If you have been diagnosed with primary Raynaud’s then you can probably be treated by your GP.
If you have been diagnosed with secondary Raynaud’s due to with an underlying condition, you may need to be referred to a specialist in the treatment of that condition. For example, people with rheumatoid arthritis may need to be referred to a specialist in treating conditions affecting the joints (rheumatologist) and people with lupus may need to be referred to a skin specialist (dermatologist).
The recommended treatment plan for primary Raynaud’s is to first see if self-help methods can help control symptoms. If this does not work then a medication called nifedipine can be used.
The treatment plan for secondary Raynaud’s is largely the same although additional medications may be required to treat any underlying health condition. For example, steroid tablets (corticosteroids) are used to treat lupus.
If it is thought that a case of secondary Raynaud’s may be arising as a side effect of a medication you are taking, you may be asked to stop taking it to see if your symptoms get better.
Self-help
The advice below is recommended for people with both primary and secondary Raynaud’s.
- Keep your whole body warm, especially your hands and feet. Wear gloves and warm footwear in cold weather. Heating aids are available from the Raynaud's and Scleroderma Association online shop. The association is a UK charity for people with Raynaud’s.
- If you smoke, quit. Quitting smoking will improve your circulation, which should help improve symptoms. Research has shown that you are up to four times more likely to successfully give up smoking if you use NHS support together with stop-smoking medicines, such as patches or gum. Ask your GP about this or visit NHS Smokefree.
- Exercise regularly as this helps improve your circulation and reduce stress levels (see below). For most people 30 minutes of vigorous exercise a day, at least five times a week, is recommended. For more information go to the Live Well section on exercise. Your GP can also give you more advice about the how much exercise is best for you.
- Try and minimise your stress levels. Regular exercise, eating a healthy diet and relaxation techniques, such as deep breathing or activities such as yoga, can help. You may find it useful to avoid stimulants such as coffee, tea and cola.
If you find it difficult to control feelings of stress, you may require additional treatment such as counselling. Read more about the treatment of stress. The Live Well section of NHS Choices also contains useful advice about stress management.
Medication
Nifedipine
If your symptoms fail to improve then you may be prescribed nifedipine. Nifedipine is a calcium channel blocker. These types of medication encourage the blood vessels to widen, which can help prevent them going into spasm.
Depending on the pattern of your symptoms and how well you respond to treatment you may be asked to take your medication every day. Alternatively, you may only need to take it on a preventative basis; for example, if there was a sudden snap of cold weather.
Side effects are common and include:
- swelling of certain parts of the body, such as your hands and feet, due to a build-up of fluid (the medical term for this is oedema)
- headache
- flushing
- dizziness
If you do experience dizziness, do not drive or use tools or machines.
Do not drink grapefruit juice when taking nifedipine as this could make the side effects much worse.
The side effects of nifedipine should improve as your body gets used to the medicine, but you should tell your GP if you find them particualry troublesome. There are alternative calcium channel blockers that may you suit you better.
Other medications
Other medications have been used in the treatment of Raynaud’s but their use is controversial as there is limited or insufficient evidence to show that they are effective in most people. However, some people have claimed to benefit from treatment. The medications include:
- angiotensin-converting enzyme (ACE) inhibitors
- fluoxetine, which was widely used in the treatment of depression
- sildenafil, which is used to treat erectile dysfunction (inability to get or maintain an erection)
Surgery
Surgery is usually only recommended if your symptoms are so severe that there is a risk the affected body part, such as your fingers, could totally lose their blood supply and begin to die (see Ulcers and Gangrene).
A type of surgery called sympathectomy is recommended. It involves cutting the nerves causing the affected blood vessels to go into spasm.
As well as preventing tissue loss, a sympathectomy should help improve any pain you may feel.
The results of a sympathectomy are often only temporary and further treatment and possibly more surgery may be required after a few years.
