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Raynaud's phenomenon is also called Raynaud's syndrome or disease. It is a disorder of blood circulation in the fingers and the condition gets worse with exposure to cold temperatures. The cold affects the person by abnormally reducing the blood circulation in the fingers causing them to become pale, white or purple. Raynaud's is sometimes called "white finger," "wax finger" or "dead finger."

Raynaud's phenomenon has many different causes. It is usually associated with hand-arm vibration syndrome but it is also part of other occupational diseases. The signs and symptoms of Raynaud's phenomenon and the workplace hazards that cause it are important to know. This awareness can help prevent Raynaud's from occurring or getting worse. If it is not detected early, the disorder can permanently affect blood circulation in the fingers.

Raynaud's phenomenon is not life threatening, but severe cases can cause disability and may force workers to quit their jobs. Severe cases can lead to breakdown of the skin and gangrene. Many affected workers have to change their activities and work habits to avoid attacks of Raynaud's.

The reasons why Raynaud's phenomenon occurs are not completely understood. A healthy body saves heat by reducing blood circulation to the extremities, like the hands and feet. This conservation response involves an extensive system of nerves and muscles to control blood flow through the smaller blood vessels in the skin. With Raynaud's phenomenon, this control system becomes hyper sensitive to cold and overcompensates in reducing the blood flow to the fingers. Raynaud's phenomenon may be caused by damage to either the muscles or nerves that control blood flow.


Signs and Symptoms

Poor blood circulation in the fingers is the most noticeable symptom of Raynaud's phenomenon. The attacks happen when the hands and/or the whole body get cold. Activities resulting in cold exposure like washing the car, holding a cold steering wheel, or the cold handlebars of a bicycle will bring on the symptoms. Attacks can also occur when a person is outdoors in the cold weather.

A typical attack occurs with "pins and needles" and a partial loss of feeling or numbness in the fingers. The fingers turn white and there is pain. Sometimes there is redness that accompanies the return of blood circulation after 30 minutes to two hours. Occupationally induced Raynaud's phenomenon gets worse if workers remain exposed to the same conditions that caused the problem. As it gets worse, the attacks become stronger and more frequent. It is very important to recognize the signs and symptoms while it is developing.

The Taylor-Pelmear scale system classifies vibration-induced Raynaud's phenomenon into four stages. Stage zero means there are no attacks. Stage one is for mild and occasional attacks affecting the tips of one or more fingers. The second stage is for moderate and occasional attacks affecting the tips and middle sections of the fingers on one or more fingers. Severe and frequent episodes affecting the entire length of most fingers are the third stage. The fourth stage is called very severe with damaged skin and possible gangrene in the fingertips


What are the causes of Raynaud's Phenomenon?

"Primary Raynaud's Phenomenon," or "Raynaud's Disease" is a condition where the causes cannot be identified. It usually affects both hands, and attacks occur in response to stress or cold. People can also get Raynaud's phenomenon as a result of certain diseases or injuries. This is known as "Secondary Raynaud's Phenomenon." At the workplace, there are several hazards can cause Raynaud's phenomenon. Hand-held power tools like chain saws and pneumatic drills and chippers can cause "hand-arm vibration syndrome (HAVS)." This ailment is also known as "Raynaud's phenomenon of occupational origin." Raynaud's phenomenon is only one aspect of the hand-arm vibration syndrome. Vibration also damages the nerves, muscles, bones and joints of the hand and arm. Before the cancer-causing effects of vinyl chloride were known, workers exposed to concentrated levels of this chemical experienced Raynaud's phenomenon. Frostbite injury can also cause Raynaud's phenomenon. One study reports that fish plant workers developed Raynaud's phenomenon after chilling and rewarming their hands several times a day over a period of years.

Some studies have suggested that gripping a hand tool too tightly could cause Raynaud's phenomenon. Other studies have diagnosed Raynaud's phenomenon in workers who injured their hands by using them for hammering, or pushing or twisting heavy objects. Raynaud's phenomenon often occurs in workers in occupations that involve exposure to vibration. One study showed that 45 percent of 58 rock drillers had attacks of Raynaud's; 25 percent of workers with less than five years of experience, and 80 percent of those with over 16 years experience.


Can Raynaud's Phenomenon be tested for?

Laboratory tests can help determine if a person has Raynaud's phenomenon. These tests measure skin sensitivity or blood flow in the fingers under cooling conditions. There is not one test that is universally accepted for detecting Raynaud's. A careful analysis of a person's work history and medical history is useful in determining if a person has Raynaud's phenomenon.


Is treatment available for Raynaud's phenomenon?

Workers with mild cases of vibration-induced Raynaud's phenomenon can recover if the cause is avoided. For severe cases, prescription drugs may reduce the attacks. The best therapy, however, is to avoid further exposure to vibration. Extra clothing and gloves are essential to keep the body and hands warm. If detected early, vibration-induced Raynaud's phenomenon will not get worse as long as further exposure to vibration is eliminated. Cases that are identified early enough may improve, but advanced cases seldom do. Precautions can be taken to reduce the number and intensity of attacks of Raynaud's. Protect the body from cold temperatures, avoid putting bare hands in cold water, protect the hand from injury and don't smoke as nicotine adversely affects circulation.