Saturday, December 14, 2019

Baby It IS Cold Outside: What You Should Know About Raynaud’s And Fibromyalgia

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.


“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


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.

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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 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,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!

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