10-Physical therapy for Raynaud’s disease (1).pdf

Physical therapy for Raynaud’s disease Raynaud's disease or phenomenon • Episodic spasm of small arteries and arterioles. • Abnormal vasoconstrictor reflex exacerbated by exposure to cold or emotional stress; tips of fingers develop pallor, cyanosis, numbness and tingling. • Typically, the fingers...

Physical therapy for Raynaud’s disease Raynaud's disease or phenomenon • Episodic spasm of small arteries and arterioles. • Abnormal vasoconstrictor reflex exacerbated by exposure to cold or emotional stress; tips of fingers develop pallor, cyanosis, numbness and tingling. • Typically, the fingers, and less commonly the toes, are involved. Rarely, the nose, ears, or lips are affected • Affects largely female . Types of Raynaud's disease • Primary Raynaud's (Raynaud’s disease) the cause is unknown. • Secondary Raynaud's (Raynaud’s Phenomenon) due to: • a connective tissue disorder, such as scleroderma or lupus, • injuries to the hands. • Smoking and thyroid problems. • birth control pills. • Diagnosis is typically based on the symptoms. Risk factors for Secondary Raynaud's • Exposure to vibration from tools like rock drillers. Vibration from such tools may also damage nerves, muscles, joints of hands. • Typists and pianists • Gripping hand tools too tightly Signs and symptoms 1. When exposed to cold temperatures, the blood supply, is markedly reduced; the skin turns pale or white and becomes cold and numb. 2. When the oxygen supply is depleted, the skin color turns blue (called cyanosis). 3. These events are episodic, and when the episode subsides or the area is warmed, the blood flow returns, and the skin color first turns red (rubor), and then back to normal, often accompanied by swelling, tingling, and a painful "pins and needles" sensation. Physical therapy program -Strengthening exercises -Electrical stimulation -Assistive devices -Hydrotherapy Strengthening exercises Grip stick 5 Hand Grip Inverted Hand Grip Therapy Putty Resist A-Band Cando Hand Exercise Web • Range of motion and muscle power exercises . • Connective Tissue Manipulation, gentle massage of connective tissues can improve blood circulation to the affected area and decrease anxiety. • superficial lymph drainage: • superficial lymph drainage is slow, delicate, rhythmical stretching of the tissues, which stimulates contraction of the lymphatic vessels, propels lymph through the collapsible superficial lymphatic system, increases local blood flow. Hydrotherapy • Hydrotherapy in the form of a whirlpool or other pool therapy may also be helpful. It has been used to treat arthritis and joint injuries or replacements. It has also been used to relieve pain, support wound healing, and help with various neurological disorders. Physical training in warm water was well tolerated and seems to improve exercise capacity as well as muscle function in small muscle groups in older patients with chronic heart failure. (Cider et al., 2003) Whirlpool tank Electrical stimulation • Transcutaneous Electrical Nerve Stimulation(TENS): • pain relieving • stimulates the blood flow throughout the body, particularly in the treated area Life-style changes • Life-style changes including; staying warm, keeping the hands and fingers covered in cold weather, layered clothing, coats, heavy socks. • Relaxation techniques to treat stress and anxiety. • Calcium channel blockers are the most effective treatment for Raynaud's phenomenon. • Patients who do not tolerate or fail to respond to calcium channel blocker therapy can try other vasodilator drugs alone or in combination. • Chemical or surgical sympathectomy has been reported to be effective in relief of symptoms for very severe, unmanageable cases, however, results of this therapy may be short-lived.