Hands and feet cold? You might assume poor circulation is to blame -- a reasonable thought but not neccessarily accurate. Women with completely normal circulation tend to have colder hands and feet than men. Several noncirculatory medical disorders, such as anemia and hypothyroidism, can also provoke this symptom. A visit to your healthcare provider is the first step to determine the cause of your cold hands and feet. If poor circulation is responsible, several measures might be recommended to improve blood flow in your extremities.
Peripheral artery disease (PAD) accounts for most cases of poor circulation in the hands and feet. The condition occurs due to fatty deposits called plaques in the arteries that impair blood flow to the extremities, possibly causing cold hands and feet and other symptoms. Approximately 75 percent of PAD is due to smoking, according to a 2004 "Reviews in Cardiovascular Medicine" article. If you smoke and have PAD, kicking the habit is the single most important step you can take to improve your circulation, symptoms and overall health. Similarly, it's important to avoid secondhand smoke. Smoking cessation will not complete reverse PAD but can lead to improvement, and slow or halt disease progression.
Eat a Heart-Healthy Diet
The levels of cholesterol and other fats in your blood influence the development and growth of plaques in the arteries, including those that supply your arms, legs and heart. Therefore, eating a heart-healthy diet is an important aspect of PAD treatment. General recommendations from the American Heart Association include:
- Limit saturated and trans fats.
- Eat a variety of fruits, vegetables, nuts and beans.
- Opt for whole rather than refined grains.
- Limit salt and sodium.
- Limit red meats.
- Eat fish at least twice per week.
- Limit sweets and sugar-sweetened beverages.
Your doctor may offer more specific recommendations based on your specific circumstances, such as whether you have diabetes or high blood pressure, or if you are carrying extra body weight.
Regular exercise helps improve your circulation via several interconnected mechansims. It enhances the performance of your circulatory system, including improved heart fitness and blood vessel responsiveness to changing oxygen demands. Exercise also helps with weight, blood pressure and cholesterol management, all of which can contribute to PAD. Depending on the severity of the disease, your doctor might recommend supervised exercise with a physical therapist or a home exercise program.
The arteries of your extremities normally constrict when exposed to cold temperature to conserve body heat. This natural response can further limit blood flow in the setting of existing poor circulation. Keeping your hands and feet warm with gloves, mittens, socks and footwear appropriate for the weather can help prevent this situation.
Massage therapy may temporarily improve blood flow to your extremities. A small study conducted among 36 healthy but sedentary young adults demonstrated improved blood flow for up to 72 hours after 30 minutes of Swedish massage, as reported in the June 2014 issue of the "Archives of Physical Medicine and Rehabilitation." Additional research is needed to determine whether these benefits also occur in people with PAD. In the meantime, you might consider massage therapy as part of your treatment plan if your healthcare provider determines that it is safe for you.
Your doctor might recommend one or more medications, depending on your individual circumstances. Per guidelines from the American College of Cardiology and American Heart Association, these might include:
- Blood thinner treatment with aspirin and/or clopidogrel (Plavix)
- Cholesterol therapy with a statin medication
- Blood pressure medication, if indicated
- Diabetes medication, if indicated
- Cilostazol, a medication that dilates blood vessels
Surgery or a procedure to reestablish adequate blood flow may be recommended for people with severe PAD.
Talk with your doctor if you have questions or concerns about your treatment. Seek immediate medical care if you develop any warning signs or symptoms in one of your hands or feet, including:
- Sudden, severe pain
- Extremely cold skin, significantly cooler than the other hand or foot
- Very pale, mottled or bluish skin coloration
- Loss of sensation or paralysis
- A wound that is enlarging or not healing
Reviewed and revised by: Tina M. St. John, M.D.
- Cochrane Database of Systematic Reviews: Exercise for Intermittent Claudication
- Evidence-Based Complementary and Alternative Medicine: Connective Tissue Reflex Massage for Type 2 Diabetic Patients with Peripheral Arterial Disease: Randomized Controlled Trial
- Circulation: 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
- The Lancet: Cold Hands, Warm Heart
- Reviews in Cardiovascular Medicine: The Relationship of Cigarette Smoking to Peripheral Arterial Disease
- American Heart Association: Diet and Lifestyle Recommendations
- Archives of Physical Medicine and Rehabilitation: Massage Therapy Restores Peripheral Vascular Function After Exertion