Raynaud's Syndrome in Fibromyalgia and ME/CFS

Having cold hands and feet is a common problem with conditions like fibromyalgia (FMS), chronic fatigue syndrome (ME/CFS), and Raynaud's syndrome.

What Is Raynaud's Syndrome?

In Raynaud's syndrome, the blood vessels constrict more than they should, which reduces blood flow. That not only makes your extremities cold, it also makes them difficult to warm up. The most commonly affected body parts are the fingers and toes, but your lips, nose, ear lobes, knees, and nipples may also be involved.

Raynaud's isn't all about the cold, though. The diminished blood flow can cause pain in the affected areas, and it may also make the skin appear blueish. Skin ulcers (sores) can occur as well since low blood flow can damage your tissues and impair healing.

Episodes of increased symptoms, described as attacks, are often triggered by things like exposure to cold or high levels of stress. An attack may last for just a few minutes or could go on for hours.

For some people, Raynaud's syndrome is a primary condition that doesn't accompany another illness. And sometimes it's a secondary condition that results from another illness.

Raynaud's is also common in lupus, rheumatoid arthritis, and Sjogren's syndrome.

We don't yet know what causes Raynaud's syndrome and there is no cure.

Diagnosing Raynaud's Syndrome

A Raynaud's syndrome diagnosis is generally based on symptoms and a physical exam. However, your healthcare provider may also order a cold stimulation test for you, in which heat sensors will record the temperature of your fingers before and after you soak them in cold water.

Your healthcare provider may also consider the possibility that you could have secondary Raynaud's syndrome.

And since FMS and ME/CFS can also cause cold fingers and toes, you might have tests that are used as part of the diagnosis of FMS or part of the ME/CFS diagnostic process, if your history and physical exam suggest that you could have one of these conditions.

They include:

• Antinuclear antibody (ANA) test
• Erythrocyte sedimentation rate (sed rate)

Treating and Managing Raynaud's Syndrome

Several treatments and management strategies can help ease the symptoms of Raynaud's. The first line of defense is modifying your habits to help prevent symptoms. You can do this by:

• Not exposing your hands to cold or protecting them when you can't avoid exposure
• Not smoking
• Not wearing anything that constricts your blood flow, including rings or tight socks
• Exercising to improve your circulation
• Managing your stress
• Avoiding possible symptom triggers that you have noticed

When a Raynaud's attack occurs, you can help ease it by:

• Moving or massaging the affected parts
• Finding a warmer place
• Running warm (not hot!) water over the cold areas

Medical treatment options include:

• Prescription medication, such as alpha blockers, calcium channel blockers, and vasodilators, which affect your blood vessels
• Injections of chemicals that block pain sensations in your hands or feet
• In rare cases, surgical removal of damaged tissues

Some alternative treatments, including biofeedback and supplementation with gingko or fish oil, have been recommended for treating Raynaud's. However, a 2009 review of available research found that they did not make a significant difference.

Raynaud's in Fibromyalgia/Chronic Fatigue Syndrome

We don't know exactly why symptoms of Raynaud's are common in people with FMS and ME/CFS. An association between FMS and digital microvascular dysfunction (diminished blood flow in the fingers and toes) suggest that symptoms of Raynaud's in FMS may be caused by different mechanisms than those seen in primary Raynaud's or secondary to autoimmune conditions like scleroderma.

Raynaud's symptoms may aggravate certain symptoms of FMS and ME/CFS, which often involve temperature sensitivity. Exposure to cold temperature can cause pain for someone with FMS/ME/CFS and may, in some cases, trigger a symptom flare. That makes it especially important to prevent Raynaud's symptoms in those patients.

While treatments for Raynaud's and FMS/ME/CFS are different, lifestyle changes such as not smoking, managing stress, and gentle exercise may help alleviate symptoms of all those conditions.

If you suspect you have Raynaud's syndrome, be sure to bring it up with your healthcare provider so you can be properly diagnosed and treated.