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40 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 7 education PATHOLOGY PERSPECTIVES Cold Hands, Warm Heart? Raynaud's Syndrome By Ruth Werner Do you want to build a snowman? Think about going outside to play in winter. As you pack that first snowball (glove-free, of course, so you can really feel it), your fingers turn pale, and your hands become numb and a bit clumsy. There's a good reason for this: your body is, very appropriately, directing blood away from your extremities and into your core. We see it in our face, too: we go pale as our blood is shunted inward. But after a while, we turn pink with new capillary dilation— this happens as the body tries to ensure the survival of our vulnerable superficial cells. It's a dynamic process that constantly weighs the risk of damage to superficial tissues and the priorities of keeping our organs warm. But what happens if that complicated response system is impaired? What if the initial vasoconstriction is so severe that some fingers turn starkly white, and then blue—the cyanosis marking the severe oxygen deprivation that is occurring—and then bright red, as the tiny blood vessels open up again and allow blood flow to return? This parade of white, to blue, to red skin—that is accompanied by variations of numbness and pain—is not a patriotic display. It is a sign of a condition called Raynaud's syndrome: a common, often inconvenient, and sometimes downright dangerous condition. RAYNAUD'S SYNDROME Raynaud's syndrome is surprisingly common: experts suggest it affects 5–10 percent of the population. Women have it more often than men, and it is most common among people in their 20s and 30s. Not everyone is sidelined by this condition, however, and it occurs on a broad continuum of severity. Someone with a mild case may never need medical treatment, but someone at the opposite end of the spectrum is at risk for losing a digit, or worse. And because about one out of every 20 people has occasional symptoms, the chances of it becoming an issue for massage therapists are fairly high.

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