Hands and Feet Cold

WHEN TO SEE YOUR DOCTOR

* The discomfort limits your activities.

* You also have persistent swollen discolored fingers or swollen joints.

* A sore develops on your fingers or toes.

What Your Symptom Is Telling You

It can happen every time when you hold a chilled can of soda or step into an air-conditioned movie theater. Suddenly, your fingers turn icy, white and numb. And your feet are so sensitive that they feel frozen to the bone after doing the dishes while standing on cool kitchen tiles. But sometimes the temperature isn't the cause at all. For some people, emotional stress is enough to turn their fingers and toes to ice.

An estimated 2 to 6 percent of all Americans have hands and feet that are overly sensitive to chilly temperatures and stress. Doctors call the condition Raynaud's syndrome, after the French physician who discovered it. With Raynaud's, a dip in the temperature or a rise in stress levels causes the small blood vessels in the extremities to go into spasm, narrowing to the point that blood can barely circulate through them. Fingers and toes turn waxy white, then blue, and are numb and cool to the touch. Then, when the fingers and toes get warm, they flush deep red and tingle and throb as blood returns full force. This kind of episode can take anywhere from a few minutes to several hours.

Seventy-five percent of people with primary Raynaud's syndrome—the most common kind—are women under 40. It's unclear why. "My guess is there's a link to female hormones, which affect the blood vessels," says Fredrick Wigley, M.D., director of rheumatology at Johns Hopkins University School of Medicine in Baltimore. In any case, the color changes, numbness and tingling may be the only symptoms, and they may get worse or better. The problem usually improves dramatically by menopause.

Secondary Raynaud's—a less common but potentially more serious kind—usually targets women over 40 and men. Factors that act on the blood vessels may trigger the problem. These include smoking, high blood pressure medicines and diseases such as rheumatoid arthritis, lupus (an autoimmune disease) and atherosclerosis. Certain wrist-flexing, wear-and-tear activities such as typing or operating vibrating power drills may increase susceptibility to secondary Raynaud's.

People with this type typically have more intense episodes that gradually worsen each winter and can affect just one finger, hand or foot. Secondary Raynaud's can lead to skin sores or tissue damage.

Symptom Relief

Here are some tips to keep your fingers and toes toasty.

Plunge your hands into warm water. If you're involved in an activity that involves cold—stuffing a turkey, for example—it helps to run your hands under warm water periodically. "This forces blood vessels to remain open," says Murray Hamlet, former director of the Army's Cold Research Division in Natick, Massachussetts.

Move your arms like a windmill. Swinging your arms briskly in 360-degree circles for a minute or two helps drive blood into the fingers and can relieve vessel spasm, according to Donald R. McIntyre, M.D., a dermatologist in private practice in Rutland, Vermont. "Just keep the elbow, fingers and wrist straight," he says.

Sip some hot cider. When the thermometer plunges, hot fruit juice can help stoke up your body's furnace because the sugar provides instant energy, says Dr. Hamlet. Hot coffee is a cold-weather no-no, however. Caffeine constricts the blood vessels, further reducing blood flow. "Alcoholic hot toddies are worse," adds John Abruzzo, M.D., professor of medicine and director of the Rheumatology and Osteoporosis Center at Thomas Jefferson University Hospital in Philadelphia. Alcohol dilates the blood vessels, which gives a sensation of warmth, he says. But the dilated vessels are actually throwing off heat. "You'll shiver more," says Dr. Abruzzo.

Have a fish feast. Fish oil may help ease primary Raynaud's symptoms by reducing the painful blood vessel spasms that cause a shutdown of blood flow to fingers and toes, according to researchers conducting a small preliminary study at Albany Medical College in New York. They observed that 5 out of 11 people who took fish-oil capsules daily for three months had symptoms stop completely. Ask your doctor about taking these capsules. In the meantime, a daily serving of sardines, salmon or tuna may keep your fingers from getting frosty, says Joel M. Kremer, M.D., professor of medicine and head of rheumatology at Albany Medical School.

Go for the loose and layered look. "Getting chilled can trigger Raynaud's syndrome because it diverts blood away from extremities," says Dr. Abruzzo. You can keep warm all over by wearing loose, layered clothing, which helps trap heat, he says. For the layer closest to your body, cotton blends are better than pure cotton or wool because they wick away chill-causing perspiration.

Cover your head when it's nippy. "You lose up to 55 percent of body heat from your head," says Dr. Hamlet. So wear a hat whenever the temperature outside dips even slightly.

Wear mittens, not gloves. Keeping the fingers together helps them generate warmth and will protect them better than gloves, says Dr. Hamlet. Insulated mittens are best, he adds.

Wear hot socks on frigid days. If you're going to be outdoors—sitting in a chilly stadium, for example—take along chemical warmers. These are small heating pouches, available in sporting goods stores, that can be placed in pockets, gloves, boots or shoes. Battery-powered "hot socks" are also a good idea.

Buy a steering wheel cover. Gripping a cold, vibrating steering wheel drains the blood from your hands and can set you up for cold fingers.

Use oven mitts to handle frozen food. And don't be embarrassed to put on mittens to rummage around in your home freezer. You can also protect your fingers from the cold by using an insulated drinking glass or wrapping a napkin around your glass, says Dr. Hamlet.

Place mats over cold tiles. Consider using a mat with built-in heating coils in any tiled or bare-floored area where you stand for prolonged periods, says Dr. Abruzzo.

Bump up the bedroom temperature. Metabolism slows during sleep, so it's important to keep your body temperature high, says Dr. Abruzzo. Wearing socks and even mittens to bed will add extra warmth on cold nights.

Retrain your arteries. This technique, developed by Dr. Hamlet, really works. First, make sure the room where you're practicing is at a temperature that is comfortable for you—not too hot and not too cold. Sit for five minutes with your hands in an insulated container filled with hot tap water. Then wrap your hands in a towel and move to a chilly area—the porch or basement, for example. Now, unwrap your hands and dunk them into a second hot-water container for ten minutes. Then go back indoors for another two to five-minute dip. Repeat this routine 3 to 6 times every other day for a total of 50 times. "Our studies showed that after the immersion procedure, hands remained seven degrees warmer when exposed to cool air," says Dr. Hamlet. The results can last two years or longer, he adds.