Article by Prof. MS Krishnamurthy.
Raynaud’s disease is characterized with the features like cold fingers or toes, sudden change of the color of the skin in response to cold or stress and a sensation of prickly feeling or stinging pain upon warming. Often numbness, pallor of the skin may also associate with this complaint.
The severity of the illness depends upon the frequency, duration and extent of the blood vessel spasm that lie behind the disorder.
Raynaud’s most commonly affects the fingers and toes; but rarely nose, ears and even lips or nipples may also affect badly.
During the attack of Raynaud’s disease, affected parts of skin usually first turn white. Then, the affected areas turn blue and feel cold and without sensation. As you warm the circulation improves and hence the affected areas will turn red and appear normal.
The color change mechanism is caused due to the narrowing of the initial blood-vessel caused because of spasm of the tiny muscles in the wall of the vessels, followed by dilation. This process is known as Raynaud’s phenomenon in modern medicine.
The mechanism of Raynaud’s phenomenon may be found in so many diseased conditions like-
Systemic lupus erythematosus
Connective tissue disorders
Hormone imbalance especially hypothyroidism and carcinoid conditions
Localised trauma (eg-frostbite) etc
Management of Raynaud’s phenomenon or disease involves preventing the contraction of the blood vessels by protecting the fingers and the toes from extreme cold and injuries. Medicaments that aggravate blood vessel spasm should be avoided by patients who are suffering from Raynaud’s disease.
Preventive measures for Raynaud’s disease:
All measures which are helpful to keep the body parts warm, are beneficial in this respect. Warm clothing in cold environments is necessary. Cotton gloves are helpful to achieve this. In extreme cold weather room heaters can be used to maintain the desired warmth. Rubber gloves or polyathylene coverings protect the hands and prevent cooling while washing dishes and clothes.
Wearing the shoes will be necessary and barefoot walking should be avoided. Any kind of compression or ligation of the blood vessels should be avoided.
The patients who are suffering from RP or RD should guard their hands and feet from direct trauma and wounds.
Direct and indirect smoking should be avoided by patients with RD.
Direct exposure to the fume, fog; chemicals, smoke etc are to be avoided as they may increase the chances of occlusion of the blood vessels.
In its severity of the illness RP can lead to gangrene and hence the loss of digits too.
Prevention of RP/RD:
Raynaud’s phenomenon can be prevented by avoiding the precipitating factors, such as cold exposure, any mechanism of constriction of blood vessels etc.
Who are prone for RD?
People of all ages can be afflicted by Raynaud’s phenomenon.
It most often starts between age 15 and 25 and it is most common in women than men. Also people living in cold places are having most chances of suffering.
Also the people who are already suffering from Carpal tunnel syndrome, Blood vessel disease, who are under the treatment for high blood pressure, migraines, or cancer are giving maximum chances of affliction. The individuals who are addicted to narcotics and those who engage in vibratory work are having maximum chances of occurrence.
Ayurvedic understanding of RD or RP:
This is a condition of Siragata vata. Due to the aetiological factors there will be blockage of the channels especially in the siras(veins and venules).This is termed as ‘kha vaigunya’ as per Ayurveda and further if the aetiological factors if not checked condition will be worsened and Suptata (numbness) and Stabdhata (stiffness) followed with Dourbalya(debility) and Kshaya (emaciation) are caused.
Thus the person who is suffering from Siragata vata may be found with reduced functions of the hand and leg or there may be proportional loss of functions.
Line of Treatment as per Ayurveda-
All measures explained under Vatarakta are suitable over here. Alternate therapy of warm and cold stands as the best way to reverse the pathophysiology.
Raktamokshana (bloodletting) by the help of leeches have shown several succesful incidences in my clinical practice.
Seka (pouring of decoctions) over the affected area continuously helps to restore the blood circulation. Lepa (external application of medicaments) and Abhyanga (oil massage) are also contributing significant benefits in this regard.
Vata and Pitta pacifying medicaments are much beneficial for both internal and external purposes.
Formulations of choice in RD and RP:
Kaishora guggulu – It acts as – aging skin health promoter, joint health, natural blood cleanser
Chandraprabha vati – used in Ayurvedic treatment of diabetes, diseases of urinary track, and many other disease conditions.
Mahamanjishthadi kashaya – This medicine is mainly used in treatment of skin diseases. Widely used in Ayurvedic medical practice across India.
Vasaguduchyadi kashaya etc
Maharaja prasarini taila
Parinatakeri narikela taila
Shunthyadi pralepa etc
Simple remedies for Raynaud’s disease:
1. The tamarind leaves (Chincha-Tamarindus indica) and pulp of Kumari(Aloe vera) are takemn in 4:1 ratio and fine paste is made. This is applied to the affected forearm and foreleg.15-20 days application daily will help to achieve symptomatic relief.
2. Seeds of cumin and mustard are fried deeply and charred. This black colored mass added to the sesame oil (Tila taila) and warmed. Little salt is also added.This is stored in glass containers. This is applied to the affected area, daily. After 1-2 hr of oil application lukewarm water is pored over the area for 5-8 minutes. This helps to increase the blood circulation and hence to relieve the congestion of the vessels.
Raynaud’s phenomenon or disease is not a common disease; but it is seen quite oftenly in the cold climates and in the cold geographical areas. Also it is most common among the militants who work in the chilling borders without rest and lot of stress. Also it is indeed essential to protect from such incidences who are going for long travels to the wintry areas and in seasons. Enough care and caution will protect the individuals from such occurings.