Raynaud’s Phenomenon (Raynaud’s Phenomenon) Flashcards
What is Raynaud’s Phenomenon?
A peripheral vascular disorder, which means it affects blood vessels outside the heart and thorax. It occurs secondary to another underlying condition
Characterized by intense spasms of the arteries and arterioles that supply the fingers and sometimes of the vessels that supply the feet
Vasospasms impair blood supply to the digits which causes colour changes and sensory symptoms
Eventually, tissue dystrophy is observable in the affected digits
Raynaud’s is Secondary To:
Occlusive arterial disease
Arteriosclerosis
Connective tissue disease such as as systemic scleroderma (on the skin)
Thoracic outlet syndrome
Pulmonary hypertension
Myoedema
Buerger’s disease
Previous vessel injury through frostbite or trauma
Occupational causes such as vibrating tools
Raynaud’s Disease
A term used to denote arterial spasms and symptoms similar to Raynaud’s phenomenon, when there is no underlying, related condition and the blood vessels appear normal
May begin unilaterally but will usually become bilateral within 4-6 months of onset
Usually affects women between 18-30 years of age
Characterized by symptoms similar to Raynaud’s phenomenon, of intermittent attacks of pallor followed by cyanosis in the digits due to abnormal vasoconstriction in the extremities
Brought on by exposure to cold or emotional stress
There appears to be some risk of RA (viem khop dang thap), as well as reduced tissue health and gangrene in the skin at the fingertips
Symptom Picture
Vasospasm of the blood vessels supplying the hands and sometimes the feet constitute an “attack”
During an attack, digits appear white and shiny, often going numb. They then turn red, which is accompanied by a burning sensation before returning to normal and slight swelling may occur
Over time, tissue health is affected. Muscles atrophy, the nails may become brittle and the skin at the fingertips may thicken
Ulcers may result in chronic infection or infrequently gangrene around the nail and fingertips
Contraindications
Cold hydrotherapy applications should not be used on the affected tissue
Stimulating or painful techniques should be used judiciously to avoid stimulating SNS firing and precipitating an attack
Deep techniques are avoided on affected tissue, if the tissue health is poor
Assessment
Health History Questions
How is your general health?
What underlying condition is related to the Raynaud’s phenomenon?
How frequent are your attacks?
What specifically triggers the attacks?
What treatment are you receiving
Are you on any medications?
Observation & Palpation
Observation of the tissue and nail health for colour, thickness and ulceration should be examined
Palpation reveals decreased skin temperature in the affected area compared with an unaffected area and some edema may be present
Massage
Permission to speak with the client’s physician is recommended in regards to the risk of thrombus formation and tissue health concerns
Full body relaxation massage is performed
Gradually over time, treatments can progress to include the proximal limb of the affected tissue
Self-Care
The client is encouraged to reduce stress through relaxation strategies
The client is educated about avoiding the cold by wearing gloves in cool weather and always wearing shoes
The client is also educated about vasoconstricting substances such as stimulants in foods (caffeine), smoking, drugs
A nutritionist or naturopath can be consulted for nutrition recommendations which may include vitamin E, calcium, magnesium and zinc supplements
Aerobic exercise is recommended to improve general circulation
Modified contrast baths, where warm and cool applications are alternated may be helpful
