Raynaud's phenomenon - Treating Raynaud's

Treatment for Raynaud's phenomenon usually involves self-help techniques, although medication is sometimes necessary.

If you have been diagnosed with primary Raynaud’s you will probably be treated by your GP.

If you have been diagnosed with secondary Raynaud’s, you may need to be referred to a specialist in the treatment of the underlying condition.

In most cases of Raynaud's, self help methods can help control symptoms (see below). If this does not work, then medication may be recommended. This is usually a medication called nifedinpine in cases of primary Raynaud's. Other medication may be used in cases of secondary Raynaud's, depending on the cause.

If it's thought your secondary Raynaud’s is a side effect of a medication you are taking, you may be asked to stop taking it to see if your symptoms improve.

Self-help

The following advice is recommended for both primary and secondary Raynaud’s.

• Keep your whole body warm, especially your hands and feet. Wear gloves and warm footwear in cold weather. 
• If you smoke, stop. Stopping smoking will improve your circulation, which should help improve symptoms.
• Exercise regularly as this helps improve your circulation and reduce stress levels (see below). For most people, 150 minutes of vigorous exercise a week is recommended. Read more about exercise.
• Try to minimise your stress levels. Regular exercise, eating a healthy diet, and relaxation techniques such as deep breathing or activities such as yoga, can help. You may find it useful to avoid stimulants such as coffee, tea and cola.

If you find it difficult to control feelings of stress, you may require additional treatment such as counselling. Read more about therapies for stress. 

Medication

Nifedipine

If your symptoms fail to improve, you may be prescribed nifedipine. This is the only medicine licensed to treat Raynaud's phenomenon in the UK. It does not cure Raynaud's, but can help relieve the symptoms.

Nifedipine is a calcium channel blocker, a type of medication that encourages the blood vessels to widen.

Depending on the pattern of your symptoms and how well you respond to treatment, you may be asked to take your medication every day. Alternatively, you may only need to take it on a preventative basis; for example, if there was a sudden snap of cold weather.

Side effects are common and include:

• swelling of certain parts of the body (oedema) such as your hands and feet, due to a build-up of fluid 
• headache
• flushing
• dizziness  

Do not drink grapefruit juice when taking nifedipine as this could make side effects much worse.

The side effects should improve as your body gets used to the medicine, but tell your GP if you find them particularly troublesome. There are alternative calcium channel blockers that may suit you better.

Other medications

Other medications have been used to treat Raynaud’s, but their use is controversial as there is limited evidence to show they are effective in most people. However, some people have claimed to benefit from treatment. These medications include:

• angiotensin-converting enzyme (ACE) inhibitors
• fluoxetine, which was widely used in the treatment of depression
• sildenafil, which is used to treat erectile dysfunction (inability to get or maintain an erection)

These medicines are not licensed for the treatment of Raynaud's in the UK, but you may be prescribed them if it is thought the potential benefit outweighs the possible risks. Read more about medicine licensing.

Surgery

Surgery for Raynaud's is rare. It is usually only recommended if your symptoms are so severe there is a risk the affected body part, such as your fingers, could lose their blood supply and begin to die. Read more about the complications of Raynaud's phenomenon.

A type of surgery called sympathectomy is sometimes used. It involves cutting the nerves that cause the affected blood vessels to spasm.

The results of a sympathectomy are often only temporary and further treatment and possibly more surgery may be required after a few years.