context: Raynaud's phenomenon consists of spasms of the small arteries of the fingers and sometimes the toes, brought on by exposure to cold or stress. Certain occupational exposures bring on Raynaud's. The episodes produce a temporary lack of blood supply to the area, causing the skin to appear white or bluish and feel cold or numb. In some cases, the symptoms of Raynaud's may be related to underlying diseases such as lupus, rheumatoid arthritis, and scleroderma. Buerger's disease most commonly affects the small- and medium-sized arteries and veins. Although the cause is unknown, there is a strong association with tobacco use or exposure. The arteries of the arms and legs become narrowed or blocked, causing lack of blood supply (ischemia) to the fingers, hands, toes and feet. Pain occurs in the arms, hands and, more frequently, the legs and feet, even when at rest. With severe blockages, the tissue may die (gangrene), requiring amputation of the fingers and toes. Superficial vein inflammation and symptoms of Raynaud's occur commonly in people with Buerger's disease. Veins are flexible, hollow tubes with flaps inside called valves. When your muscles contract, the valves open and blood moves through the veins. When your muscles relax, the valves close, keeping blood flowing in one direction through the veins. If the valves inside your veins become damaged, the valves may not close completely. This allows blood to flow in both directions. When your muscles relax, the valves inside the damaged vein(s) will not be able to hold the blood. This can cause pooling of blood or swelling in the veins. The veins bulge and appear as ropes under the skin. The blood begins to move more slowly through the veins, it may stick to the sides of the vessel walls and blood clots can form. Peripheral vascular disease ( PVD) or peripheral arterial disease ( PAD) is sometimes called âpoor circulation.â It usually refers to the narrowing of arteries in the legs, causing less blood flow to the muscles. PAD can also affect the arms, stomach and neck. It is caused by atherosclerosis of the arteries (cholesterol plaques causing hardening and narrowing of the artery) due to high cholesterol, diabetes, smoking, high blood pressure, inactivity and obesity. The most common symptom of PAD of the legs is claudication, which is pain occurring while walking and relieved with rest. You may also feel cramping or a tiredness in the leg or hip muscles while walking. Varicose veins are bulging, swollen, purple, ropy veins, seen just under your skin, caused by damaged valves within the veins. They are more common in women than men and often run in families. They can also be caused by pregnancy, being severely overweight, or by standing for long periods of time. The symptoms include: Bulging, swollen, purple, ropy, veins seen under the skin Spider veins -- small red or purple bursts on your knees, calves, or thighs, caused by swollen capillaries (small blood vessels) Aching, stinging, or swelling of the legs at the end of the day Blood clots in the veins are usually caused by: Long bed rest and/or immobility Damage to veins from injury or infection Damage to the valves in the vein, causing pooling near the valve flaps Pregnancy and hormones (such as estrogen or birth control pills) Genetic disorders Conditions causing slowed blood flow or thicker blood, such as congestive heart failure ( CHF) or certain tumors There are many types of blood clots that can occur in the veins: Deep vein thrombosis ( DVT) is a blood clot occurring in a deep vein. Pulmonary embolism is a blood clot that breaks loose from a vein and travels to the lungs. Chronic venous insufficiency isn't a blood clot, but a condition that occurs when damaged vein valves or a DVT causes long-term pooling of blood and swelling in the legs. If uncontrolled, fluid will leak into the surrounding tissues in the ankles and feet, and may eventually cause skin breakdown and ulceration. Blood clotting disorders are conditions that make the blood more likely to form blood clots in the arteries and veins. These conditions may be inherited (congenital, occurring at birth) or acquired and include: Elevated levels of factors in the blood which cause blood to clot (fibrinogen, factor VIII, prothrombin) Deficiency of natural anticoagulant (blood-thinning) proteins (antithrombin, protein C, protein S) Elevated blood counts Abnormal fibrinolysis (the breakdown of fibrin) Abnormal changes in the lining of the blood vessels (endothelium) The lymphatic system is a circulatory system that includes an extensive network of lymph vessels and lymph nodes. The lymphatic system helps coordinate the immune system's function to protect the body from foreign substances. Lymphedema is an abnormal build-up of fluid that causes swelling, most often in the arms or legs. Lymphedema develops when lymph vessels or lymph nodes are missing, impaired, damaged or removed. Primary lymphedema is rare and is caused by the absence of certain lymph vessels at birth, or it may be caused by abnormalities in the lymphatic vessels. Secondary lymphedema occurs as a result of a blockage or interruption that alters the lymphatic system. Secondary lymphedema can develop from an infection, malignancy, surgery, scar tissue formation, obesity, trauma, deep vein thrombosis ( DVT), radiation or other cancer treatment. Symptoms may include: Pain or heaviness in the area affected Numbness, weakness, or a tingling in the affected area Therapies to treat vascular pain can include medications, angioplasty, or bypass surgery. Angioplasty is a procedure to reduce or eliminate blockages in blood vessels. In bypass surgery, surgeons take a segment of a healthy blood vessel from another part of the body and make a detour around the blocked blood vessel. Doctors who specialize in pain management can sometimes help if other treatments don't work. For some people, nerve blocks and other techniques can reduce pain and improve circulation.