Your symptoms suggest Raynaud's disease.

This is a condition in which the blood vessels tighten (constrict) excessively. Doctors call this vasospasm. It usually happens in the fingers or toes (or both). It can be triggered by cold temperatures or emotional stress. In severe cases, these changes may be more constant (then we call it fixed vasospasm). Raynaud's is reversible. When warmed, the fingers return to normal.

Treatment for Raynaud's disease includes:

• Avoiding exposure to cold
  Use good gloves and hand warmers. Use cup insulators for cold beverages.
• Maintaining core temperature
  Bundle up before heading out the door. Turn up the thermostat a few degrees. It can make a big difference.
• Taking blood pressure pills to open blood vessels
  Calcium-channel blockers such as amlodipine or nifedipine are typically the first choice. If they are not effective or cause side effects, other options include hydralazine, losartan, or topical nitroglycerin ointment.
• Nerve blocks
  For severe cases, nerve blocks that interfere with the nerve signals that direct blood vessels to constrict may be effective.
• Taking newer drugs that show promise for Raynaud's disease
  Prostacyclin and sildenafil are currently approved for other conditions, but their ability to dilate blood vessels makes them potentially effective agents for Raynaud's Disease.

Raynaud's disease may be associated with scleroderma or other autoimmune diseases. If you also have severe heartburn or skin thickening over the fingers, for example, you could have an autoimmune condition as a contributor to Raynaud's disease.

Neck pain is a common symptom, especially among computer users. Muscle tension is often to blame. It's possible that a diseased blood vessel in your neck or upper arm might cause neck pain and contribute to vasospasm. Or, thyroid disease may cause neck pain and contribute to Raynaud's disease. However, these are remote possibilities. It's much more likely that your neck and hand symptoms are unrelated.

Raynaud's and Hardening of the Arteries Some people have a combination of vasospasm and another blood vessel disease. The most common one is atherosclerosis. This is the "hardening of the arteries," which can happen among people with various risk factors:

• Smoking
• Family history of atherosclerosis
• Diabetes
• High blood pressure
• High cholesterol

With atherosclerosis, deposits of cholesterol line the blood vessels throughout the body. This narrows the vessels and limits the flow of blood. Often there is inflammation in the vessels. This makes the vessels more prone to a sudden reduction in blood flow. When atherosclerosis and vasospasm occur together, it's important to treat both.

Treatment for atherosclerosis includes:

• Controlling blood sugar, blood pressure and cholesterol
• Aspirin
• Not smoking
• Medications called "beta blockers" (including metoprolol/Lopressor or atenolol/Tenormin; however, this type of drug may make Raynaud's disease worse)
• Surgery to open up or bypass the narrowed artery

See your doctor for an evaluation. It's important to review your symptoms in detail and have a detailed neurologic and vascular examination. Together, you and your doctor can decide on the best choice of treatment.