NFCI (for medical professionals)

What is NFCI?  

NFCI is caused by prolonged exposure to cold and often cold/wet conditions (up to about 15 °C) and usually affects the hands and/or feet. The tissue does not freeze, but it is thought that the prolonged vasoconstriction causes damage to the small sensory nerves and blood vessels. Although NFCI is a more common problem in the military, it can also occur in civilians exposed to the cold e.g. if they are undertaking outdoor activities, are homeless or become incapacitated (e.g. the elderly). 

What are the symptoms of NFCI?

The symptoms of NFCI vary between individuals both in phenotype and severity. The long-term symptoms of NFCI most commonly seen are persistent pain, impaired sensory perception and cold sensitivity. In some cases, hyperhidrosis (sweating in the injured tissue) may also be present.

The most bothersome problems associated with NFCI are neuropathic pain and cold sensitivity. Neuropathic pain typically presents as hypoaestheisa or anaesthesia and dysaesthesia, rarely when normothermic, but commonly in association with cold sensitivity. Cold sensitivity may be experienced as neuropathic symptoms on exposure to cold/wind, or as an unusually quick peripheral cooling, or a mixture of both. 

NFCI is more common in the digits but, unlike Raynaud’s Phenomenon, can affect the whole hand and foot. Some patients may experience both NFCI and Raynaud’s and of course Raynaud’s may be confused with NFCI as it can appear for the first time during a significant cold exposure; Hand-Arm Vibration Syndrome (HAVS) may also co-exist.