Cold hands and feet syndrome: what is it and is it dangerous?

“It’s so cold, your arms and legs are freezing…” In the latitudes where our endless country lies, this state is familiar to everyone. If coldness in the extremities is due solely to prolonged exposure to the street in damp and cold weather, this is absolutely normal.

Actually, if your hands and feet stop being cold a few minutes after you go into a warm room and warm up, this is not at all the cold hands and feet syndrome that we will consider today.

Therefore, we announce our programs “ Human Health ” and “ Mental Self-Regulation ” and get down to the topic.

Cold hands and feet syndrome: what is it?

Cold hands and feet syndrome is a condition in which a person constantly feels cold hands and feet, even at normal ambient temperatures. This phenomenon has another name:

Raynaud’s syndrome.

This is cold hands and feet syndrome – a pathology in which peripheral vessels in the area of ​​​​the feet and hands, primarily the fingers, are affected. A spasm occurs in the limbs and blood circulation is disrupted. There can be many reasons, and we will talk about them a little later.

The description of cold hands and feet syndrome was first made in 1862 by the French physician Maurice Auguste Gabriel Raynaud (1834-1881). And, as usual in such cases, the syndrome received his name. In scientific terms, Raynaud’s syndrome refers to vasospastic diseases with predominant damage to small terminal arteries and arterioles.

For reference: Vasopathy, also known as angiopathy, is damage to blood vessels caused by a disorder of nervous regulation. Vasopathy is manifested by dystonia, temporary reversible spasms and vascular paresis.

This syndrome most often affects the upper extremities, and usually occurs symmetrically and bilaterally. According to statistics, Raynaud’s syndrome occurs in approximately 5% of the population, and women suffer from it almost 5 times more often than men [ A. Herrick, F. Wigley, 2020 ].

Is it dangerous? What to do if you have cold hands and feet syndrome? Is this a disease or just a physiological feature of the body? First, let’s study the clinical picture of this phenomenon.

Cold hands and feet syndrome: description, symptoms and clinical features

In general terms, we have already understood how this syndrome manifests itself. For a more detailed understanding of the situation, one of the latest studies of Raynaud’s syndrome will help us, where all its causes and manifestations are described in as much detail as possible [ R. Musa, A. Qurie, 2022 ]. What did scientists find out?

Clinical features:

• There is a change in skin color, most often on the fingers.
• Clearly demarcated areas of consistently changed color of the skin of the fingers are observed: pale, blue, red, which is why one can find such a name as “three-phase Raynaud’s syndrome.”
• The first phases of color change indicate a state of hypoxia and vasospasm, and after vasospasm ends, the skin becomes red.
• The process begins with a change in skin color on one finger, then spreads further, “covering” the remaining fingers on the hands of both hands.
• The process may be accompanied by changes in skin color on the ears, tip of the nose, in various parts of the face and above the knees.
• Livedo reticularis (the so-called “vascular network”) may appear on the extremities, which disappears after the completion of vasospasm.
• Occasionally, numbness of the tongue and impaired speech may occur , which becomes slurred and as if “blurred”.

Vasospasm can last up to 20 minutes and end with a rapid restoration of blood flow, as evidenced by the bright pink color of the skin. The frequency and duration of episodes of vasospasm may vary depending on the causes and time of year. In winter, attacks usually last longer and recur more often than in summer. In general, doctors distinguish three main stages of the disease.

Symptoms of the stages of the disease:

• Angiospastic stage – short-term spasms of the vessels of the terminal phalanges of the fingers (2-5th fingers / 1-3rd toes). This spasm is quickly replaced by vasodilatation with redness of the skin and warming of the fingers.
• Angioparalytic stage – the hand and fingers and toes become cyanotic in color, swelling and pastiness (loose tissue) of the fingers are observed.
• Trophoparalytic stage – a tendency to develop purulent inflammations, ulcers, foci of superficial necrosis of the soft tissues of the terminal phalanges.

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Depending on the stage and nuances of a person’s condition, visual manifestations of Raynaud’s syndrome may look different:

 

The last stage is extremely rare. Usually, cold hands and feet syndrome can be dealt with much earlier. Or, at a minimum, ensure that the condition does not worsen. Correct diagnosis of the causes of the syndrome plays an important role in this.

Causes of cold hands and feet syndrome

It is believed that three main mechanisms contribute to the occurrence of Raynaud’s syndrome: decreased blood flow, narrowing of blood vessels, and neurogenic reactions [ R. Musa, A. Qurie, 2022 ]. Vasospastic reactions are most often provoked by low air temperature and emotional stress .

However, this is not always a self-sufficient, exhaustive cause of the problem. Very often, the root cause of the syndrome is a disease, and cold hands and feet are already “derived” diseases.

Main causes and risk factors:

• Insufficiently stable thermoregulation in women due to constant changes in hormonal levels is why the syndrome occurs much more often in women than in men.
• Problems with thermoregulation due to body type – tall, thin people with an asthenic build suffer from cold hands and feet syndrome more often than people of average and short stature.
• Age-related characteristics associated with a slowdown in metabolic processes in the body, including the process of heat exchange.
• Instability of thermoregulation in infants under one year of age.
• Lack of nutrients received by the body – for example, due to a strict diet , which negatively affects all processes in the body.
• Iron deficiency anemia, lack of hemoglobin and oxygen starvation of body tissues, which disrupts heat exchange. It can be recognized by additional signs: fatigue, frequent dizziness, increased drowsiness, and possible tinnitus.
• Lack of thyroid hormones – hypothyroidism inhibits metabolic processes, which disrupts thermoregulation. Additional signs will help you recognize them – brittle nails, weight gain , constipation, dry skin.
• Vegetative-vascular dystonia is a lack of coordination of the action of the sympathetic and parasympathetic autonomic nervous system. Observable signs are pressure surges, rapid heartbeat, pain in the heart area in the absence of heart disease.
• Hypotension or low blood pressure, which impairs heat exchange. Additional signs are excessive sweating, weakness, low temperature.
• Obliterating endarteritis, also known as “smoker’s disease,” is a deterioration in the patency of blood vessels in the legs that provokes a decrease in temperature.
• Diabetes mellitus, which leads to impaired blood supply and, consequently, heat exchange.
• Heart failure and related problems of blood supply and, accordingly, thermoregulation.
• Osteochondrosis – deformation of the vertebrae begins to interfere with normal blood flow and thermoregulation.
• Poor blood supply due to stress, smoking , wearing clothing, shoes, and accessories that compress the skin and blood vessels.
• Hereditary factors that predetermine the structural features of the circulatory system and insufficiently intensive blood supply to the extremities.

These are the main causes and risk factors for cold hands and feet syndrome. Can we consider that cold hands and feet syndrome itself is a disease? As we can see, in most cases this syndrome indicates other health problems and is a consequence of various diseases and physical conditions. What to do if such a syndrome occurs?

Prevention and treatment of cold hands and feet syndrome

The best prevention of cold hands and feet syndrome is treatment of the disease that became the root cause of the syndrome. Or, at a minimum, measures to alleviate the course of this disease so that it does not lead to complications in the form of Raynaud’s syndrome.

In addition, a number of different preventive measures can be taken to avoid frequent and acute manifestations of this symptom. By the way, very often doctors fail to establish the main root cause of Raynaud’s syndrome. In this case, symptomatic treatment is carried out, and the main efforts are focused on prevention and prevention of the development of Raynaud’s syndrome into the acute stage.

Prevention of cold hands and feet syndrome:

• Dress “for the weather” – you should dress in such a way as to keep your hands and feet warm in cold and damp weather. In winter, be sure to wear warm clothes, a hat, gloves or mittens, warm socks and winter shoes.
• Avoid hypothermia – you should avoid prolonged exposure to the wind, under air conditioning, or outdoors in cold weather.
• Do not carry heavy bags and other objects in your hands – this “squeezes” the blood vessels in your hands and impedes heat supply.
• Manage stress – if you are exposed to stress, you should master yoga, meditation , and breathing self-regulation practices so that anxiety does not cause a sharp narrowing of blood vessels and disruption of heat exchange.
• Exercise – Regular exercise can help improve circulation and prevent cold hands and feet. If you have a medical condition that limits physical activity, you should contact your healthcare provider to get recommendations for physical activity that is appropriate for you.
• Quit smoking or reduce the number of cigarettes you smoke per day – smoking can impair blood circulation and worsen the symptoms of cold extremities.
• Insulate your home – this will avoid systematic hypothermia during the cold season. Useful recommendations can be found in the material “21 ways to stay warm in winter without high energy bills” [ O. Kolesov, 2014 ].
• Follow the doctor’s recommendations – if you are diagnosed with cold hands and feet syndrome, you need to carefully follow the doctor’s recommendations, do not skip medications, do not ignore sports , fitness and other physical activity prescribed by the doctor.

For Raynaud’s syndrome, especially in its advanced stage, vasodilators are almost always prescribed. You should adhere to the recommended dosage and frequency of taking the medicine, and refrain from self-medication and “self-prescription” of the medicine.

It should be remembered that for a medicine to work in the body, as they say, “there must be work”, and a medicine never acts according to the principle “the more the better”. An excess of vasodilator drugs can lead to complications as serious as taking them late, skipping or ignoring doctor’s orders.

In addition, for Raynaud’s syndrome, doctors often recommend several lifestyle changes, such as quitting smoking, watching your diet, engaging in physical activity, and controlling risk factors associated with cardiovascular disease.

General lifestyle changes along with other non-pharmacological interventions remain the primary focus of treatment for patients with Raynaud’s syndrome. It was found that the most therapeutically significant in the treatment of this syndrome were calcium channel blockers, alpha-1 adrenergic receptor antagonists, prostaglandin analogs, and phosphodiesterase inhibitors, angiotensin-converting enzyme inhibitors and nitric oxide [ I. Nawaz et al., 2022 ].

In the advanced stage of Raynaud’s syndrome, surgical treatment, namely sympathectomy, is often used. The essence is the so-called “switching off” of the nerve fibers along which pathological impulses travel, causing the blood vessels to spasm.

There are different types of sympathectomy, and endoscopic sympathectomy is considered the least traumatic. However, if necessary, upper thoracic sympathectomy can be used.

Let us clarify that endoscopic sympathectomy is often mentioned in the context of combating excess sweating [ Genesis, 2021 ]. Considering that sweating is the most important mechanism of thermoregulation, such an intervention can significantly improve a person’s condition.

What to do if you have not too advanced cold hands and feet syndrome, but prevention does not always help, and you are already frozen? How to warm up safely without harming your health?

To begin with, let us remind you that you should never suddenly heat up cold hands and feet by immersing them in hot water or placing them close to a fire source in a stove or fireplace – this is harmful to health, because a sharp temperature change can cause tissue necrosis.

Alcohol is not the best way. Under no circumstances should you “warm up” by drinking in the cold, because after a short-term dilation of blood vessels, they quickly begin to narrow, which worsens the condition and can lead to frostbite. If you are used to warming up with alcohol, drink only after you find yourself in a warm room and are guaranteed to be in it for the next few hours.

However, there are much safer ways to stay warm if you’re cold. Study the “Memo for hypothermia and frostbite” and follow the useful advice [ SGKP No. 1, 2022 ].

What to do and how to warm up if you are cold:

• Find a warm shelter – a heated room, shelter from the wind, etc. In open areas, you should create a shelter from available materials.
• Dress warmly – put on another layer of clothing, wrap yourself in a blanket or rug, use pockets to additionally warm cold hands.
• Drink warming drinks – tea, coffee, cocoa and others, except alcohol.
• Eat warming food – heated soup, main course, oatmeal.
• Warm up – a few simple physical exercises will activate blood circulation and increase heat production.
• Perform a light massage or self-massage of frozen limbs – this will improve blood circulation and speed up warming. Suitable if physical impact does not cause pain.
• Make a warm compress or bath for cold hands and feet – it is important that the water is warm, but not hot.
• Take a pet in your arms or place it near cold feet – a cat or dog will quickly “share” its warmth.
• Take a warm bath or warm shower, gradually immersing parts of the body in warm water – this will ensure smooth heating and avoid sudden changes in temperature.
• Use heating elements – an electric heater, a heating pad, an electric sheet.

Of course, all electrical appliances must be in good working order. If you have concomitant diseases, you should definitely read the instructions “How safe are electric blankets, sheets and heating pads?” with instructions for use in various diseases [ Beurer, 2022 ].

Let us remind you once again that you should not heat up too quickly or too much. If your electric sheet has a temperature control, you don’t need to set it to maximum right away. If there is no such regulator, you should not lie on the sheet for too long – it is better to do several “warming sessions” of several minutes each.

And, perhaps, it’s worth talking separately about how to safely take a warming bath during hypothermia and cold hands and feet syndrome. So, the main recommendations of doctors:

• Preliminary preparation – check the water temperature before entering the bath. It should be warm, but not hot, approximately 37-39 °C. It’s best to use a bath thermometer or built-in thermostat to make sure the water isn’t too hot.
• Gradual immersion – Never immerse yourself in a hot water bath straight away. You should start with warm water and then gradually add hot water as desired so that your body can get used to the changing temperature. This will help avoid shock from sudden temperature changes.
• Time limit – you should stay in the water no longer than 15-20 minutes to avoid excessive heat load on the body.
• Gradual “cooling down” – after leaving the bath, you should wrap yourself in a soft towel or put on a robe to keep warm.

Of course, you need to remember the safety rules in the bathroom: the floors should not be wet and slippery, there should be anti-slip mats on the floor and at the entrance to the bath, and there should be no electrical appliances with exposed heating elements in the room itself. All lighting fixtures must be protected by shades.

As for cold hands and feet syndrome itself, if your physical condition does not improve after taking all of the above measures, you should seek medical help and not expect health complications.

In principle, all these recommendations are intended only for moderate hypothermia. If your condition is serious, do not rely solely on warm clothing, warm drinks and a warm bath. You should see a doctor as soon as possible to accurately diagnose the condition and determine appropriate treatment.

This is the most basic thing you need to know about cold hands syndrome. And, of course, take care of your health, because in most cases, cold hands and feet syndrome is a consequence of some more complex disease. Recommendations for prevention are useful to everyone without exception, especially in our high latitudes, where it can be cold or very cool for 10 months a year.

We wish you health and warmth. We invite you to our programs “ Mental Self-Regulation ” and “ Human Health ”, and ask you to share your personal experience on the topic of the article: