Formula Medical Group
Apple Valley, CA

James Krider, MD

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Cold hands and feet

The body adjusts to cold by altering circulation to maintain warmth for its vital organs. As a result, blood flow to the hands and feet diminishes, while blood flow to the body's core increases. Therefore, the hands and feet are more likely to become cold first. Wearing warm gloves and socks should prevent problems.

Sometimes chronic health problems cause cold hands or feet even indoors, leading to extreme reactions to even minor cold exposure. In rare cases, the coldness signals an emergency.

Causes of cold hands and feet

Severe anxiety and stress can trigger a variety of mechanisms in the body that disturb normal circulation. For example, if a stressful situation provokes Overbreathing (hyperventilation), the body may not get sufficient oxygen. Although it is uncommon, such anxiety — especially when provoked by a life-threatening event — can impair circulation to the extremities and cause cold hands and feet.

Buerger's disease
Buerger's disease is a peripheral vascular disorder also known as thromboangiitis obliterans. It affects small and medium-sized arteries and veins in the hands and feet. An inflammatory reaction occurs in the blood vessels, interfering with normal circulation. In addition to a cold sensation in the affected limbs, it may also make the skin bluish. If nerves are inflamed, pain may also occur. The disorder primarily affects men between the ages of 20 and 40 who smoke.

Carpal tunnel syndrome
This is a disorder in which the median nerve that serves the fingers becomes compressed in the wrist, causing hand pain, numbness, and a feeling of coldness.

Circulatory diseases
Any form of cardiovascular disease can interfere with circulation. When the peripheral circulation is diminished, it can result in a chronic sensation of coldness in the hands and feet.

Cyanosis is a bluish coloring of the skin caused by a lack of oxygen in the blood. Hands and feet also may be cold in the presence of cyanosis. It can be caused by respiratory and circulatory problems, and may be an initial symptom of congenital heart disease in infants. The sudden development of cyanosis, particularly in infants, may be a warning sign of medical emergency.

Prolonged cold exposure, or even shorter periods of exposure among persons who are in poor health or have compromised circulation, can lead to hypothermia and, eventually, frostbite. A milder reaction to cold exposure is sometimes called chilblains. Reactions usually start in the hands and feet, and progress from a cold sensation to an itching or burning sensation. Next, the skin becomes red and swollen. If frostbite is allowed to progress, blisters may form and break.

Pulmonary edema
Also known as wet lungs, pulmonary edema is a sudden and potentially life-threatening symptom of heart failure. Swollen lung tissue results from inefficient heart pumping action. It can also be caused by lung infections from pneumonia, chemical injuries, irritants, and some noxious gases such as sulfur dioxide and nitrogen oxide.

Raynaud's phenomenon
This is a disorder in which tiny arteries in the fingers and toes go into spasm, interfering with blood flow. The result can be painfully cold fingers and toes, and pale or bluish skin color. It may occur independently of other conditions, in which case it is known as Raynaud's disease. In other instances, it occurs as a secondary effect of other medical problems such as certain types of arthritis, cardiovascular disease, or primary pulmonary hypertension.

Rheumatic diseases
Several rheumatic disorders place people at greater risk of Raynaud's phenomenon. These include systemic lupus erythematosus, rheumatoid arthritis, and scleroderma. The reason for this association is not entirely clear, but inflammatory changes in the blood vessels seem to be involved.

Smoking cigarettes damages the blood vessels and interferes with normal circulation. It is not uncommon for heavy smokers to experience cold hands and feet and more marked reactions to cold weather. Smoking also contributes to the development of atherosclerosis and other circulatory problems.

Advice about cold hands and feet

If you have a chronic condition that predisposes you to cold hands and feet, you may avoid discomfort by taking the following steps:

  • Do not smoke.
  • In cold weather, consider wearing two layers of gloves and socks when going out. Wear thick soled shoes to limit contact with cold ground.
  • Avoid handling ice cubes and frozen foods.
  • Keep your home warm in winter. If the indoor temperature cannot be controlled, consider purchasing a thin pair of silk knit gloves to protect your hands.
  • Avoid wearing tight clothing or wrist bands that can impair circulation in surface blood vessels.
  • Improve overall general health with good nutrition and regular exercise.

This article was last reviewed October 19, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.

Artery Hardening
Arthritis, rheum
Bluish skin
Buerger's disease
Carpal Tunnel Synd
Congenital heart dis.
Congenital lung dis.
Heart failure, cong.
Poor hand circ.
Poor leg circ
Pulmonary hyperten
Repetitive Stress

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