Raynaud disease. Raynaud's syndrome: symptoms and treatment

Raynaud's Syndrome - pathological condition, characterized by a sharp spasm of peripheral vessels, trophic disorders and the appearance of pain. Vasospasm leads to paroxysmal disturbance of blood flow in the capillaries and arterioles of the hands and feet. The etiology of the syndrome has not been fully elucidated. It is believed that reversible narrowing of blood vessels occurs due to psycho-emotional overstrain, stress or cold exposure.

The syndrome was first described in 1863 by French neuropathologist Maurice Raynaud. The doctor studied and systematized the signs of this pathology in detail, but initially attributed it to the group of neuroses. He called the cause of the disease excessive excitability. Modern scientists have refuted this assumption. They observed young laundresses who were in regular contact with cold water- one of the main provocateurs of the syndrome. The skin of their hands first turned pale, and then turned blue. These phenomena were accompanied by a violation of sensitivity, tingling, pain in the hands. The conclusion suggested itself: prolonged hypothermia is the cause of vasospasm and dyscirculatory disorders.

Raynaud's syndrome in most cases is a manifestation of systemic diseases - collagenosis, scleroderma, rheumatism, vasculitis, as well as endocrinopathies, psychopathies, hematological and neurological ailments. In extremely rare cases, the syndrome acts as an independent nosology, the causes of which have not been established.

Patients experience paroxysmal vasospasm. Acute violation blood circulation in a limited area of ​​the body is the pathomorphological basis of the syndrome. This phenomenon is caused by a disorder in the functioning of the autonomic nervous system, namely, an increase in the tone of its sympathetic department. The syndrome is most often found in residents of countries with a cold climate. It predominantly affects young and mature women. Symmetry and bilateralism- a mandatory sign of angiotrophoneurosis. Therapeutic measures consist in the use of drugs that dilate blood vessels. In severe cases, surgery is indicated. In the absence of timely and correct treatment, trophic changes in soft tissues occur.

Etiology

The causes of Raynaud's syndrome currently remain unknown. There are several theories and assumptions regarding its etiology. Violation neurohumoral regulation vascular tone, due to the influence of predisposing factors - the main hypothesis of the origin of the syndrome.

Provoking factors include:

• hereditary predisposition,
• Chronic finger injury
• Endocrine dysfunctions - diabetes mellitus, hypo- or hyperthyroidism, pheochromocytoma,
• Hematological disorders - thrombocytosis, cryoglobulinemia, thrombophlebitis,
• Stress, anxiety, outbursts of emotions,
• Systemic and local hypothermia - frequent contact with cold water,
• Degenerative-dystrophic diseases of the spine,
• Damage to diencephalic structures
• psychopathology,
• Alcoholism, drug addiction,
• Poisoning the body with salts of heavy metals,
• Occupational pathology and industrial hazards - vibration disease, interaction with chemicals, local and general hypothermia,
• long and uncontrolled reception vasoconstrictor drugs,
• Autoimmune disorders - rheumatic diseases, SLE, scleroderma.

Spontaneous occurrence of seizures is typical for neglected and complicated forms of pathology. In this case, there is no influence of a provoking factor.

Pathogenesis

Autoimmune processes are characterized by the formation in the body of autoantibodies to its own cells and tissues, which are perceived by it as foreign. Genetic predisposition plays an important role in the development of such changes. It provokes the debut of inflammation, most often an infection. It is viruses and bacteria that are the antigens against which antibodies are produced, which also attack their own structures.

1. With collagenoses, the vascular wall of arterioles and capillaries becomes inflamed, their structure changes, and the work of the endothelium is disrupted. Blood vessels narrow, which leads to dyscirculatory disorders. In parts of the body remote from the heart, blood circulates somewhat worse. This is associated with vasospasm in the distal extremities, on the nose and tongue. The spasmodic area turns pale due to the complete desolation of the capillaries. Prolonged hypoxia leads to disruption of trophism and the appearance of pain. This is how the ischemic stage of the syndrome develops.
2. Since the blood circulation is temporarily suspended, it accumulates in the venules. They overflow with blood, and the affected area turns blue. Blood retention in venules and arteriovenular anastomoses leads to local cyanosis. This is the second cyanotic stage of the disease. A sharp vasospasm is always accompanied by numbness and pain. It is caused by the formation of lactic acid in tissues that are prone to oxygen starvation. Lactic acid is a pain trigger.
3. The third stage is manifested by hyperemia caused by vasodilation, restoration of local blood flow and a sharp rush of blood. With the progression of the pathology, a mesh vascular pattern appears on the skin, blisters with hemorrhagic or serous contents, and areas of necrosis.

Blood rheology also affects systemic blood flow. An increase in blood viscosity and clotting is the cause of thrombosis. Clots are an obstruction to the flow of blood. Blood circulation first slows down, and then completely stops, which is also manifested by pallor, cyanosis and hyperemia. With a lack of blood mediators and hormones responsible for a normal response to stress, a spasm of blood vessels occurs. A pathological reaction to negative endogenous and exogenous factors is also manifested by vasospasm.

The risk group for this pathology includes typists, computer users, pianists, as well as persons suffering from migraine.

Signs and manifestations

Raynaud's syndrome is characterized by a paroxysmal course, staging and specificity of clinical manifestations. The fingers are usually affected. Under the influence of such provocateurs as cold, stress and smoking, paresthesia occurs, the skin turns white, cold and numb. Gradually, these feelings are replaced by burning, pain and bursting. Feet and bones become cyanotic and swollen. When local hyperemia and hyperthermia occur, the attack ends.

In the absence of treatment and as the pathology develops, the attacks become more prolonged. They become more frequent and arise spontaneously. Tissue ischemia during a long course is complicated by the formation trophic ulcers and foci of necrosis, which are difficult to treat. Negative consequences ailments are also: nail dystrophy, curvature of the fingers, gangrenous lesions.

Syndrome stages:

• Angiospastic - pallor of the skin, chilliness, numbness, slight tingling, a feeling of "crawling on the skin", aching pain and loss of sensitivity due to vasospasm, which is quickly replaced by their dilation and hyperemia of the skin;
• Angioparalytic - has a long course with periods of remission and exacerbation, manifested by cyanosis, swelling and pastosity of the skin, severe pain, cold sweat;
• Trophoparalytic - vasodilatation, normalization of blood circulation, reduction of pain; in the absence of appropriate therapy, ulcers, panaritium, and areas of necrosis appear on the skin.

progression of Raynaud's syndrome

The first two stages are not dangerous for the patient. Vascular injury is rare. In patients, the fingers swell, there is difficulty in breathing, the work of the nervous system is disturbed, which is manifested by cephalgia, pulsation and bursting in the temples, pain in the legs, incoordination of movements, hypertension, cardialgia. The third stage is accompanied by necrotic tissue damage and ulceration. This happens in especially severe cases in individuals with a whole bunch of concomitant diseases.

Clinical manifestations pathologies:

1. Pallor of the skin occurs in the first minutes after the provocation. It is caused by a sharp and sudden narrowing of the capillaries, leading to impaired blood circulation. Slowing blood flow is the cause of pale skin color. As the blood supply deteriorates, pallor increases.
2. Pain occurs in the first stage of the syndrome. Disturbed blood supply leads to tissue hypoxia and metabolic disorders in them. At the stage of cyanosis, the pain syndrome increases and reaches a maximum. When the vessels expand and blood circulation is restored, the pain goes away.
3. Numbness occurs with or after pain. Its appearance is also associated with metabolic disorders and hypoxia. Patients feel a slight tingling in the fingers, which disappears after the restoration of blood circulation.
4. Cyanosis replaces the pallor of the skin. Its immediate cause is blood filling and congestion in the veins. When the blood flow in the arteries slows down, the entire burden is transferred to the veins. Their overflow with blood persists throughout the entire period of spasm. Stagnation of blood in dilated veins makes the skin bluish and pasty.
5. Hyperemia is a sign of the final stage of the disease. Redness of the skin is associated with the expansion of spasmodic arteries and blood flow to them.

stages of an attack of Raynaud's syndrome

Prolonged attacks are accompanied by the appearance on the skin not only dystrophic changes, but also blisters with serous-hemorrhagic filling. They open up, exposing dead tissue. In their place, long-term non-healing ulcers and rough scars are formed. Ulcers are the entry gates of infection leading to the onset of gangrene. The severe course of the pathology leads to osteolysis and gross deformity of the fingers.

In children, Raynaud's syndrome first manifests itself clinically at 11-12 years of age. Its symptoms are practically no different from those in adults. But in addition to changes in skin color and temperature, experts pay attention to dystrophic signs of the disease - the appearance of sores, deformation of the nail plates, reddening of the face, arthralgia, generalized edema, signs of asthenia, cracks in the corners of the mouth. Most of these manifestations are indirect signs of autoimmune disorders.

Raynaud's syndrome without treatment steadily progresses and often ends with the death of the affected limbs and the patient's disability. There are cases when the syndrome stopped on its own in the first stage.

Diagnostic measures

Diagnosis of pathology does not cause any particular difficulties for specialists, since the symptoms of the syndrome are very specific. To find out its cause, it is necessary to send the patient for a comprehensive comprehensive examination. Doctors talk with the patient, examine him, find out complaints, collect an anamnesis of life and illness. Importance in diagnosing and prescribing treatment, they have the results of additional methods - laboratory and instrumental.

A cold test allows you to assess the state of blood flow. The patient's skin is exposed to cold temperatures, causing vasospasm, and then the hands are warmed. At healthy people the spasm passes quickly - the skin becomes pink without signs of cyanosis. In individuals with Raynaud's syndrome, this process takes longer. There may be areas of bluing.

Laboratory diagnostics:

• Hemogram - increase in ESR, erythrocytopenia, leukopenia, thrombocytopenia.
• A blood test for biochemical markers - dysproteinemia, an increase in certain enzymes: creatine phosphokinase, LDH, ALT, AST, aldolase.
• Coagulogram - an increase in blood viscosity and platelet clotting ability, a decrease in clotting time.
• Urinalysis - proteinuria, hematuria, cylindruria, myoglobinuria.
• Immunogram - an increase in Ig M, G, E, many immune complexes, the presence of rheumatoid factor and specific antibodies to various diseases.

Angiography, capillaroscopy, vascular contrast radiography, ultrasound and tomography of the spine and internal organs, as well as dopplerography of blood vessels - additional methods, allowing to identify the cause of the syndrome and differentiate it from other diseases with similar symptoms.

After receiving all the results of the study, the doctor prescribes proper treatment, aimed at eliminating directly the Raynaud phenomenon or the underlying disease manifested by this syndrome.

Medical process

Relieve the condition during an attack before the onset medical procedures immediate action will help. The affected limb must be warmed by holding it in warm water or massaging it with a woolen cloth. It is good to drink a cup of hot tea. Vigorous swings of the arms raised above the head contribute to the rush of blood to the hands.

Patients with Raynaud's syndrome should receive medicines for life. They are prescribed the following medications:

1. Vasodilator drugs - Nifedipine, Diltiazem, Verapamil, Kapoten, Lisinopril;
2. Antiplatelet agents - "Pentoxifylline", "Trental", "Vazonite";
3. Antispasmodics - "Drotaverin", "Platifillin";
4. NSAIDs - "Indomethacin", "Diclofenac", "Butadion";
5. Glucocorticosteroids - "Prednisolone", "Dexamethasone";
6. Cytostatics - "Methotrexate".

Surgical treatment is carried out in the absence of the effect of conservative therapy. Sympathectomy or ganglionectomy are operations that are indicated for all patients with a progressive form of the disease. In order to prevent a new spasm of the blood vessels, during the surgical intervention, the nerve fibers that carry pathological impulses are “turned off”. Currently, sympathectomy is performed endoscopically. The syndrome may recur 2-3 weeks after surgery.

Non-pharmacological methods used to treat Raynaud's syndrome:

• psychotherapy,
• acupuncture,
• electrophoresis,
• magnetotherapy,
• oxygen therapy,
• massage,
• hydrotherapy,
• paraffin applications,
• ozokerite,
• mud treatment,
• extracorporeal hemocorrection.

The disease can be treated with traditional medicine. For this use:

1. contrast coniferous and turpentine baths,
2. heat compresses from pumpkin or aloe juice,
3. adaptogens,
4. decoction with wild strawberries, celery and parsley juice, rosehip infusion, lemon and garlic remedy, onion mixture, coniferous decoction, knotweed tincture.

Diet is of great importance in the treatment of patients. It consists in the exclusion from the diet of fatty foods, smoked meats, sauces, sausages. You should eat foods high in ascorbic acid, rutin, and fiber.

The treatment process is laborious and long. It requires a lot of patience and discipline from the patient and doctor. To stop the steady progression of pathology, it is necessary to eliminate all existing etiopathogenetic factors.

Forecasting and preventive measures

Raynaud's syndrome is a pathology with a relatively favorable prognosis. If the underlying disease does not progress, and there are no provoking factors, the syndrome responds well to therapy. In some cases, it is enough to change the place of residence, climatic conditions, profession, and ischemic attacks will cease to occur.

Preventive measures to avoid Raynaud's syndrome:

• Permanent protection of the hands and feet from the cold with mittens, gloves, warm socks,
• Fighting bad habits especially with smoking
• Treatment of concomitant diseases,
• Protection of the body from hypothermia, exposure to harmful physical and chemical factors,
• Stress prevention, positive mood,
• Hardening hands with contrast baths,
• proper nutrition,
• Doing healthy lifestyle life,
• Wearing clothes according to the season and shoes according to size,
• Lubrication before bedtime of hands and feet with a nourishing cream,
• Using mild soap
• Hand protection with household gloves when using aggressive cleaners and disinfectants.

It happens that the banal vasoconstriction becomes the cause of disability. This, it would seem at first glance, not the most dangerous disease often leads to serious consequences. Gangrene and limb amputation are the outcome of the syndrome, which can occur in patients who do not seek medical help on time.

Video: doctors about Raynaud's syndrome

Raynaud's syndrome- This is a complex of symptoms that develop as a result of a sharp narrowing of blood vessels under the influence of stress or cold. Most often, it affects the vessels of the fingers, toes, and chin. This syndrome is most often a manifestation of various connective tissue diseases, but it can also be an independent disease.

Raynaud's syndrome occurs in 3 - 5 percent of the population, more often recorded in cold regions. Among patients with this disease, there are five times more women than men. According to some sources, the disease develops only in 27 percent of cases at the age of over 40 years, the rest of the diagnoses occur at the age of 15 to 25 years. In 85 percent of cases, Raynaud's syndrome is a symptom of a disease, and only 15 percent is an independent disease.

Interesting Facts
Raynaud's syndrome is named after the French neurologist and therapist Maurice Raynaud. A 26-year-old girl came to the doctor with complaints of severe numbness of her upper extremities. After conducting a survey, Maurice Reynaud came to the conclusion that this deviation is a separate disease. Subsequently, based on five cases from practice, the doctor described in detail and systematized the signs of this pathology.

Raynaud's Syndrome suffered famous oceanographer, underwater photographer and scuba diving pioneer Hans Heinrich Romulus Hass. Due to illness, Hans Hass was declared unfit for military service in the Austrian army. Pathology did not prevent the scientist from making more than seventy films about the life of marine inhabitants, which today are the property of mankind.

Causes of Raynaud's Syndrome

Causes of Raynaud's syndrome:

• connective tissue diseases - scleroderma, rheumatoid arthritis, systemic lupus erythematosus;
• vascular disease- vasculitis;
• blood diseases and circulatory pathologies;
• endocrine pathologies;
• professional pathologies.

Connective tissue diseases

Under the influence of provoking factors ( cold, stress) the vessels narrow sharply, and blood circulation is disturbed. Worst of all, blood circulates in distant ( distal) parts of the body such as fingers and toes, chin, tip of the nose. This explains the manifestation of the symptoms of Raynaud's syndrome in these areas of the body.

With a sharp narrowing of small vessels, the skin in this area begins to turn pale due to a lack of blood supply. In the absence of blood in the tissues, trophic disorders are noted, which are accompanied by pain. Since the blood does not circulate, it accumulates in the veins. Full-blooded veins subsequently give a bluish color to the skin.

Vascular disease - vasculitis

Vasculitis associated with Raynaud's syndrome:

• nodular periarteritis;
• Wegener's disease;
• cryoglobulinemic vasculitis;
• medication-associated vasculitis.

Circulatory pathologies

Blood clots can form in various situations - under the influence of cold, nicotine, emotions. A short-term cessation of blood circulation in the vessels is manifested by a sharp pallor, which is replaced by cyanosis and redness.

Blood diseases and circulatory pathologies accompanied by Raynaud's syndrome:

• thrombocytosis of various etiologies;
• cryoglobulinemia;

Other blood diseases in Raynaud's syndrome follow a similar scenario, only blood clots are formed under the influence of other factors. The formation of microthrombi may be associated with inflammation of the walls of the veins ( with thrombophlebitis) or taking certain medications ( e.g. hormonal drugs).

Endocrine pathologies

The hormone has a similar effect. thyroid gland- triiodothyronine. It not only has a vasospastic effect, but also increases the sensitivity of blood vessels to adrenaline and norepinephrine. Therefore, with its increased production, people may experience Raynaud's syndrome.

Occupational pathologies

Under the influence of prolonged vibration, or rather, mechanical waves, irreversible destruction occurs, which underlie the development of Raynaud's syndrome. These destructions affect vessels, nerve endings, bodies of Vater-Pacini and other structures that are located on upper limbs. Destructive phenomena in these structures are the cause of the development of Raynaud's syndrome.

In addition to the immediate causes of Raynaud's syndrome, there are many more factors under the influence of which its symptoms develop.

Factors that provoke the development of Raynaud's syndrome:

• stress;
• emotional stress;
• taking medications that have a vasoconstrictive effect.

In addition to environmental factors, the symptoms of the syndrome may appear due to excitement, emotional stress, stress. Since Raynaud's syndrome itself is characterized by episodic ( microcirculation disturbances are fixed only for a short period), then the factors provoking it differ in short duration. This means that only a little excitement or stress is enough to cause it to occur.

Taking medication

Raynaud's syndrome symptoms

Raynaud's syndrome phases:

• first phase ( vasoconstrictor) - manifested by pallor of the skin, lasts 10 - 15 minutes;
• second phase ( cyanotic) - pallor is replaced by a bluish coloration of the skin, which lasts a couple of minutes;
• third phase ( reactive hyperemia) - manifested by reddening of the skin.

Symptom	Manifestation	A photo
Paleness of the skin of the hands	This symptom develops first within 5 to 10 minutes after the provoking factor ( going out into the cold, emotions). Paleness develops due to a sharp spasm of blood vessels. As a result, blood circulation is disturbed in them. Slow blood flow in the narrowed arteries of the hand and gives the skin such a pale color. The worse the blood circulation in the vessels, the paler the hands.
Pain	Pain syndrome accompanies the first phase of Raynaud's syndrome. Due to poor blood supply, the tissues are less supplied with oxygen, as a result of which the metabolism in them is disturbed. However, pain can also be observed in the reddening phase.
Numbness	The feeling of numbness may develop after the pain syndrome, before or instead of it. The development of this sensation, as well as the pain syndrome, is associated with impaired metabolism in the tissues due to the lack of oxygen. Numbness is accompanied by a tingling sensation in the fingers, which is also due to impaired blood supply. Numbness with a sensation of tingling disappears after the restoration of blood circulation.
Blueness of the skin	The bluish color comes to replace the pale color. It is due to blood filling and congestion in the veins. Due to a sharp spasm, the movement of blood in the arteries stops, but at the same time, the veins take on the entire load. They fill with blood, and as long as the arteries are spasmodic, it stagnates in them. This venous congestion gives the skin a bluish discoloration ( because the veins have a bluish tint).
Redness	Redness is the third phase of Raynaud's syndrome, which follows the cyanosis of the skin. It is due to the expansion of previously narrowed arteries and blood flow to the vessels of the skin. As a result of this, the hands, after pallor and cyanosis, acquire a red tint.

Skin color symptoms develop gradually. First, pallor appears, the severity of which depends on the degree of vascular spasm. Most often, this phase is accompanied by a sensation of pain. The pain syndrome is present in all phases, but is most pronounced in the first, when the fingers are pale.

The second phase is more characterized by the appearance of so-called paresthesias ( numbness, crawling sensations, tingling), which develop as a result of venous congestion.

These symptoms are core to Raynaud's, but not to the underlying disease. Therefore, they are also accompanied by the symptoms of the disease against which Raynaud's syndrome developed. Most often, these are rheumatic diseases, which are characterized by symptoms of joint damage and general symptoms of inflammation. Autoimmune diseases are characterized skin changes, as well as changes in the internal organs.

Diagnosis of Raynaud's syndrome

Laboratory methods used in the diagnosis of Raynaud's syndrome:

• coagulogram ( blood coagulation parameters);
• immunological tests ( immunity research);

General blood analysis

Anemia syndrome
Anemia reflects a decrease in red blood cells less than 3.5 x 10 12 and hemoglobin less than 120 grams per liter. More often found hemolytic anemia, which appears due to the massive destruction of red blood cells in the vessels. With such anemia, in addition to a decrease in red blood cells and hemoglobin, there is an increase in the number of reticulocytes - more than 2 percent.

Leukopenic and thrombocytopenic syndrome
With systemic lupus erythematosus, scleroderma and phospholipid syndrome, leukopenia is noted ( decrease in the number of leukocytes less than 4x 10 9 /liter) and thrombocytopenia ( decrease in platelets less than 180x 10 9 /liter). These laboratory syndromes may not always occur and are noted only during exacerbation.

Blood chemistry

The list of enzymes, the level of which may increase with Raynaud's syndrome:

• creatine phosphokinase ( KF);
• lactate dehydrogenase ( LDH);
• alanine aminotransferase ( ALT);
• aspartate aminotransferase ( AST);
• aldolase.

Coagulogram

General urine analysis

Immunological tests

Mandatory immunological parameters:

• blood immunoglobulins;
• rheumatoid factor;
• immune complexes circulating in the blood;
• specific and nonspecific antibodies.

Rheumatoid factor and immune complexes
Immunological analysis detects rheumatoid factor in the blood, the level of which may vary depending on the duration and stage of the disease. It appears in almost all autoimmune diseases and connective tissue diseases. It is worth remembering that its absence does not exclude the presence rheumatic diseases.
The autoimmune component of the disease leads to the appearance in the blood a large number immune complexes, which are a complex of some antigen ( virus, bacterium) and antibodies, which were synthesized by the body in response to the penetration of the antigen.

Specific and non-specific antibodies
Most often, people suffering from Raynaud's syndrome are examined for the presence of antinuclear and anticentromere antibodies.
The detection of antinuclear antibodies in the blood indicates a rheumatic cause of Raynaud's syndrome. With the help of immunofluorescent analysis, specific antibodies to various diseases can also be determined.
Systemic scleroderma is characterized by the appearance of specific anticentromeric antibodies. Antibodies to the Scl-70 antigen have high specificity. 30 percent of people with scleroderma have antibodies to this antigen.

Myospecific antibodies ( more often - antisynthetase) appear with myositis and dermatomyositis. Immunological markers of systemic lupus erythematosus are antibodies to DNA and to phospholipids.

Treatment of Raynaud's syndrome with medicines

Vasodilator drugs, as well as drugs that improve blood circulation

Many people recommend calcium channel inhibitors as vasodilators ( nifedipine, diltiazem), which are prescribed together with agents that improve the rheological properties of blood ( trental, vazaprostan).

Anti-inflammatory drugs used in the treatment of Raynaud's syndrome

In the acute period of connective tissue pathologies, steroid drugs are prescribed ( dexamethasone) and cytostatics ( methotrexate). The treatment regimen with these drugs is determined individually by the attending physician based on the underlying disease.

Alternative methods of treatment of Raynaud's syndrome

• contrast baths;
• compresses;
• rubbing;
• ointments;
• vasodilators;
• anti-inflammatory agents.

Contrast baths

Coniferous bath
Pour two hundred grams of chopped needles with two liters ( 8 glasses) boiling water and keep on low heat for five to ten minutes, avoiding boiling. Next, the needles should be left for half an hour to infuse. Strain the remedy and add 5 tablespoons of coarse table salt to it. Divide into two parts and pour the decoction into containers for contrast baths.

Combined contrast baths
For a bath with cold water, you need a decoction of oak bark. Pour 20 grams ( 2 tablespoons) bark with a liter of boiling water and soak on low heat for ten minutes. After 20 - 30 minutes, add the infused oak broth to a bowl of cold water.
For a hot bath, prepare a decoction of calamus and stinging nettle. Pour 15 grams of calamus ( rhizome) and 3 grams ( one tablespoon) nettle herbs with one liter of boiling water. Prepare the remedy in the same way as a decoction of oak bark.

Compresses

Pumpkin compress
For the procedure, you will need pumpkin porridge and a scarf or scarf made of natural wool. Apply the porridge to the limbs that are bothering you. Fix the composition on top with cling film and wrap with a woolen cloth. The duration of the procedure is two to three hours. To cook porridge, take one slice of pumpkin ( 400 - 500 grams) and bake it in the oven. Peel the finished pumpkin, cut into small pieces and add half a glass ( 125 milliliters) whisk boiling water with a blender.

Aloe juice compress
Cut two or three bottom leaves of a three-year-old aloe plant and chop them. Squeeze out the gruel and soak gauze bandages with aloe juice. Apply dressings to the affected areas of the body and leave for several hours. A pre-made massage of the limbs will help to increase the effectiveness of the procedure.

Onion compress
Onion compress ingredients:

• onion - 75 grams ( 1 medium onion);
• honey - 1 teaspoon;
• kefir - 2 tablespoons.

Rubbing agents

Tincture on red pepper and pickles
Tincture Components :

• pickled cucumbers - 300 grams, which is approximately equal to three cucumbers;
• hot red pepper - 75 grams ( three pods);
• vodka 40 percent - 500 milliliters.

Oil for rubbing
Rub Oil Ingredients:

• peppermint - 6 grams ( one tablespoon);
• motherwort - 4 grams ( one tablespoon);
• yarrow ( grass) – 5 grams ( one tablespoon);
• dill seeds - 5 grams ( one tablespoon);
• anise seed - 15 grams ( one tablespoon);
• vegetable oil - 250 milliliters ( one glass).

Pour the raw material with heated oil and leave to infuse for a week. Then strain and use for massage.

Ointments

Wormwood ointment
Heat in a water bath 100 grams badger fat. Add 30 grams ( 10 tablespoons) dry wormwood and place the container ( glass or ceramic) in the oven for 6 hours. Strain the fat and pour it into a container suitable for storage in the refrigerator. Ointment can be prepared on the basis of lard ( melted pork fat ), and replace the wormwood with celandine or calendula.

Medications with vasodilating action
The use of mixtures and infusions with a vasodilating effect helps to reduce the frequency and intensity of spasms.

Decoction with wild strawberries
To prepare a decoction, you should take two tablespoons of chopped fresh wild strawberry leaves and steam them with two glasses ( 500 milliliters) boiling water. After the composition has been infused for an hour, it must be filtered and cooled. The drink should be divided into two parts and drunk, the first part in the morning, the second part in the evening before going to bed.
Mixture of celery and parsley
Celery and parsley have powerful anti-inflammatory effects, which is why they are recommended for Raynaud's syndrome along with other folk remedies.

Ingredients for the mixture:

• parsley - 1 kilogram;
• celery stalks and greens - 1 kilogram;
• lemon - 2 pieces ( 250 grams);
• natural honey - 250 grams.

Rosehip infusion
Rosehip Infusion Ingredients:

• rosehip - 15 grams;
• St. John's wort - 5 grams;
• white birch leaves - one tablespoon ( 2.5 grams).

Lemon and Garlic Remedy
The systematic use of this remedy restores the elasticity of the arteries and prevents the occurrence of spasms.

Components of the folk mixture:

• lemons - 5 medium lemons;
• garlic - 5 heads;
• natural honey - 500 milliliters.

Decoction with golden mustache juice
Pour 10 grams of thyme with cold water and heat to 80 degrees. Remove from heat and leave to infuse for an hour. After that, strain the thyme decoction and add 10 drops of golden mustache juice. It is necessary to take the remedy for two weeks at 100 milliliters per day.

Infusion based on common harmala
Harmala-based infusion expands peripheral vessels. To prepare it, steam 3 grams of the plant with a glass of boiling water and leave to infuse. Strained infusion drink one tablespoon several times a day.

onion mix
To prepare an onion-based remedy for the treatment of Raynaud's syndrome, fresh onion juice and natural honey should be mixed in equal parts. It is necessary to prepare the mixture daily, as healing substances quickly disappear from onion juice. Take honey-onion mixture should be one tablespoon an hour before meals three times a day. After three weeks, you should pause for a month.

Anti-inflammatory drugs

Coniferous decoction
Coniferous decoction components:

• pine needles - 3 tablespoons;
• rosehip berries - 40 grams ( two and a half tablespoons);
• onion peel- 3 tablespoons;
• natural honey - 5 tablespoons.

Infusion of knotweed, medicinal lungwort and horsetail
Mix dry chopped ingredients, pour 3 cups of water and heat in a water bath, avoiding boiling. Leave the broth to brew for half an hour, then filter and pour into a dish that is convenient for storage in the refrigerator. The decoction is taken one third of a glass three times a day.

Infusion Ingredients:

• horsetail - 3 tablespoons;
• medicinal lungwort - 3 tablespoons;
• knotweed - 3 tablespoons.

Raynaud's syndrome It is customary to call a disorder that causes a strong narrowing of the blood vessels of the skin, which occurs in humans as a result of a strong or exposure to cold.

This disease is named after Maurice Raynaud who described the disease in 1862. This disorder has a paroxysmal, vasospastic character. It is classified as a systemic disease of the connective tissue. This disease, according to various sources, affects from 3 to 5% of the population. At the same time, women are more susceptible to attacks of this syndrome. As a rule, Raynaud's syndrome manifests itself in a person at a later age, after 35 years. At the same time, Raynaud's disease can occur in people as early as fifteen years of age.

is a manifestation of the so-called Raynaud phenomenon . In medicine, this phenomenon is usually divided into two types. Raynaud's disease defined as the primary Raynaud phenomenon. Its feature is the course regardless of other diseases. Among the total number of cases given state Raynaud's disease accounts for approximately 90% of cases.

Raynaud's syndrome is defined as a secondary Raynaud's phenomenon, since basically this pathology manifests itself as part of another ailment.

Causes of Raynaud's Syndrome

The causes that provoke the manifestation of Raynaud's syndrome in a person are often the most various diseases. There is evidence that Raynaud's syndrome can manifest itself in people with 70 diseases.

This condition is typical for patients with some rheumatic ailments : , scleroderma , , nodular periarthritis and others. Raynaud's syndrome also manifests itself in vascular diseases : obliterating , post-thrombotic or thrombotic syndrome . Accompanies this syndrome and some blood diseases : paroxysmal hemoglobinuria , cryoglobulinemia , thrombocytosis , multiple myeloma .

There is also the concept occupational Raynaud's syndrome , which can develop due to vibration, strong and regular hypothermia, as well as work with polyvinyl chloride. emergence neurogenic Raynaud's syndrome associated, as a rule, with compression of the neurovascular bundle with the development of algodystrophy, carpal tunnel syndrome. So-called drug Raynaud's syndrome occurs as a reaction to taking certain drugs - ergotamine , , beta blockers , drugs with antitumor effects, etc. After the drug is canceled, such manifestations mostly disappear.

A number of other diseases have also been noted that can cause Raynaud's syndrome in humans.

Raynaud's syndrome symptoms

Raynaud's syndrome manifests itself in the form of seizures, in which there is a spasm of the vessels of the skin. Most often, this syndrome manifests itself on the toes and hands, in more rare cases - on the earlobes, nose, lips, tongue. Very often, people who suffer from this disease do not realize that they are experiencing the symptoms of Raynaud's syndrome, believing that such a reaction is only a reaction of the body to exposure to cold. During the attack, the color of the skin gradually changes: initially it becomes white, later it turns blue, and after the attack, its redness is observed. At the first stage of the attack, pronounced pallor of the skin occurs as a result of a sharp outflow of blood. In the second stage, blue skin occurs as a reaction to a lack of oxygen. At the third stage, blood circulation is restored and intense reddening of the skin half of the blood occurs. Sometimes a person may not have all stages during an attack.

Symmetry is always observed on both limbs. The duration of such an attack, as a rule, is about 20 minutes. However, sometimes Raynaud's syndrome is observed in a patient for several hours. When a person has an attack of Raynaud's syndrome, his skin is always cold, in addition, sometimes there is a sharp numbness, loss of sensitivity of varying degrees, tingling in the limbs affected by the attack.

Basically, with an attack of Raynaud's syndrome, pain occurs after the attack has ended. In addition, the patient also feels bursting, skin hyperthermia is observed. Over time, the patient shows trophic changes: skin turgor decreases, fingertips retract or flatten, ulcers appear that heal for a long time.

This disease often progresses over a long period of time. Initially, the symptoms described appear only on the tips of a few fingers, but later they already appear on all fingers, as a rule, not affecting only the thumb.

In the process of such an attack, both on the legs and on the hands, a pattern similar to marble, which is called livedo mesh .

In addition to the described signs of the disease, the symptoms of Raynaud's syndrome are manifested by numbness, cooling of the skin, possibly a manifestation of pain. Between attacks, a person's hands often remain cyanotic, the skin on them is cold.

Diagnosis of Raynaud's syndrome

There are general and special methods for diagnosing Raynaud's syndrome. At the same time, Raynaud's disease is diagnosed under the condition that all diseases in which this syndrome can manifest itself are excluded. The exclusion of diseases should be confirmed by further observations. In the course of the study, patients undergo capillaroscopy in order to detect and clarify the type of damage to the skin vessels. In addition, during the diagnostic process, it is prescribed to carry out laboratory analysis blood.

Conducting allows you to find out the necessary data about the properties of blood. In addition, in some cases, for the diagnosis of Raynaud's syndrome, it is advisable to conduct an immunological and radiological study. Sometimes a study of digital blood flow is also performed using Doppler ultrasound, angiography and other methods.

There are also a number of clear medical criteria on the basis of which the diagnosis is made. This is the presence of vascular spasm, which occurs due to exposure to stress or cold; symmetry of the localization of the manifestations of vascular attacks: the presence of normal pulsation of the arteries that are palpable; periodic manifestations of vascular attacks for two or more years.

Raynaud's syndrome treatment

Effective treatment of Raynaud's syndrome depends on how much it is possible to eliminate those factors that provoke the manifestation of this syndrome, as well as to provide an impact on the mechanisms that provoke disturbances in the functioning of the vessels.

The attending physician will definitely advise the patient, first of all, to prevent hypothermia of the body, quit smoking, not contact with a variety of chemicals, and also prevent other factors that provoke the manifestation of vasospasm. In some cases, it is enough to radically change some working conditions or move to an area where the climate is warmer, and Raynaud's syndrome disappears on its own.

In other cases, the treatment of Raynaud's syndrome involves the use drug therapy in the form of taking drugs that have a vasodilating effect. In this case, calcium antagonists have an effective effect. Most often, patients are prescribed , . In addition, other calcium entry blockers are also used in the course of therapy: , , nicardipine .

If the patient has progressive Raynaud's syndrome, then treatment is advisable. This drug is administered by drip intravenously, the course is from 10 to 20 infusions. Already after the third infusion, the drug begins to affect the patient's condition, but its maximum effectiveness is noticeable after completing the full course of treatment with the drug. The frequency of attacks, their intensity and duration is markedly reduced. The effect of the drug persists, as a rule, for 4 to 6 months, so it is advisable to repeat the course of taking it twice a year.

Also in progress complex therapy this disease angiotensin-converting enzyme inhibitors are used, namely the drug. Taking this drug is prescribed for a long period - from six months to a year. The doses in which the patient takes the drug are determined individually by the attending physician. Also used in the treatment of Raynaud's syndrome ketanserin , which is mainly prescribed for elderly patients.

Except these drugs in the treatment of Raynaud's syndrome, drugs are used that improve general properties blood, reducing its viscosity. it , and other drugs.

The approach to the treatment of this disease must be necessarily complex. Each patient needs to realize that the treatment of Raynaud's syndrome can last several years, and at the same time it is necessary to use medicines belonging to different groups.

In the process of complex therapy, local treatment is also used by applying a 50-70% solution to areas that are affected by the disease during attacks. Such applications are effective as an adjunct to treatment with drugs with vascular and anti-inflammatory effects.

The attending physician necessarily pays attention to whether there are in the course of treatment side effects: swelling, nausea, headaches, allergies. In the presence of such phenomena, the dose of the drug is reduced, or it is canceled completely.

In addition, other methods of therapy are successfully used in the treatment of Raynaud's syndrome - physiotherapy, psychotherapy, thermal procedures, electrophoresis, , reflexology. Also at this disease massage is shown.

Very rarely, with this disease, it is advisable to use surgical treatment, which involves the removal of the nerve located next to the diseased arteries.

In most cases, Raynaud's syndrome is not dangerous. Many patients do not worry because of the not too intense manifestations of this disease. However, you should be aware that in the most difficult cases, the progression of Raynaud's syndrome leads to the development and subsequent amputation of the affected limb.

The doctors

Medications

Prevention of Raynaud's syndrome

There are currently no developed methods primary prevention Raynaud's syndrome. As methods of secondary prevention, it is important to prevent the impact on the human body of factors that provoke the development of vasospasm. In addition, as a secondary prevention, it is used drug treatment Raynaud's syndrome, aimed at achieving remission of the underlying disease.

People who are prone to attacks of Raynaud's syndrome should wear warm mittens and socks, waterproof boots, drink hot tea and other drinks during the cold season. It is also advisable not to abuse caffeinated drinks, which, like nicotine, provoke vasoconstriction.

List of sources

• Sigidin Ya.A., Guseva N.G., Ivanova M.M. Diffuse connective tissue diseases. - M.: Medicine, 1994;
• V.A. Nasonova, N.V. Bunchuk. Rheumatic diseases. - M.: Medicine, 1997;
• Rheumatology: A national guide. Ed. E.L. Nasonova, V.A. Nasonova. M., 2008;
• Guseva N.G. Systemic scleroderma and pseudoscleroderma syndromes. - M.: Medicine, 1993.

Raynaud's syndrome is a phenomenon in which a reversible spasm of the blood vessels of the fingers and toes periodically manifests itself, as a reaction to stress or cold. There are other provoking factors - systemic diseases. In this case, it is customary to talk about Raynaud's disease.

This pathology is named after Maurice Raynaud, who gave its description while still a medical student. He described it as follows: a case of episodic symmetrical spasm of the blood vessels of the hands, accompanied by soreness and blanching skin.

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  The reasons

  Allocate primary and secondary syndrome:

  1. 1. Primary Raynaud's syndrome. In this case, the cause of the pathology is unknown. The spasm develops independently, has a periodic nature and affects only the vessels in the fingers. The syndrome usually proceeds mildly, with due attention, the patient does not need to resort to medical treatment.
  2. 2. Secondary Raynaud's syndrome. Manifested against the background of another disease. Usually occurs when connective tissue is damaged in autoimmune processes. But some drugs or pathologies (vibration disease, intoxication, etc.) can act as the cause. Unlike the primary syndrome, in this case, in the later stages, irreversible changes in the limbs can occur with the formation of ulcers or tissue death.

  To date, the exact cause of the pathology has not been established. But scientists put forward several theories about the mechanism of development of this disease. This does not exclude the possibility of other causes of Raynaud's syndrome.

  Main proposed mechanisms:

  1. 1. Vascular disorders. With a lack of biological active substances necessary for a normal physiological response to stressful situations, spasm or insufficient relaxation of blood vessels may occur.
  2. 2. Intravascular pathologies. When the surface or structure of the vessel changes in combination with the impaired function of the endothelial cells that form its wall, circulatory disorders may occur, exacerbated by arterial spasm.
  3. 3. Neurological disorders. In neurology, it is assumed that with Raynaud's syndrome and disease, there is a violation of the nervous regulation of the motor activity of the vessels, as a result of which an inadequate reaction to certain factors of the internal or external environment is observed.

  Raynaud's syndrome and disease manifest themselves in most cases against the background of certain provoking factors that have a varying degree of influence on the condition of the vessels of the extremities and blood circulation:

  • exposure to cold water;
  • hypothermia;
  • vibration;
  • psycho-emotional stress;
  • taking vasoconstrictor drugs;
  • contact with heavy metals and PVC;
  • smoking.

  In the later stages of Raynaud's syndrome, vasospasms can occur spontaneously, even in the absence of any provoking factor.

  Raynaud's disease is most often observed in the following systemic diseases:

  • systemic lupus erythematosus;
  • vibration disease;
  • vascular disease;
  • cryoglobulinemia;
  • scleroderma;
  • intoxication with polyvinyl chloride.

  Raynaud's phenomenon in itself is not dangerous, therefore, with proper treatment, the prognosis for patients is favorable. But in some cases, with prolonged vasospasm or a combination with another disease, Raynaud's syndrome can lead to a complete cessation of blood circulation in the fingers or even a limb, followed by tissue death. This is most often observed in stage 3 of the disease.

  

  Symptoms

  With Raynaud's syndrome, characteristic lesions predominantly of the fingers appear. Moreover, more often blood circulation is disturbed in the index, middle and ring fingers, and less often in the little finger and thumb. In rare cases, other exposed areas of the body (chin, toes, tips of the nose and ears) are affected, despite the fact that they are also regularly exposed to cold and other precipitating factors. Clinical signs men and women do not differ.

  The severity of symptoms is determined by the stage of pathology.

  

  First stage

  The first stage is called angiospastic, because it is characterized by spasm, that is, narrowing of blood vessels. At this stage, the symptoms of the disease are of a short duration.

  The first manifestation of the disease is a change in the color of the skin. This symptom first occurs due to a violation of the nervous and hormonal regulation of vascular tone. With a sharp spasm of arterioles (small blood vessels), their blood supply decreases. Because of this, the fingers become pale.

  
  

  A characteristic feature of Raynaud's disease is a clear boundary between the affected and healthy tissue. At the first stage, the spasm lasts from 2 to 4 minutes, after which there is a compensatory expansion of the vessels, as a result of which they are filled with blood and the skin acquires its usual color.

  At this stage in the development of Raynaud's disease, edema may appear in the joints, which are caused by increased permeability of blood vessels and sweating of the liquid component of blood plasma into the surrounding tissues.

  Since a constant local temperature is maintained due to the microcirculation of blood, which heats up when passing through the internal organs, a decrease in temperature is observed in the affected areas. With spasm of blood vessels, the temperature difference can be from 2 to 4 degrees or more.

  If blood circulation in the fingers is disturbed, the delivery of nutrients to the fingers stops. nerve fibers which are extremely sensitive to oxygen starvation. With hypoxia of the fingertips, the patient feels a slight tingling or “goosebumps”. After a few minutes, the sensitivity is significantly weakened until it disappears completely.

  Spasm of the vessels of the fingertips leads to the occurrence of pain. During normal functioning, the cells of the body constantly secrete lactic acid and other by-products of their vital activity, which depart along with the blood stream. With spasm of arterioles, these substances accumulate where they are formed, as a result of which pain sensations of a stabbing, burning or aching character appear. After normalization of blood circulation, a large concentration of toxic substances is carried with the blood flow to nearby tissues, therefore, a short-term increase in pain during the period of reflex vasodilation is possible.

  

  Second stage

  The development of the second stage begins about six months after the onset of the first symptoms of Raynaud's disease. It is characterized by a greater severity of violations of the mechanisms of regulation of vascular tone. Therefore, there is a decrease in the frequency, but an increase in the duration of seizures that can occur under the influence of the factors described above or spontaneously.

  
  

  In the second stage of the disease, spasm of the vessels of the fingertips leads to the formation of severe cyanosis. Under normal conditions, the oxygen contained in red blood cells is transferred to the cells of various tissues and carbon dioxide is released in return. arterial blood, rich in oxygen, has a red color, and venous, saturated with carbon dioxide, has a characteristic bluish tint. This explains the cyanosis of the fingers with impaired blood circulation. The released carbon dioxide does not have time to be carried away with the venous blood flow to the lungs.

  In the second stage of Raynaud's disease, a pathological expansion of the venous vessels is noted, as a result of which the manifestations of the pathology are further enhanced. The pain is longer and more intense than in the first stage of the disease.

  Third stage

  The third stage appears 1-3 years after the development of the disease. It is characterized by necrosis of the tissues of the fingers, associated with circulatory disorders. With insufficient supply of tissues with oxygen, the cells die and eventually are rejected, forming ulcers in their places that can reach several mm in depth.

  Their bleeding is noted in rare cases, while they are painless. Ulcers heal for a long time (from several days to weeks), form dense scars.

  
  

  If there is a violation of local blood circulation, the risk of developing infectious diseases as the local immune defense weakens. This is facilitated by local ischemia and necrosis.

  The disease is able to stop on its own even at the first stage after several attacks. If this does not happen, then it proceeds for a very long time, and pain attacks that increase in frequency and duration lead to the need to consult a doctor.

  The first two stages of Raynaud's syndrome are not dangerous. Damage to the vessels at these stages is noted in rare cases. The 3rd stage is dangerous, which poses a threat of the appearance of ulcers on the skin, necrosis of tissues and even loss of a limb. However, it appears only in advanced cases and in people who have Raynaud's disease provoked by another serious illness.

  Manifestations on the toes

  Possible case with a predominant lesion lower extremities. Signs of pathology are the same as on the hands. First, there is a painful vasospasm, leading to blanching of the fingers and a change in temperature. Attacks last from 10 to 30 minutes. In the later stages, spasms become longer, blue extremities are possible.

  
  

  When the legs are affected, their motor function is significantly impaired. Patients begin to suffer from lameness, severe pain during attacks when standing or walking.

  Features of the disease in children

  Raynaud's syndrome in children, as a rule, first manifests itself at 11-12 years old, but in some cases it can develop even more early age. Clinical signs differ little from those seen in adults and include blanching of the fingertips, localized fever, and pain.

  But when a disease is detected in children, special attention is paid to other signs that can indicate the onset of the development of autoimmune diseases. Secondary Raynaud's syndrome can be combined with the following clinical manifestations:

  • nail plates in the form of watch glasses;
  • nodules when feeling fingers;
  • sores on the fingertips;
  • swelling of the skin;
  • soreness and stiffness in the joints;
  • general weakness;
  • persistent redness of the face;
  • ulcers at the corners of the mouth.

  These and other symptoms do not indicate an autoimmune pathology, but they often accompany it, therefore, if Raynaud's disease is suspected, a thorough diagnosis should be made to early detection potentially dangerous diseases.

  Diagnostics

  The doctor makes a diagnosis, relying on the patient's complaints and objective data obtained during additional studies. One of these is capillaroscopy of the nail bed. It allows you to identify functional and structural changes in the vessels of the extremities. Another technique is cold tests, the essence of which is to assess the condition of the hands and feet after they are immersed for 2-3 minutes in water with a temperature of 10 degrees.

  In Raynaud's disease, diagnosis consists in assessing the following criteria:

  • symmetry of areas with angiospasms;
  • the level of impaired blood circulation in the extremities;
  • the presence of other venous diseases;
  • the duration of symptoms of the disease.

  Laboratory methods are also used to make a diagnosis:

  • general analysis of blood and urine;
  • coagulogram - assessment of blood clotting;
  • blood chemistry;
  • immunological analyses.

  Treatment

  The treatment of Raynaud's disease is complex. Medication or surgery established only if it is impossible to control the disease in other ways.

  Usually, the therapist deals with the treatment of the disease. But if there is a secondary Raynaud's syndrome, which developed against the background of systemic diseases of the connective tissue, then a rheumatologist who is a specialist in autoimmune pathologies is observed. The effectiveness of therapy depends entirely on the patient's consciousness, since, first of all, it is necessary to eliminate provoking factors (stress, cold, smoking, alcohol and vibration).

  Raynaud's syndrome is not able to have a significant impact on the course of pregnancy, therefore, in this case, its therapy also comes down to the prevention of vasospasm.

  Medicines

  In primary Raynaud's syndrome, drug therapy is carried out in the cold season to prevent vasospasm and complications. With a secondary syndrome, long-term and regular drug treatment is prescribed.

  To prevent vasospasm, several groups of drugs are used that have a vasodilating effect and improve blood rheology:

  1. 1. Calcium channel blockers (Cordaflex, Normpodipine, Corinfar, Amlodipine, Tenox, Plendil, Felodipine, Nifedipine, Felodipine). They reduce the frequency of attacks of vasospasm. Appointed by monthly courses in the cold season with a break for the same period. If a therapeutic effect from this group of drugs is insufficient, then they are combined with other drugs.

  Calcium channel blockers are contraindicated in the following cases:

  • minor age;
  • pregnancy and lactation;
  • upper arterial pressure does not exceed 90 mm Hg. Art.;
  • no more than 4 weeks have passed since an acute attack of myocardial infarction;
  • stenosis (aortic and mitral);
  • tachycardia.
  1. 2. Vasodilators and antiplatelet agents (Dipyridamole, Trental, Pentoxifylline, Curantyl, Pentinyl, Papaverine hydrochloride). They help reduce blood viscosity, reduce platelet aggregation, increase oxygen saturation of tissues and have a vasodilating effect. Use drugs in courses of 1-2 months. From this group, nitroglycerin ointment 2% is isolated, which is applied topically to the fingers of the extremities 2-3 times a day. It is effective in both primary and secondary forms of the disease, in the healing of ulcers.
  2. 3. Alpha-blockers (Doxazosin, Prazosin). Their action is based on blocking norepinephrine, a hormone responsible for vasoconstriction. They help to eliminate the pathological link of the disease and stabilize blood circulation in the limbs. But their action may be insufficient under severe stress.

  Surgery

  Surgical methods are used extremely rarely in Raynaud's disease. They are necessary in cases of increased risk of soft tissue necrosis of the fingers and toes.

  There are the following types surgical treatment:

  • Stem sympathectomy. The bottom line is the intersection of the section of the sympathetic nerve on the limbs, which is responsible for the spasm of the vessels in them. This reduces the duration and frequency of attacks of the disease.
  • chemical injections. The action is based on the chemical blocking of the transmission of nerve impulses in the sympathetic nerves with the help of anesthetics or botulinum toxin type A.

  A significant disadvantage of surgical treatment is that the effect obtained can be short-lived.

  Physiotherapy

  Physiotherapeutic procedures can prevent vasospasm by improving the condition of their walls. With Raynaud's syndrome, the following methods are used:

  • Magnetotherapy. Inductors act on the cervical and thoracic region spine for 15 minutes. Sessions are held daily for two weeks.
  • Electrophoresis. It is carried out using sedatives (sodium bromide, Diazepam), antispasmodics (Dibazol, Eufillin, Papaverine). In this case, they act on the palms and feet for 10 minutes. A total of 10 sessions are carried out.
  • Paraffin and ozocerite applications. The area with spasmodic vessels is affected by a temperature of 38-40 degrees. The procedure lasts from 15 to 25 minutes. In total, up to 10-15 sessions are carried out.
  • Mud treatment. Apply bromine-iodine, hydrogen sulfide and nitrogen-thermal baths. One procedure takes up to 20 minutes. The course of therapy includes 10 sessions.
  • Sulphide baths. The main component is hydrogen sulfide, which penetrates the skin, improving microcirculation in tissues and stimulating metabolism. The procedure takes from 10 to 15 minutes, in total, 5-10 sessions are performed.

  Folk methods

  Before resorting to traditional medicine methods, it is recommended to consult a doctor in order to exclude complications. In addition, folk remedies are effective only on early stages Raynaud's disease, therefore they are considered only as additional measure to basic conservative therapy.

  The following popular recipes and methods are distinguished:

  • A decoction of pine needles and wild rose. Finely chopped needles of young pine needles are taken, mixed with half a glass of honey and with the same amount of husk onion and 2-3 tablespoons of rose hips. The resulting mixture is seasoned with boiling water, after which it is boiled for 10 minutes and infused for 8-12 hours. The decoction is consumed 100 ml 3-5 times a day, preferably after a meal.

Have you ever noticed that your fingers turn blue or red in the cold or under stress? Or maybe the skin of the fingers changes color even without apparent reason? Sometimes these symptoms can signal serious health problems.

How Raynaud's Syndrome Manifests

Raynaud's syndrome occurs in the form of attacks with numbness and discoloration of the skin of the fingers lasting 15-20 minutes. A stressful situation or cold can provoke an attack, and sometimes the provoking factor is not obvious.

Of course, discomfort in the fingers and redness in the cold occur in healthy people, this is a normal reaction of the skin vessels. But in people with Raynaud's syndrome, you can notice an important difference - gradual change in color of the skin of the fingers: they first noticeably turn pale, then turn blue and turn red at the end of the attack. In this case, all fingers are involved, except for the first (large).

In addition to the fingers, ears, the tip of the nose, and the tongue may be involved. Frequently joins tingling, numbness and even pain in the fingers, which pass at the end of the attack.

Reasons for the appearance

Presumably, the basis is a genetic predisposition. And the syndrome itself is caused by a short-term spasm of small vessels.

There are primary Raynaud's syndrome (disease) and secondary Raynaud's syndrome. In the vast majority of cases (approximately 90%), primary Raynaud's syndrome occurs. In itself, this disease, although unpleasant, is not dangerous for life and health. Usually the first symptoms appear at a young age (20-30 years).

Secondary Raynaud's syndrome always occurs against the background of another disease and may be a signal of a serious illness (for example, scleroderma, hypothyroidism, diabetes, syringomyelia, etc.). Therefore, if you have symptoms characteristic of Raynaud's syndrome, and even more so if they appeared in adulthood, you need to undergo a thorough examination.

Who is at risk

Among the risk factors, the most significant are:

• female (women suffer 5 times more often than men, but with increasing age, the frequency of occurrence becomes approximately the same);
• living in an area with a cold climate;
• heredity (in 30% of cases it occurs in close relatives);
• exposure to vibration (for example, work as a driller, polisher) or low temperatures (work in a cold shop).

Both primary and secondary Raynaud's syndrome can be aggravated by the use of substances that cause vasospasm (eg, smoking, drinking strong coffee), the use of vasoconstrictive drugs (eg, migraine triptans).

Necessary examinations

If you suspect that you have Raynaud's syndrome, then first of all you need to contact a therapist. Be prepared to answer questions in detail about the timing of symptoms, possible triggers, the nature of your work, and other health concerns.

All these details are necessary for planning further examination and excluding a secondary syndrome, because it is extremely important to establish whether the symptoms are caused by another disease. For the secondary syndrome, in contrast to the primary, the following symptoms are characteristic:

• symptoms appear asymmetrically (for example, one arm may be more affected than the other);
• later age of onset of manifestations (usually after 30 years);
• the onset of symptoms is not associated with a stressful situation or cold;
• the presence of antinuclear antibodies in the blood (these are immunoglobulins that appear in the blood in autoimmune diseases).

After a conversation with a therapist, you may need to consult other specialists - a rheumatologist, phlebologist, vascular surgeon, endocrinologist, neurologist - with subsequent examinations.

Treatment: with and without pills

If the examination revealed a secondary Raynaud's syndrome, then the underlying disease is treated first.

Both pharmacological and non-pharmacological methods of treatment are used. The following medications are most commonly used:

• calcium channel blockers (eg nifedipine, amlodipine);
• alpha-blockers (for example, doxazine);
• vasodilators (eg dipyridamole);
• antispasmodics (no-shpa) and other means.

Physiotherapy, acupuncture, massage are actively used. And extremely rarely, only with the ineffectiveness of other methods of treatment, it is necessary to resort to surgical treatment.

Maria Meshcherina

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