Raynaud's disease is more than simply having cold hands and cold feet, and it's not the same as frostbite. Signs and symptoms of Raynaud's depend on the frequency, duration and severity of the blood vessel spasms that underlie the disorder.

Signs and symptoms include:

1. Sequence of color changes in your skin in response to cold or stress
2. Numb, prickly feeling or stinging pain upon warming or relief of stress

At first during an attack of Raynaud's, affected areas of your skin usually turn white. Then, the areas often turn blue and feel cold and numb, and your sensory perception is dull. The affected skin may look slightly swollen. As circulation improves, the affected areas may turn red, throb, tingle or swell. The order of the changes of color isn't the same for all people, and not everyone experiences all three colors.

Occasionally, an attack affects just one or two fingers or toes. Attacks don't necessarily always affect the same digits. Although Raynaud's most commonly affects your fingers and toes, the condition can also affect other areas of your body such as your nose, cheeks, ears and even tongue. An attack may last less than a minute to several hours. Over time, attacks may grow more severe.

People who have Raynaud's accompanied by another disease may also have symptoms related to their underlying condition.

Doctors don't completely understand the cause of Raynaud's attacks, but blood vessels in the hands and feet appear to overreact to cold temperatures or stress.

When your body is exposed to cold temperatures, your extremities lose heat. Your body slows down blood supply to your fingers and toes to preserve your body's core temperature. Your body specifically reduces blood flow by narrowing the small arteries under the skin of your extremities. In people with Raynaud's, this normal response is exaggerated.

Stress causes a similar reaction to cold in the body, and likewise the body's response may be exaggerated.

With Raynaud's, arteries to your fingers and toes go into what's called vasospasm. This constricts the vessels, dramatically but temporarily limiting blood supply. Over time, these same small arteries may also thicken slightly, further limiting blood flow. The result is that affected skin turns a pale and dusky color due to the lack of blood flow to the area. Once the spasms subside and blood returns to the area, the tissue may turn red before returning to a normal color.

Cold temperatures are most likely to provoke an attack. Exposure to cold can be as simple as putting your hands under a faucet of running cold water, taking something out of the freezer or exposure to cold air. For some people, exposure to cold temperatures isn't necessary. Emotional stress alone can cause an episode of Raynaud's.

Some researchers are studying whether Raynaud's may be partly an inherited disorder.

Raynaud's occurs in two main types:

Primary Raynaud's

This is Raynaud's without an underlying disease or associated medical problem that could provoke vasospasm. Also called Raynaud's disease, it's the most common form of the disorder. Primary Raynaud's typically affects the digits of both hands and both feet.

Secondary Raynaud's

This is Raynaud's caused by an underlying problem. Also called Raynaud's phenomenon, secondary Raynaud's usually affects both of your hands or both feet. Although secondary Raynaud's is less common than the primary form, it's often a more complex and serious disorder.

Causes of secondary Raynaud's include:

• Scleroderma
• Lupus
• Rheumatoid arthritis
• Sjogren's syndrome
• Diseases of the arteries
• Carpal tunnel syndrome
• Repetitive trauma
• Smoking
• Certain medications
• Chemical exposure
• Other causes

Primary Raynaud's mainly affects women. Although anyone can develop the condition, women between the ages of 15 and 40 are most often affected.

Raynaud's disease affects a small percentage of Americans, approximately 5 to 10% of the general population and every 4 in 10,000 Canadians.

It's more common in people who live in colder climates.

Risk factors for secondary Raynaud's include associated diseases, such as scleroderma and lupus, and smoking.

People in certain occupations, such as workers who operate tools that vibrate, also may be more vulnerable to secondary Raynaud's.

The first and most important action is to warm your hands or feet or any other affected areas of skin. The following steps can help you gently warm your fingers and toes:

- move to a warmer area
- place your hands under your armpits
- wiggle your fingers and toes
- make wide circles, or windmills, with your arms
- run warm (not hot) water over your fingers and toes
- massage your hands and feet

It is extremely difficult to get my hands or feet feeling warm. I often put a warm water bottle on my feet covered with a light blanket and often have to wear warm gloves when working on my computer.

I remember the first time my feet were so cold and I couldn't get them warm. This was many years ago and didn't even realize I had Raynaud's. Anyhow, I jumped into a hot bath to warm up! Yikes, don't ever do that, it is extremely painful!