When should I worry about cold hands and feet in winter?

You might want to wrap up before stepping outside this week, as temperatures are set to plummet across the country.

The UK Health Security Agency has issued an amber cold health alert, which is in place for the North East, North West and Yorkshire and the Humber, while a yellow alert is in place for the rest of England between 12pm on Monday until 8am on Friday.

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

We spoke with Dr Sam Firoozi, consultant interventional cardiologist at HCA Healthcare UK’s The Harley Street Clinic, who explained why our hands and feet are particularly vulnerable to the cold weather and outlined the key warning signs that might indicate that it’s time to see a doctor.

“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,” explains 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?

Conditions such as Raynaud’s phenomenon involve 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 conditions associated with this.

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

In addition, patients can also experience Raynaud’s phenomenon as a result of 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,” explains 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, than I would seek medical advice,” advises 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 patient to track any changes.

“It can be very helpful to take photos of any changes with your smartphone,” recommends Firoozi. “If it’s a new pattern of abnormality, that should be discussed with your GP.”

What steps can individuals take to boost circulation and stay warm during the winter months?

“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 also 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.