So first to JoAnn, ppl never pay attention about anything until they dont have to deal with it on "their own skin". So, I'm not surprised about what you're saying of ppl on forums. :)
Now to my post. From my understanding, the article is saying that superficially EM and Raynaud's may appear like completely different (oposite) conditions. One caused by vasodilatation and other by vasoconstriction. BUT that in cases when ppl having BOTH conditions, they don't stand like two different things, but are related. Means the worse your Raynaud's is, the worse will your EM get, simply like if the body is trying to "fix" the extreme cold by making it hot, but it kinda overreacts. That in these cases when patiens dealing with both conditions (EM is the more annoying one, no doubt about that) it helps (in my case it definitely does help) to treat the Raynaud's as a primary condition by using vasodilatators and that it simultaneously improve the EM. As they wrote "A mild vasodilator (to
prevent the original Raynaud’s phenomenon) can help some patients." (patients with both conditions)
It sounds very logical to me, tbh I always felt it this way, so for me the words I read were just reassuring information that I understand by body well.
Simply, if you have Raynaud's, Erythromelalgia can be just secondary to it. If you treat Raynaud's your EM goes away.
That's why my sympatectomy surgery (which dilates the small vessels) has such a possitive effect, despite I was more bothered by EM than Raynaud's before. "In erythromelalgia associated with Raynaud’s, the sufferer
does not necessarily notice the blanching of the digit or
limb but is merely aware of the hot burning extremity."
Using vasodilatators is definitely helpful in these cases. Let's call it EM secondary to Raynaud's.
I hope I wrote this at least a lil bit understandable, I'm not native English speaker, so sorry for this. :)
This all also means when you have EM secondary to Raynauds that every cooling down your extremities during the EM flare makes it all only worse, putting you into the vicious circle. The more cold the more hot follows. :)
For me this works on 100%. And dont forget it doesnt have to be just getting really cold and feeling really bothered by Raynaud's, in EM secondary to Raynaud's just chilly feet one day usually means burning feet in a close future. (the same day, the other, or even the next week.)