Non-drug based treatments Conservative approaches to treatment aim to reduce exposure to triggers, such as cold and emotional stress. Advise the patient to try to keep warm, perhaps by using hand and feet warmers, which are commercially available. The frequency and severity of attacks can be reduced by avoiding dramatic changes in environmental temperature and taking steps to reduce occupational cold exposure. Vasodilation can be increased during attacks by rotating the arms in a windmill pattern, placing the hands under warm water or in a warm body fold such as the axilla, and performing the swing arm manoeuvre(raising both arms above the shoulders and forcefully swinging them across the body to generate a force that promotes blood flow distally to thefingers).12Another simple tipis to avoid