Hence, the importance of exploring this condition has risen even higher than ever before. Raynaud’s disease is also commonly known as Raynaud’s Syndrome or Raynaud’s Phenomenon.

It is a condition surrounded by home-remedies and old-wives-tales and everyone who experiences/suffers from it has their own hacks, tips, and tricks. The aim of this article will be to explore the condition in a bit more depth and endeavour to navigate through a few myths surrounding this condition.

So, what happens in Raynaud’s disease?

Raynaud’s is a condition where the hyperactivity of blood vessels to cold temperature causes the tiny blood vessels in our extremities called capillaries to contract and narrow (aka vasoconstriction/vasospasm) which further leads to reduced blood flow to the tissues of our extremities such as toes and fingers-tips (Temprano, 2016).

Types of Raynaud’s disease?

Raynaud’s disease is mainly categorised as either Primary Raynaud’s (aka Raynaud’s Disease) or Secondary Raynaud’s.

Primary Raynaud’s: Cause is not known. Underlying hereditary issue is suspected to be passed on from parent to child. More commonly seen to be symmetric/bilaterally (i.e., effecting toes or fingers of both
limbs) and can be elicited by cold temperatures and even emotional stress. Often multiple digits will be affected.

Secondary Raynaud’s caused because of other ailment/s such as underlying autoimmune, vascular and/or connective tissue disorders (The American Association of Rheumatology, 2021).
If the pallor is extending more proximally beyond the joints of the toes or fingers metatarsophalangeal joints and metacarpophalangeal joints respectively) then the involvement of other large blood vessels can be suspected and is more likely to be Secondary Raynaud’s.

Common Signs & Symptoms

Generally, the extremities of the body are affected and commonly seen in toes and fingers but other regions such as nose tip and ear can also be affected.

Some common signs & symptoms include pale (aka blanching), waxy-white or purple discolouration of skin (aka “wax finger”), sometimes pale with mildly bluish discolouration (aka cyanosis), temperature cold to touch, and pain can be present. Sometimes abnormally reddish discolouration (aka erythema) can be seen when perfusion is restored (Linnemann & Erbe, 2015).

Worsening of skin integrity/quality can also be commonly seen.

Symptoms can be worse in cold mornings especially when those feet touch cold ground surface after enjoying the comfort and warmth of the blanket overnight.

However, the symptoms can be present at night as well when lying flat on bed and when the blood-flow is not getting its usual help from the gravity to reach feet and toes.

The severity can really vary on a case-by-case basis but can be severe enough to cause ulcers and gangrene and other infections as poor blood-supply starves the tissues and cells of the oxygen and nutrition it needs to survive (Lee & Park, 2018).

In the following image purple discolouration can be seen on the distal aspect (apices) of the 3rd and 4th digits.

How Can a Podiatrist Help?

Diagnosis:

Speedy and accurate diagnosis can be the key to not only successful outcomes with Raynaud’s disease but also prevent worsening of other medical conditions which can manifest with similar signs & symptoms to Raynaud’s disease and sometimes even coexist at the same time along with Raynaud’s.

A podiatrist can help through conducting assessments facilitating speedy diagnosis. Some such assessments include:

Toe Pressure Test: As this condition affects smaller blood vessels (capillaries) more, a “toe-pressure” test can be conducted to assess the blood flow to the toes smaller blood vessels. Moreover, this test can also be very useful when diabetes is also present as a comorbidity. This is because in diabetes the high blood glucose levels  calcify the bigger blood vessels, hence assessing uncalcified smaller capillaries gives reliable results.

Doppler Test: This test is somewhat similar to an ultrasound test but allowing us to listen to your blood flowing and pulses. Oftentimes, we can learn a lot simply by listening!

Hands-On Physical and Vascular Assessments: the value of “hands-on” clinical tests is oftentimes undervalued in the era of modern medicine and technology. But from anecdotal experience it is my opinion that certain clinical tests can also aid in further narrowing of diagnosis and sometimes even help us identify the category of Raynaud’s.

Treatment:

As previously mentioned, there are myriad of interventions to help with this condition and almost everyone suffering from it has their own regimen found to be effective for them.

The treatment can range from simple lifestyle modifications, gentle lukewarm-water foot baths, paraffin wax baths, topical patches, topical creams, otc (over-the-counter) oral supplements, and some dry needling techniques (Goundry, Bell, Langtree & Moorthy, 2012).

In very severe cases, specialist intervention, pharmacological oral treatments, and invasive procedures might be required. Our strong advice is not to self-treat when it comes to this condition and to seek professional medical help.
Self-treating can lead to poor diagnosis and less focused treatment with poor results.
Moreover, the potential for worsening of other underlying conditions if undiagnosed.

What Can you do In the Meantime?

Warm woolen socks in bed and around the house can help.
Seek and follow professional advice tailored to you.

Common Mistakes to Avoid:

Some common mistakes associated with this condition and often happening due to self-treatment:
– Burns caused by trying to warm feet using hot water, heater, etc (especially when
protective sensation in feet is reduced (ie in cases of numbness)
– Footwear changes without professional opinion leading to more falls and other
musculoskeletal and skin issues.
– Over-the-counter skin patches- potential to cause blood pressure issues)
– Potential side effects from topical creams.
*Please note that the purpose of this article is solely to promote public health awareness.
Information from this article is not to be used for self-diagnosing and/or self-treating. Please seek
professional medical care for your concerns.

Author:
Tushar Singh (Podiatrist)
B.App.Sc, M.Pod.Prac.

Reference List:

Goundry, B., Bell, L., Langtree, M., & Moorthy, A. (2012). Diagnosis and management of
Raynaud’s phenomenon. BMJ, 344(feb07 1), e289-e289. doi: 10.1136/bmj.e289

Lee, Y., & Park, K. (2018). Secondary Raynaud’s Phenomenon and Skin Necrosis of Toes in the
Paraplegic Patient with Hypertension. Drug Safety – Case Reports, 5(1). doi:
10.1007/s40800-018-0071-6

Linnemann, B., & Erbe, M. (2015). Raynauds phenomenon – assessment and differential
diagnoses. Vasa, 44(3), 0166-0177. doi: 10.1024/0301-1526/a000426

Raynaud’s Phenomenon. (2021). Retrieved 26 August 2021, from
https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Raynauds-Phenomenon

Temprano, K. (2016). A Review of Raynaud’s Disease. The Journal Of The Missouri State Medical
Association, 113(2). Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139949

The Dietary Guidelines for Australians are designed to help people choose foods for a healthy life.

The guidelines advise the following:

Guideline 1

To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs

• Children and adolescents should eat sufficient nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.
• Older people should eat nutritious foods and keep physically active to help maintain muscle strength and a healthy weight.

Guideline 2

Enjoy a wide variety of nutritious foods everyday from the five food groups. This includes:

• Plenty of vegetables, including different types and colours, and legumes/beans
• Fruit
• Grain (cereal) foods, mostly wholegrain and/or high fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
• Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
• Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat milks are not suitable for children under the age of two years)
• And drink plenty of water.

Guideline 3

Limit intake of foods containing saturated fat, added salt, added sugars and alcohol

• Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries,
  pies, processed meats, commercial burgers, pizza, fried foods, potato chips,
  crisps and other savoury snacks.
• Replace high fat foods which contain mostly saturated fat with foods that contain mostly polyunsaturated and mono unsaturated fats. For example swap butter, cream, cooking margarine, coconut and palm oil with unsaturated fats from oils, spreads, nut butters/pastes and avocado.
• Low fat diets are not suitable for children under the age of two years.
• Limit intake of foods and drinks containing added salt.
• Read labels to choose lower sodium (salt) options among similar foods.
• Do not add salt to foods in cooking or at the table.
• Limit intake of foods and drinks containing added sugars such as confectionery, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and
  sports drinks.
• If you choose to drink alcohol, limit intake. For women who are pregnant, planning a pregnancy or breastfeeding, not drinking alcohol is the safest option.

Guideline 4

Encourage, support and promote breastfeeding

Guideline 5

Care for your food; prepare and store it safely

There are also Dietary Guidelines specifically designed for children and adolescents.

An Accredited Practising Dietitian can provide practical, expert and individual advice on how to incorporate the Dietary Guidelines into every day eating, contact us now to book a consultation with our dieticians. 

To view the original article click here.

This information was obtained with permission from the National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council.

Waist circumference

Your health can be affected by how much you weigh as well as by your body shape. Men often carry their excess weight around their middle, while women often carry their excess weight on their hips and thighs. Carrying excess weight around your middle (being ‘apple-shaped’) is more of a health risk than if your excess weight is on your hips and thighs (being ‘pear-shaped’). Measuring your waist circumference is a simple way to check how much body fat you have.

Why is waist circumference an important number to know?

Waist measurement guidelines increase a person’s understanding of their likelihood of developing lifestyle-related chronic diseases. These diseases include cardiovascular disease, stroke, type 2 diabetes and some cancers.

Measuring waist circumference is also an easy way to tell how much body fat a person has and where it is placed around their body. The following guidelines are based on World Health Organisation and National Health and Medical Research Council recommendations.

Increased risk of developing chronic disease

• Adult men: more than 94 cm
• Adult women: more than 80 cm

Greatly increased risk

• Adult men: more than 102 cm
• Adult women: more than 88 cm

Please note that the above waist measurements are recommended for Adult Caucasian men and Caucasian and Asian women with other community groups and ages yet to be determined.

Body Mass Index

Body mass index, or BMI, is used to judge whether you are underweight, overweight, obese or in a normal weight range for your height. It is useful to know this, and consider alongside waist circumference, as increases or decreases in weight outside the ideal range may increase your health risks.

To learn more about BMI and how to calculator yours, visit the BMI calculator.

Blood Pressure

Blood pressure varies from moment to moment. It is affected by many factors including body position, breathing, your emotional state, physical activity and sleep. There is no ‘normal’ or ‘ideal’ blood pressure reading. The following figures should only be used as a guide: 

• Normal: Less than 120/80
• High/Normal: Between 120/80 and 140/90
• High: Equal to or more than140/90
• Very High: Equal to or more than 180/110

If you want to make sure that your numbers are right contact us now and book in for a consultation.

To view the original version of this article click here.