Cold hands and feet? Here are the steps you can take to boost circulation during the winter

Hands and feet are vulnerable in winter, but if they are persistently ‘frozen’, it could signal a serious condition

Several underlying medical conditions can present as prolonged cold extremities. Picture: iStock

You might want to wrap up before stepping outside this week, as temperatures drop and winter sets in.

When the air turns much colder, it’s normal for your hands and feet to feel chilly, but if they stay cold it may be a sign of something more serious.

Consultant cardiologist Dr Sam Firoozi explains why our hands and feet are particularly vulnerable to the cold and outlines the key warning signs that might indicate that it’s time to see a doctor.

What happens to our hands and feet during cold weather?

“The blood circulation to the hands and feet is regulated by the autonomic nervous system, which is an involuntary nervous system that we all have,” says Firoozi. 

“Its job is to open up the arteries (vasodilation) to encourage more blood flow in warmer weather. 

"Conversely, in the colder weather, this system constricts the small blood vessels in the peripheries [such as our hands and feet] to restrict blood flow (vasoconstriction) to the edges in order to maintain heat and maintain body temperature.”

Which medical conditions can lead to unusually cold extremities?

Raynaud’s phenomenon involves an exaggerated response of the autonomic nervous system.

“Raynaud’s phenomenon is a situation where that constriction in response to cold environments is very much exaggerated,” says Firoozi. “Not only is the circulation poorer, but in some cases circulation can completely shut down, causing white or blue discolouration in the fingertips, which can be very painful.”

There are also other associated conditions.

“The conditions that are typically associated with Raynaud’s include scleroderma, rheumatoid arthritis, and SLE [systemic lupus erythematosus], which is an autoimmune condition,” says Firoozi.

In addition, patients can also experience Raynaud’s phenomenon from a limb injury.

“Patients with a nerve injury to their arms can experience very bizarre autonomic responses, where, actually, it can vary from going to complete vasoconstriction, followed by extreme vasodilation,” says Firoozi. “This can cause limbs to go blue and white and then become bright pink, and can be very painful.”

Furthermore, certain medications can also trigger Raynaud’s.

“Beta blockers, a type of cardiac medication, have been associated with Raynaud’s, because they block that sympathetic receptor,” says the cardiologist.

What warning signs should you see a doctor about?

“In really cold weather, we all have experiences of numb fingertips, but if you experience extreme discolouration, which takes a long time to correct, then I would seek medical advice,” says Firoozi.

“For most of us, everything returns back to normal after a minute or two, but in patients with Raynaud’s, it can take a long time.

“If you get permanent discolouration or a change in the appearance of your fingertips or nails, that’s not normal.”

Pain is also a red flag.

“Initially, it can feel like a burning pain, associated with numbness, and then it can be a really painful throbbing-like pain,” says Firoozi.

The cardiologist also encourages patients to track any changes.

“It can be very helpful to take photos of any changes with your smartphone,” says Firoozi.

“If it’s a new pattern of abnormality, that should be discussed with your GP.”

What steps can we take to boost circulation during the winter?

“Keep your hands warm in gloves or your pockets,” advises Firoozi. “There are also gels that you can warm up in the microwave and then hold in your pocket. In addition, you can get special gloves, which have heaters in them.”

Meanwhile, patients with Raynaud’s are sometimes prescribed medication, especially if their symptoms are severe.

“Some patients might need medication that can actually open up arteries in the peripheries, such as calcium blockers,” says Firoozi.

Surgery is also an option in extreme cases. 

“People can have an operation where the sympathetic nerve that supplies the peripheries is deliberately surgically destroyed or resected to prevent Raynaud’s phenomenon from happening,” says Firoozi.