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When Color Hurts |
It
is getting cold outside. Sure, it isn’t frigid everywhere, but it is seasonably
colder this time of the year. Those of us with fibromyalgia who also experience
Raynaud’s symptoms understand we are at a higher risk of an attack. What is the
connection, are there other triggers, and is there anything we can do?
Research tells us symptoms of Raynaud’s phenomenon occur in fibromyalgia patients.
However, there are differences in some observations between the primary
Raynaud’s group (those without a co-occurring disorder that would explain the
phenomenon) and the secondary Raynaud’s group (which in this case includes subjects
with fibromyalgia). I am not sure where
those of us diagnosed with primary Raynaud’s decades before being diagnosed
with fibromyalgia belong on this spectrum, but I am also not sure it
matters. So, let’s look more at what it is and how we can manage the symptoms.
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“When
[Raynaud’s] occurs by itself, it is called Raynaud’s disease, or primary
Raynaud’s phenomenon. When it occurs along with other diseases, such as
scleroderma, rheumatoid arthritis, systemic lupus erythematosus, polymyositis,
dermatomyositis, Sjogren’s syndrome, or mixed connective tissue disease, it is
called secondary Raynaud’s phenomenon.”Cooper and Miller, 2010, pg. 106-107
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Symptoms
A
defining characteristic of Raynaud's is that it mostly affects the fingers, nose
and toes, though it can affect other areas of the body like the ears and nipples.
The symptoms of Raynaud’s most commonly occur when exposed to cold, though it
can also be triggered by anxiety or stress.
During an attack skin color often changes from pale to blue, and turns red during re-warming, though
fibromyalgia patients are more likely to exhibit only pallor. If you have it, you know we also experience extreme numbness during the acute phase. This puts us at a greater risk for
frost bite and reminds us why we should pay close attention. I carry gloves with me year round because so many places keep it cold, particularly grocery stores where we are also handling cold meat and frozen foods.
It
is suspected that the nerves to the blood vessels cause them to spasm. These
vasospasms affect our microcirculation and deprive our small blood vessels
(capillaries) of blood and oxygen, hence pale or blue color changes. As
blood vessels relax during re-warming, redness of the skin occurs. This phase is
frequently associated with extreme incapacitating pain, stinging and/or burning. If you have
Raynaud’s, you know there is no mistaking the symptoms.
*Symptoms
of Raynaud’s should not be confused with feeling cold, which is often
associated with fibromyalgia. Cold intolerance could be due to an upset in our neuro-endocrine system, and could be
attributed to autonomic effects of fibromyalgia or hypothyroidism.
Your
doctor may order a cold stimulation test, a nail fold
capillaroscopy, or vascular ultrasound to make the diagnosis and determine if
Raynaud’s is primary or secondary.
Treatment goals:
·
Re-warm
slowly.
·
Protect
fingers, toes and nose from cold exposure to prevent frostbite and skin ulcers.
·
Avoid
emotional stress.
·
Avoid
alcohol, particularly when you know you will be exposed to cold.
·
Don’t
smoke.
·
Avoid
use of tools that vibrate the hands.
·
Myofascial
trigger point (MTrP) nerve entrapment can worsen symptoms of Raynaud’s, so
check MTrPs associated with the referral patterns to the affected area. Check
out this great
article at NielAsher.com Continuing Professional Education.
·
Vasodilator
type medications may be indicated in severe cases.
·
There
are certain medications to avoid if you have Raynaud’s, so be sure to consult
with your physician or pharmacist.
Report
any unusual symptoms or skin breakdown to your physician immediately.
Additional
Reading:
In healing,
Think adversity?-See opportunity!
~ • ~ • ~ • ~ • ~ • ~
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