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Vibration White Finger » VWF and raynauds disease

Vibration White Finger (VWF) is a form of Raynauds Disease caused by vibration, usually through work. Raynauds disease is a syndrome where cold or emotion provokes narrowing of the blood vessels, dilation of the blood vessels and reperfusion (where parts of the body become inflamed and red). It takes its name from Maurice Raynaud, who first observed and described the condition in 1862.

During an attack, the arteries narrow and limit blood circulation to affected areas. There is a restriction in the blood supply to the extremities of the body, usually the fingers and toes but also the nose and the ears.

These body parts initially turn white and look dead (due to a spasm of arterioles) then blue (from pooling of deoxygenated blood in dilated venules) and then become inflamed and/or red (reperfusion). As Vibration White Finger develops, this process can accompanied by significant pain, numbness or a tingling sensation.

People suffering from Raynauds and Vibration White Finger have an exaggerated sensitivity to suddenly decreasing temperatures. A falling temperature can cause severe narrowing of the blood vessels which lasts much longer (sometimes hours) than the exposure to a cold temperature. Generally, episodes can last a few minutes, but in severe cases there can be multiple, prolonged episodes every day. People with Raynauds have an increase in vascular reactivity and there is increased incidence of angina and migraine.

You can have Raynauds without any disease being associated with it, in which case it is called Raynauds disease or primary Raynauds. It can also form part of another disease, in which case doctors may refer to it as Raynauds phenomenon or secondary Raynauds.

Causes of secondary Raynauds include: connective tissue disease; obstructive arterial disease; neurological disorders like carpal tunnel syndrome; and hyper-viscosity disorders like thrombosis.

How common is it?

Raynauds affects around five percent of the population, and ninety percent of sufferers have primary Raynauds. It is far more common in women than in men, with one in ten women affected, especially teenage women, and the disease is more common in colder climates.

Symptoms connected with primary Raynauds

  • Episodic, phasic colour changes (white, blue, red) affecting the fingers, toes or other extremities. People with Raynauds have described the colours they see as including purple, yellow, orange, black and grey
  • Pain, paraesthesia or discomfort
  • Reaction to cold or emotional stress
  • Migraines (an associated condition)
  • No secondary cause
  • No tissue necrosis or ulceration
  • Negative antinuclear antibody tests

Symptoms connected with secondary Raynauds

  • Skin rashes and photosensitivity
  • Dry eyes or mouth
  • Muscle weakness or pain
  • Swallowing difficulties
  • Breathlessness
  • Mouth ulcers
  • Onset at age 30 +
  • Episodes are intense, painful and asymmetrical
  • Clinical features suggest a connective tissue disease

A medical examination will include

  • Checking the peripheral pulses - for peripheral vascular disease
  • Checking the blood pressure in both arms - unequal blood pressure indicates proximal vascular occlusion
  • Neck examination: for visible or palpable cervical rib
  • Any signs suggesting connective tissue disease, alopecia (hair loss), altered skin texture, calcinosis (deposits of calcium in soft tissues) or telangiectasia (focal red lesions due to visible dilation of small blood vessels under the skin)
  • Trophic skin changes (due to poor blood supply) on the tips of the fingers or toes such as scarring, pitting or ulceration suggesting connective tissue disease

Treatment of Raynauds depends on how extreme the symptoms are and whether it is connected to any other illness.

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