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

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 six patients with Raynaud's disease and four patients with Raynaud's phenomenon. After ice immersion of their hands, ten normal patients showed rewarming to baseline temperatures in less than six minutes, while in nine of ten patients with Raynaud's syndrome, rewarming took more than 40 minutes. Two of ten patients with Raynaud's syndrome showed rewarming in less than six minutes after SL administration of nitroglycerin, while eight of ten patients with Raynaud's syndrome showed rewarming in less than 20 minutes after biofeedback training sessions. Six of the ten still showed rewarming in 20 minutes or less eight weeks after the sessions were over. A swinging arm maneuver provided no objective improvement. Sublingual 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.