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Talking about the Weather and Toes

Talking about the Weather and Toes

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“Don’t knock the weather.  If it didn’t change once in a while, nine out of ten people couldn’t start a conversation.”  ~Kin Hubbard

One thing about Utah is that the weather is crazy.  It’s unpredictable.  It’s interesting.  It can go from 60 degrees and sunny to 30 degrees and snowy in less than 24 hours.  Every winter I see patients with foot conditions associated with cold weather. This winter has seemed especially looooonnnnggg and chilly, which makes it more likely for people to suffer from a common foot problem that has ties to this cold weather.  It is a condition known as Raynaud’s disease, and 1 out of every 10 Americans suffer from it. 

In most patients Raynaud’s is more of an annoyance than a disability. Most people with Raynaud’s notice their toes turning colors.  In this condition the toes first turn white, then blue, then red.  Often just one or two toes or fingers are involved, and not everyone experiences all three colors.  These color changes can be associated with discomfort like tingling, burning, numbness, stinging, or throbbing.  The reason for this is that in Raynaud’s the small blood vessels that supply blood to your skin clamp down in response to cold temperatures or stress.

Raynaud’s can be broken up into two types, primary and secondary.  Both types are nine times as likely to affect women.  Primary Raynaud’s is the most common type and is not associated with any other type of disease.  This type is usually discovered between the ages of 15 and 30 and may have a genetic link (a parent, sibling or child may have it as well).  It occurs more in people who live in cold climates (think Utah from October or November to April or May).

Secondary Raynaud’s (aka Raynaud’s phenomenon) is associated with certain diseases, occupations, and chemicals.  Autoimmune diseases like Lupus, Scleroderma, Rheumatoid arthritis, and Sjogren’s syndrome are linked with Raynaud’s as are other conditions such as carpal tunnel and tarsal tunnel syndromes, and thyroid dysfunction.  Jobs that involve working with vibrating tools and repetitive motions like playing the piano for long periods of time can also cause this type of phenomenon.  Smoking and caffeine are also known triggers.   

Most of the time Raynaud’s can be treated by dressing warmly and avoiding situations in which your hands and feet come into direct contact with the cold.  Wearing a hat outside in the winter is important because a lot of body heat escapes through your head.  Wearing socks to bed and putting an extra blanket at the foot of the bed may help as well.  Avoiding caffeinated beverages, smoking and cold remedies such as pseudoephedrine may be recommended.  And then there’s everyone’s favorite recommendation: Moving to Hawaii or the Caribbean. 

Occasionally patients will develop blisters or sores on the tips of their toes.  Very rarely Raynaud’s can lead to gangrene and result in amputation.  If you think you may have Raynaud’s schedule a visit with Dr. Jeffrey Carlson at Tooele Medical Group Foot & Ankle Clinic.  He can help try to find the reason you have this condition whether it be smoking, your body’s response to stress, a compressed nerve, or an underlying autoimmune disease.  He can rule out causes of secondary Raynaud’s with vascular testing, blood tests, and nerve blocks.  You may be referred to a rheumatologist or your primary care physician if he feels your problem is serious enough that you could benefit from medication to open your blood vessels and promote circulation. 

Dr. Jeffrey Carlson can be reached at 435-843-3647. More information is available on his website at www.tooelefootandankle.com and you can follow his Facebook page Tooele Podiatrist, Dr. Jeff Carlson.