Raynaud's disease is a pathology characterized by the occurrence of angiotrophoneurosis with a primary lesion of arterioles and small arteries and (in most cases the upper limbs, a little less often - the feet, skin areas on the nose, chin and ears). As a result, the affected area does not receive the necessary nutrition due to a significant decrease in the volume of blood entering it. A similar disease in women occurs several times more often than in men, it mainly occurs in young or middle age.
Raynaud's syndrome is a phenomenon in which from time to time there is a reversible vasospasm in the fingers and toes in response to a stressful situation or hypothermia.
Main causes of this pathology
The percentage of hereditary predisposition to Raynaud's disease is very small, and is about 5% of all cases. Most common localizationdiseases are peripheral areas of the limbs - feet and hands. The defeat of these areas most often occurs symmetrically.
The main causes of this disease are:
- Among the main factors (causes) of Raynaud's disease is the impact of low temperatures. In some people, even short-term episodic exposure to cold and high humidity can cause the disease to develop.
- Injuries. As the causes of the disease, physical injuries are very dangerous, which include squeezing the limbs, excessive and intense loads, as well as injuries that are associated with exposure to various chemicals.
- Rheumatic conditions such as periarthritis nodosa (inflammation of the tendons), rheumatoid arthritis (joint disease), scleroderma, systemic lupus erythematosus.
- Another cause of Raynaud's disease is strong emotional experiences. There is scientific data showing that about half of the patients suffered from this syndrome due to psycho-emotional overload.
- Disturbances in the functions of the internal organs, as well as some endocrine diseases, such as hypothyroidism and pheochromocytoma.
- Down syndrome.
- Taking certain medications can also cause this syndrome. This applies to drugs that have a pronounced vasoconstrictor effect. Most often, these medicines are used to treat hypertension and migraines.
Let's considersymptoms of Raynaud's disease.
Symptomatics
This disease occurs in the form of attacks, each of which usually consists of three stages:
- Spasm of the vessels of the upper or lower extremities. The fingers become cold and pale, and pain may occur.
- The pain begins to increase sharply, the skin of the extremities becomes bluish, cold sweat appears.
- At the next stage, the intensity of the spasm decreases sharply, the skin warms up and its normal color returns. Limb functions are being restored.
Symptoms of Raynaud's disease, affecting the color of the skin, develop gradually. First, there is a characteristic pallor, the severity of which depends on the degree of vasospasm. Most often, this phase is accompanied by pain sensations, which are present, as a rule, in all phases, but are most pronounced in the first, when the fingers of the extremities are pale.
In some patients, attacks may occur several times a day, in others - once every few months. The progression of this disease leads to a lengthening of the duration of the attacks to about an hour, as well as to their frequency and sudden onset without any special reasons. Between them, the feet and hands are cold, cyanotic, wet.
What are patients complaining about?
The frequency of dysfunction of the nervous system in Raynaud's disease is observed in about half of the cases. Patients complain of the following conditions:
- constant headache;
- heaviness in the temples;
- back pain and limb pain;
- discoordination of movements.
Stages of Raynaud's disease
The course of the pathology is divided into three main stages: angiospastic, angioparalytic and atrophoparalytic.
At the first stage, there is the occurrence of short-term bouts of numbness of the skin, a decrease in temperature in the affected areas and blanching of the skin, followed by the onset of pain. After an attack, visual changes in these areas are not observed.
At the second stage, some other symptoms of the disease are added to the listed signs. The color of the skin begins to acquire a bluish tint, the color of the skin becomes "marble", it is also possible the appearance of puffiness, especially in the affected areas. Pain during an attack becomes more intense and pronounced.
The duration of both stages is on average three to five years. With the development of the pathological process, it is often possible to observe the symptoms of all three stages at the same time.
At the third stage of the pathology, there is a tendency to form ulcers and felons, up to the necrosis of the skin and soft tissues of the phalanges.
This is what Raynaud's disease is dangerous for.
What is recommended for sickness?
With the development of such a pathology, it is extremely important to eliminate the factors that contribute to the onset of the disease. If the cause of its occurrence is professional activity, it should be changed or corrected.
People with thispathology is contraindicated to engage in work that is associated with hypothermia of the extremities, precise movements of the fingers, contacts with a variety of chemicals. Which doctor should I see for Raynaud's disease?
Diagnosing a pathological phenomenon
If you suspect the development of a disease, you should contact a specialist such as an angiologist, but a rheumatologist is also involved in the diagnosis and treatment of such diseases. Additionally, a consultation with a vascular surgeon and a cardiologist may be required.
What is the diagnosis of Raynaud's disease?
The main diagnostic criterion for the occurrence of this pathology is a steady spasm of the vessels of the skin. The hallmark of such a spasm is that when warmed, the circulation in the limbs is not restored, they still remain pale and cold.
When diagnosing patients with Raynaud's disease (according to ICD-10 - code I73.0.), it should first be established whether such a phenomenon is not a constitutional feature of the peripheral blood circulation, i.e. a natural physiological reaction under the influence of low temperatures varying intensities.
The following laboratory tests are also mandatory for diagnosis:
- Complete blood count.
- Extended coagulogram, erythrocyte and platelet properties, fibrinogen levels.
- Assays for c-reactive total and protein, globulin fractions and albumin.
OnAt the present stage of development of medical science, specialists noted the high efficiency of a new method for diagnosing Raynaud's disease - wide-field capillaroscopy of the nail bed. This method has the accuracy of diagnosing this disease.
The final diagnosis can be established only after receiving the results of a thorough instrumental and laboratory examination. If the patient does not have concomitant diseases that could cause the symptom complex of the disease, an appropriate diagnosis is established.
Treatment of Raynaud's disease should be timely.
Treatment techniques
Therapy of patients presents some difficulties, which are usually associated with the need to identify the specific cause that provoked such a syndrome, so the decision on how to treat this disease, or rather, in what way it is more correct to do it, in order to achieve the greatest efficiency, discussed from various points of view.
In cases where the primary occurrence of this pathology is determined, patient therapy should include treatment of the underlying pathology and observation by an appropriate specialist.
Clinical guidelines for Raynaud's disease must be strictly followed.
Treatment is usually symptomatic and includes the following medicines:
- general tonic drugs;
- antispasmodics;
- analgesics;
- drugs that normalize hormonalbody background.
In the first and second stages of the disease, drug therapy also includes drugs that reduce blood density, for example, Dipyridamole or Curantil.
From physiotherapeutic procedures, it is possible to use:
- electrosleep;
- electrical stimulation of the frontotemporal zones in the brain;
- diadynamic currents or ultrasound to the lumbar and cervical sympathetic nodes;
- electrophoresis with sedatives and antispasmodics;
- magnetotherapy.
At the third stage of the development of the pathological process in Raynaud's disease, characterized by the development of ulcerative skin lesions and necrosis of its areas, wound healing therapy is prescribed. Treatment of pathology can last a very long time, sometimes for years, until the period when the occurrence of angiospasms does not stop responding to the use of vasodilators.
One of the important components of the treatment of Raynaud's disease is to limit the patient's contact with various provoking factors. With increased emotional stress, sedative medications should be prescribed to the patient. In cases where it is impossible to exclude contact with a cold and humid environment, patients are advised to dress warmer than usual, and especially warm the feet and hands.
Surgical methods of therapy consist in sympathectomy, which is characterized by an artificial interruption of the flow of pathological impulses that lead to vasospasm insome parts of the autonomic nervous system, which is responsible for the state of the tone of small blood vessels.
Food
Diet in the event of this pathology coincides with the diet of patients suffering from atherosclerosis of the extremities. With Raynaud's disease, fatty foods should be excluded from the diet as much as possible - smoked meats, sausages, fatty meats, poultry legs, mayonnaise, sour cream, fatty cottage cheese.
Products should contain a large amount of B vitamins, vitamin C and routine, which help strengthen the vascular walls and increase their elasticity, which helps them respond adequately to temperature changes in the environment.
It is also recommended to consume a large amount of fruits and vegetables in any form. In addition to being considered a source of vitamins, these foods are rich in fiber, which is a source of nutrition for beneficial microorganisms that live on the intestinal mucosa, resulting in a lot of energy that warms the body.
What other treatment for Raynaud's would be effective?
Folk methods of treating the disease
When a pathology occurs, a variety of folk recipes are used, which in this disease are no less effective than medications.
For example, fir baths have a good effect. In this case, the water in the bath should not be too hot. Fir oil is added to it, as well as any other oils that have a calming andvasodilating effect. The time of taking such a bath is no more than fifteen minutes.
There is also a Siberian recipe for treating this syndrome - eat a piece of bread with a few drops of fir oil on an empty stomach.
Treatment of Raynaud's disease with folk remedies should be carried out under the supervision of a doctor.
The following folk recipe is also advisable: take a few leaves of an aloe plant (preferably at least three years old), chop them and squeeze the juice. After that, it is necessary to prepare a gauze bandage, soak it with aloe juice and apply it to the affected areas of the body for several hours. To increase the positive effect of this procedure, it is recommended to preliminarily massage the limbs.
Sudden attacks of this disease can be more easily tolerated by using soft massages, warming drinks and woolen cloth, which is wrapped around numb limbs.
Drugs for Raynaud's disease
With this pathology, the following medications are most popular, which are prescribed by specialists not only immediately at the time of an attack of the disease, but also for systemic treatment:
- "Actovegin" is an antihypoxic drug that has three types of effect: neuroprotective, metabolic and microcirculatory. The drug increases the absorption of oxygen by tissues, has a positive effect on the transport and utilization of glucose, which improves the energy metabolism of cells and reduces the formation of lactate during ischemia. In addition, this toolprevents the occurrence of apoptosis, which is induced by beta-amyloid. The positive effect of the drug is an increase in the rate of blood flow in the capillaries, a decrease in the pericapillary zones, a decrease in the myogenic tone of arterioles and vascular sphincters, as well as the degree of shunting arteriovenular blood flow.
- "Mydocalm" is a medication that is a centrally acting muscle relaxant. This drug has a local anesthetic and membrane-stabilizing effect, inhibits the passage of impulses of motor neurons and primary afferent fibers, which contributes to the blocking of spinal synaptic reflexes, inhibits the release of mediators by inhibiting calcium entry into the synapses. The drug also enhances peripheral blood flow.
- "Sermion" - a drug that improves peripheral and cerebral circulation, which, in addition, is an alpha-blocker. Improves hemodynamic and metabolic processes, reduces platelet aggregation and normalizes the rheological properties of blood, improves blood flow in the extremities, has an adrenoceptor blocking effect and affects the neurotransmitter cerebral systems, increasing their activity, improves cognitive processes.
These medications are widely used in systemic therapy and prevention of Raynaud's disease, significantly reducing the frequency of pathological attacks and the manifestation of the main symptoms of this disease. Do not start the disease, be sure to consult a specialist at the first symptomsproviding qualified assistance.
