Treating Raynaud's

You can usually treat Raynaud's phenomenon yourself, although medication is sometimes necessary.

If you've been diagnosed with secondary Raynauds, you may be referred to a specialist in the treatment of the underlying condition.

If your secondary Raynauds may be a side effect of a medication, you may be asked to stop taking it, to see if your symptoms improve.

Self-help

The following advice is recommended forboth primary and secondary Raynauds.

• Keep your whole body warm, especially your hands and feet. Wear gloves and warm footwear in cold weather.
• If you smoke, stop. Quitting smoking will improve your circulation, which should help to improve symptoms.
• Exercise regularly, as this helps to improve your circulation and reduce stress levels (see below). For most people, 150 minutes of vigorous exercise a week is recommended.
• Try to 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. This is the only medicine licensed to treat Raynaud's phenomenon in the UK. It doesn't cure Raynaud's, but can help to relieve the symptoms.

Nifedipine is a calcium channel blocker a type of medication that encourages the blood vessels to widen.

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 as prevention; for example, duringa sudden snap of cold weather.

Side effects are common and include:

• oedema swelling of certain parts of the body, such as your hands and feet, due to a build-up of fluid
• headaches
• heart palpitations
• dizziness
• constipation

Don't drink grapefruit juice when taking nifedipine, as this could make side effects worse.

The side effects should improve as your body gets used to the medicine, but tell your GP if you find them particularly troublesome. There are alternative calcium channel blockers that may suit you better.

Other medications

Other medications have been used to treat Raynauds, but their use is controversial, as there is limited evidence to show they're effective in most people. However, some people have claimed to benefit from treatment. These 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)

These medicines are not licensed for the treatment of Raynaud's in the UK, but you may be prescribed them if it's thought the potential benefit outweighs the possible risks. It's usually only recommended if your symptoms are so severe that there's a risk the affected body part, such as your fingers, could lose their blood supply and begin to die. It involves cutting the nerves causing the affected blood vessels to spasm.

The results of a sympathectomy are often only temporary and further treatment and possibly more surgery may be required after a few years.