always try to maintain a balanced, healthy diet and avoid caffeine and alcohol.

Some food supplements have helped Raynaud's sufferers, including evening primrose oil, gingko biloba and fish oils. Certain foods are also believed to help, like ginger, garlic and spicy food.

Eating protein can help the body to heal quicker with recovering from surgery or suffering from digital ulcers.

If you smoke, try to quit

It is incredibly important to stop smoking, one cigarette can reduce the body's temperature by up to one degree for up to 20 minutes. There are real benefits to stopping. For example:

• Stopping smoking your treatment is safer for you.
• You can expect to respond better to your treatment.
• In the longer term, you will reduce your chances of your Raynaud’s worsening.

Stop Smoking Helplines

• NHS Smoking Helpline: 0800 022 4332 (England) Website: www.nhs.uk/smokefree
• Smokeline: 0800 848 484 (Scotland) Website: www.canstopsmoking.com
• Want2Stop (Northern Ireland) Website: www.want2stop.info
• Smokers Helpline (Wales) Helpline: 0808 085 2219 Website: www.stopsmokingwales.com

Take care during pregnancy and breastfeeding

Primary Raynaud's has little impact on pregnancy. Most patients find that the Raynaud's symptoms are less severe during pregnancy, probably due to the hormonal changes that occur. However, Raynaud's symptoms may worsen three or four months after delivery, and will usually then return to the previous severity. The effect of any Raynaud's medication you are taking should be considered, as some commonly used drugs are not safe during pregnancy.
Practical aspects to avoid attacks should be taken during delivery, such as warming infusion fluids. Raynaud's can affect the nipples when a mother is breastfeeding.

Take gentle exercise

Exercise, within your own limits, can boost circulation and may improve Raynaud's. Even very gentle exercise can help to get the blood flowing – if you are feeling cold, for example, try swinging your arms as you walk.

Occasionally, exercise can trigger Raynaud's attacks. Look out for signs of this happening and change your fitness plan if needs be. Many find swimming can help their Raynaud's, but please check the temperature of the water before swimming as a cold pool could trigger an attack.

Try one of these low impact exercises to see if it helps your Raynaud's. Exercise is a great way to lift your mood and ensure that you stay fit and healthy:

• Walking is by far the most popular low-impact exercise. It works the cardiovascular system and burns calories. To get your heart rate up, walk faster than a stroll. Picking up the pace can increase the intensity of your workouts. Add short bursts of speed or walk up an occasional steep hill.
• Swimming works the whole body. It's a great way to tone up and get trim. Swimming a few lengths involves most of the muscle groups, and you'll get a good aerobic workout if you increase the pace. Swimming can also help you lose weight if you swim at a steady and continuous pace throughout your session.
• Cycling is a low-impact activity. But you can still injure yourself if you have the wrong size bike, or if the saddle and handlebars are at the wrong height. Cycling is an aerobic exercise that works your lower body and cardiovascular system. Start slowly and increase the length of your cycling sessions gradually.
• Yoga can improve both your physical fitness and your general wellbeing through a series of postures and breathing exercises. Regular yoga practice helps develop strength, balance, and flexibility. It can also lift your mood.
• Pilates focuses on rebalancing the body and improving posture through slow, controlled movements and exercises. Regular practise can help you improve muscle strength and your overall sense of wellbeing. It can be helpful for people who can't or must not jump around too much.
• Dancing is one of the best things about dancing is that while you're having fun moving to music and meeting new people, you're getting all the health benefits of a good workout. From Ceroc to the foxtrot, there's a dance style to suit all tastes.

Please consult your GP before making any major lifestyle changes.

These websites will help you find activities near you:

• NHS  – www.nhs.uk/livewell/fitness

• Active Scotland – www.activescotland.org.uk

• Sport Wales – www.sportwales.org.uk

• Sport Northern Ireland – www.sportni.net

• Be Inspired – www.beinspireduk.org

Benefits you may be entitled to

Your Raynaud's symptoms may limit your ability to support yourself. If this is the case, you may be able to apply for financial support. Further information about welfare benefits se our UK welfare benefits section. Please get in touch with one the following:

• Department of Work and Pensions – visit the DWP website
• Your energy supplier - they might provide support for Raynaud's sufferers on a discretionary basis.

Get help with work place issues

If you struggle in the workplace, make sure you talk to your employer about it. The NHS has more information on health in the workplace here

Page updated: 31 March 2021