Reasons Your Hands and Feet Feel Cold First — and What to Do About It

29. Sjogren’s Syndrome: The "Dry and Cold" Connection

Sjogren’s syndrome is an autoimmune condition primarily known for causing dry eyes and a dry mouth, but it frequently involves the vascular system in a way that leaves hands and feet perpetually chilled. In Sjogren’s, the body’s immune system attacks its own moisture-producing glands, but it also commonly triggers secondary Raynaud’s phenomenon. What makes this unique is that the inflammation can extend to the small blood vessels themselves (vasculitis), causing them to become thickened or narrowed. This physical change in the vessel wall, combined with an overactive nervous system response, creates a persistent state of low blood flow. If you experience cold extremities alongside gritty-feeling eyes, a persistent dry cough, or joint pain, it may point toward this systemic issue rather than simple sensitivity to temperature. Doctors diagnose Sjogren's through specific antibody blood tests (such as Anti-SSA and Anti-SSB) and occasionally a lip biopsy. Management involves systemic anti-inflammatory treatments and meticulous protection from cold to prevent tissue damage.

30. Complex Regional Pain Syndrome (CRPS): The Nerve-Vessel Misfire

Complex Regional Pain Syndrome (CRPS) is a chronic condition that usually develops after an injury, surgery, or stroke, but the subsequent pain is out of proportion to the original event. What makes it a unique cause of cold extremities is the "warm-to-cold" transition. In the "cold" stage of CRPS, the affected limb (usually a hand or foot) becomes significantly colder than the rest of the body due to severe, localized autonomic dysfunction. The nerves incorrectly signal the blood vessels to stay in a state of permanent, tight constriction. This results in skin that appears bluish or pale, feels icy to the touch, and may even show changes in hair or nail growth. Unlike standard circulation issues, CRPS is often accompanied by extreme sensitivity to touch and swelling. Doctors typically use a combination of physical exams and bone scans for diagnosis. Treatment often requires a multidisciplinary approach, including specialized physical therapy and nerve blocks, to "retrain" the nervous system to allow normal blood flow to return to the limb.