Raynaud's syndrome. Treatment with sublingual administration of nitroglycerin, swinging arm maneuver, and biofeedback training

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Abstract
Sublingual (SL) administration of nitroglycerin, a swinging arm maneuver and biofeedback were evaluated for their effectiveness in decreasing hand rewarming time after ice immersion in 6 patients with Raynaud''s disease and 4 patients with Raynaud''s phenomenon. After ice immersion of their hands, 10 normal patients showed rewarming to baseline temperatures in < 6 min, while in 9 of 10 patients with Raynaud''s syndrome, rewarming took > 40 min. Two of ten patients with Raynaud''s syndrome showed rewarming in < 6 min after SL administration of nitroglycerin, while 8 of 10 patients with Raynaud''s syndrome showed rewarming in < 20 min after biofeedback training sessions. Six of the 10 still showed rewarming in 20 min or less 8 wk after the sessions were over. A swinging arm maneuver provided no objective improvement. SL administration of nitroglycerin provides a new alternative therapy for certain individuals. Effective biofeedback training can be learned in a relatively short time but should be reserved for the well motivated patient.

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