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Winter weather is in full swing. Even though it’s cold outside, the thought of riding on the trainer can sometimes feel unbearable. Yet, riding outside and feeling like you’re freezing the entire time also sounds unappealing, especially if you’re someone who’s hands and feet (or both) hurt from the cold.
If you’ve ever experienced your fingers and toes becoming painful or completely numb, even when you’re wearing gloves or other thermal gear designed to keep you warm, you may have a condition called Raynaud’s. While numbers vary depending on the source, the Cleveland Clinic estimates that 1 in 20 people in the U.S. have this issue. Here’s how to recognize it and address it.
What is Raynaud’s?
Raynaud’s is a condition that affects the blood vessels, causing them to narrow, and this typically happens in the fingers and toes. When a person with Raynaud’s is exposed to cold temperatures or experiences emotional stress, that’s when blood vessels become smaller, which reduces the amount of blood that can reach the skin’s surface, according to Penn Medicine.
There are two different types of Raynaud’s.“Raynaud’s can either be primary or secondary. Primary Raynaud’s affects young people, women, and girls more commonly than men and boys. The onset can occur in late childhood through the late 20s,” says Christina Downey, M.D., associate professor of medicine and interim chief in the Division of Rheumatology at Loma Linda University in Loma Linda, California.
Primary Raynaud’s is not caused by an underlying medical condition so receiving a diagnosis can be especially challenging, considering there’s not really a root cause of the problem. Though primary Raynaud’s “may be uncomfortable, it is very unlikely to lead to any complications,” says Downey.
On the other hand, secondary Raynaud’s is more complex. “Secondary Raynaud’s is due to an underlying medical condition, mostly connective tissue diseases like scleroderma, inflammatory myositis, antiphospholipid syndrome, lupus, or mixed connective tissue disease,” says Downey. Secondary Raynaud’s could result in progressive, irreversible tissue damage.
A medical provider will help you determine whether you have primary or secondary Raynaud’s, based on symptoms, your medical history, and an exam.
How to Recognize Raynaud’s Symptoms
Hallmark signs of Raynaud’s include prolonged coldness of the affected area. According to Penn Medicine, it may take about 20 minutes for your fingers or toes to return to normal temperatures after cold exposure. The skin usually turns white, but sometimes may also change to blue or purple. Because blood flow is reduced in the extremities, the fingers and toes may have little to no sensation, making it difficult to shift gears or even wipe your face. You may also experience numbness and tingling sensations.
When you warm your hands and feet, you may experience redness of the skin, a stinging, burning, or throbbing sensation, or even swelling, according to the National Institutes of Health. Regardless of the area affected, symptoms may last from several minutes to a few hours.
Raynaud’s symptoms are most common in the hands and feet. However, they may also be present at the tip of the nose and ears, according to Elena Schiopu, M.D., director of clinical trials for the Division of Rheumatology at Augusta University Health in Augusta, Georgia. A Clinical Medicine Journal study confirmed that the lips and nipples can also be affected by Raynaud’s.
Risk Factors for Raynaud’s
Several studies and expert sources confirm that those assigned female at birth experience Raynaud’s more than those assigned male. While the cause is not 100 percent known, an often cited reason for this difference is estrogen. “There is without a doubt a significant hormonal effect on the blood vessels’ walls” explains Schiopu.
Hormones are only one factor in the Raynaud’s Rubix cube when it comes to women’s increased risk. “It is difficult to say [exactly] why women tend to get Raynaud’s more than men, but among other reasons, men’s basal metabolism is slightly more intense, so they may have a higher inner temperature,” says Schiopu.
Another risk factor for Raynaud’s is where you live. “People in northern countries are more affected than tropical ones,” Schiopu says.
It’s important to note that though many people experience the worst bouts of Raynaud’s during colder months, “Raynaud’s isn’t strictly related to cold, especially secondary Raynauds; it can occur spontaneously or as a result of stress,” says Downey.
Additionally, your hobbies or occupation may also influence your risk of Raynaud’s. A 2017 meta-analysis found that people working with pneumatic tools, such as vibrating chisels, drills, and hammers, have a nearly seven-fold risk of developing Raynaud’s, because of the blood vessel damage caused by the vibrations from this equipment.
Older research also says certain lifestyle factors may increase your risk. For example, higher levels of emotional stress, women who drink heavily, and men who smoke may have increased chances of developing Raynaud’s.
When to Seek Medical Treatment for Raynaud’s
For most people, Raynaud’s isn’t disabling, but it can affect your quality of life. Prolonged exposure to cold, especially during long rides, can cause irreversible damage. If your fingers or toes change from normal color to blue or white, you can’t rewarm them, or you lose pulse in your finger, Downey suggests seeking emergency care to prevent permanent loss of tissue.
Beyond serious symptoms, determining when to seek medical care can require more vigilance. Northern Virginia-based USA Cycling level 2 certified coach Jill Patterson, has lived with Raynaud’s symptoms since childhood. “[After] years of having slightly restricted circulation in my feet, plus these attacks time and again, I got chilblains [painful inflammation of small blood vessels]. I’ve gotten frostbite, and now I do not have good circulation [in my feet]. I could be in a hot shower and sweating like crazy and my feet are numb and white,” says Patterson.
Though Patterson’s symptoms align with primary Raynaud’s, she affirms that more prescriptive medical care may be necessary as her condition progresses.
In secondary Raynaud’s, the risks for tissue damage are higher and medical intervention should not be delayed. “[When] Raynaud’s is due to an underlying connective tissue disease, it can lead to autoamputation of digits if not treated properly. This [damage] will start with skin ulcerations around the fingertips or nailbed and progress to complete loss of digit tissue,” says Downey. This is when the damage becomes irreversible, so you want to seek care before that happens.
What to Know About Riding With Raynaud’s
To keep Raynaud’s symptoms at bay, lifestyle changes and preventive measures may be enough to keep you riding. Thermal or electric gloves, hand warmers, and warm socks can all provide insulation from cooler temperatures.
Keeping the extremities warm is essential because “during exercise, the body tries to [move] as much blood to the heart and muscles, ‘stealing’ it away from the periphery of the body (hands and feet), which are using a lot of oxygen to put up the type of physical performance cyclists need when they ride,” Schiopu says.
Patterson suggests wearing larger shoes to accommodate thick wool socks. “I [normally] wear a size 37, but my winter [cycling] shoes are size 38,” she says. Many riders may opt for winter riding boots. However, Patterson cautions that the inability to let air out may result in foot sweating. “Wet and cold do not mix. That’s one reason why I don’t like winter boots. You can’t adjust them,” she says. Instead, Patterson recommends “thick wool socks paired with really good shoe covers” to keep your feet warm and dry.
You also want to keep the rest of your body warm so you still get blood flow to the extremities. Dressing in layers helps to protect your core, while cycling hats pull double-duty by keeping your head and ears warm, and gaiters can provide insulation around the neck. Full-length or thermal bibs also help to keep your body warm, with many having relief points to prevent overheating.
While protecting yourself externally is important, some studies suggest that what you eat can also improve Raynaud’s symptoms. Schiopu suggests a diet rich in vitamins A and E, like avocado and carrots. Vitamin E helps to improve the health of blood vessels, while vitamin A has wound healing benefits to help with any damage to areas affected by Raynaud’s. Schiopu also suggests avoiding ultra processed foods.
When out for a ride, Patterson suggests breaking up solid foods or choosing liquid nutrition to keep blood flowing throughout the body and not straight to the gut to help you digest larger amounts of food. “It’s important to keep calories and carbs coming in to keep your body fueled,” she says. Patterson finds it best to break up a bar and eat it in three or four parts over the course of an hour or to opt for liquid nutrition to help with digestion.
In addition to staying fueling during your ride, postride care is also essential. When stopping at rest stops or finishing a ride, it is vital to rewarm affected areas carefully. Your first instinct may be to place your hands or feet as close to a heating source as possible. Resist the urge and slowly warm your skin to prevent tissue damage. According to an article by Fredrick Wigley, M.D., professor of medicine at the Johns Hopkins University School of Medicine, rubbing the hands together can restore blood flow to help alleviate symptoms.
If you are still cold after employing the measures above, it may be time to talk to your doctor. Medications can help to relax blood vessels to increase blood flow to the affected areas.
Raynaud’s can be painful and frustrating, but careful planning, preparation, and lifestyle modifications can help you to ride outside year round.
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