Health: Out on a limb: the pain of Raynaud's

CURIOUSER and curiouser, I remember thinking, as I sat outside a pub in Dorset on a gloriously hot August afternoon, watching my left hand turn first white, then blue, then a livid shade of purple.

Over the next few weeks, I grew accustomed to these abrupt attacks of numbness, which were invariably followed by dramatic displays of colour. But it was not until six months later that I discovered what lay behind them; I had Raynaud's, a painful and potentially debilitating circulatory disorder.

People with Raynaud's are highly sensitive to temperature changes, which cause spasms in the small arteries of the fingers and toes, cutting off blood supply to the extremities. Opening a fridge door, or picking up a cold drink - even in summertime - can be a sufficient trigger. With the tissues starved of blood, ulcers develop which, in severe cases, can lead to gangrene and amputation.

Early diagnosis and treatment are important, particularly for patients for whom Raynaud's is secondary to a rarer and more serious disease, scleroderma. Yet there is still a high degree of ignorance, according to the Raynaud's and Scleroderma Association, which has just launched a national campaign to raise awareness.

The campaign, accompanied by striking black and white posters featuring a pair of hands with icicles hanging off them, is partly aimed at determining the prevalence of Raynaud's. Some estimate that it affects about 10 million people - nine-tenths of them women - in Britain, albeit in a mild form in most cases.

Among GPs, according to Anne Mawdsley, director of the association, there is still some reluctance to take Raynaud's seriously. "Doctors are better than they were in the past, but mainly because patients are asserting themselves more," she says.

My own experience, it seems, was fairly typical. The first specialist whom I saw warned me that my fingers would drop off if I wasn't careful, but said that all he could prescribe was a warm pair of gloves. A year on, under the care of a team at the Royal Free Hospital in London, I know better. Conventional drugs - namely vasodilators, which widen the arteries - can help, as can certain vitamins and supplements.

Only the symptoms can be treated, though. There is no cure for the condition, which is named after Maurice Raynaud, the French doctor who published a thesis about it in 1862. No cause has been identified either, although some believe that stress can be a factor.

Anne Mawdsley, who suffers from a particularly severe form of Raynaud's, described the pain that she experiences. "It's excruciating. It feels as if your fingers have been squeezed in a vice, or trapped in a car door. Picking up a milk bottle, or walking from one room to another, can be enough to shut the blood supply down."

For about 3,500 people in this country, Raynaud's is the first symptom of scleroderma, an auto-immune disease which affects the skin and internal organs, and can be fatal.

Warm hands are the often elusive goal for people with Raynaud's, but gloves alone are not sufficient. The association stresses the importance of keeping the rest of the body warm, and of eating hot food, taking regular exercise and using heating aids, such as hand warmers.

The Raynaud's and Scleroderma Association, 112 Crewe Road, Alsager, Cheshire, ST7 2JA, tel 01270 872776.

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