Raynaud's disease - Wokingham, Berkshire

On this page

1. Overview
2. Symptoms
3. Causes
4. Raynaud's in Chinese medicine
5. Acupuncture for Raynaud's disease
6. Moxibustion for Raynaud's disease
7. Chinese herbal medicine for Raynaud's disease
8. Self-care tips
9. Treatment at my clinic
10. Frequently asked questions
11. References

1. Overview

Raynaud’s disease (also called Raynaud’s phenomenon or Raynaud’s syndrome) is a condition characterised by episodes of exaggerated vasospasm — sudden contraction of the small blood vessels supplying the fingers and toes — in response to cold temperatures or emotional stress. During an attack, blood flow to the extremities is severely reduced, causing the characteristic colour changes and discomfort that define the condition. It affects approximately 3–5% of the global population and is significantly more common in women than men. It occurs more frequently in cold climates and during winter months.

In western medicine, there are two types. Primary Raynaud’s, sometimes called primary Raynaud’s disease, occurs when there is no identifiable underlying cause and is the most common form. Secondary Raynaud’s, also called Raynaud’s phenomenon, occurs as a result of another condition — most commonly an autoimmune or connective tissue disorder such as systemic sclerosis (scleroderma), lupus, or rheumatoid arthritis. In traditional Chinese medicine (TCM), the underlying pattern driving the attacks is always identifiable and guides treatment directly.

Acupuncture and moxibustion are effective treatments for Raynaud’s disease, reducing the frequency and severity of attacks by improving peripheral circulation, warming the channels and addressing the underlying TCM patterns. A systematic review and meta-analysis published in Acupuncture in Medicine (2023) confirmed that acupuncture is associated with increased remission incidence, a decreased daily number of attacks, and improved cold stimulation test outcomes in people with Raynaud’s syndrome.

2. Symptoms

Raynaud’s disease produces a characteristic sequence of colour changes in the affected extremities, most commonly the fingers and toes, though the ears, nose, lips and nipples can also be affected. Attacks are typically triggered by cold exposure or emotional stress and can last from a few minutes to several hours. The classic triphasic colour change proceeds as follows:

1. White (pallor) phase — the initial ischaemic phase, when arterial spasm cuts off blood supply to the digits; the fingers or toes turn white (pallor) and may feel numb, cold and heavy; this is the most diagnostically characteristic phase
2. Blue (cyanosis) phase — as oxygen in the residual blood in the capillaries is depleted, the digits turn blue (cyanosis); there may be aching, throbbing or pain as deoxygenation progresses
3. Red (reactive hyperaemia) phase — when the vasospasm resolves and blood flow returns, reactive arteriolar dilation produces a flushed, red colour in the affected digits; this phase is often accompanied by throbbing, tingling, burning or pins and needles as circulation is restored

Additional symptoms in Raynaud’s disease include cold hands and feet even outside of acute attacks, numbness and reduced sensation in the fingers, pain and tenderness in the digits during attacks, and in severe or long-standing secondary cases, skin changes or digital ulcers. Emotional stress and anxiety are well-established triggers alongside cold, and managing these co-morbidities is an important part of comprehensive treatment.

3. Causes

Raynaud’s disease arises from an exaggerated vasospastic response in the peripheral vascular system. The precise mechanisms differ between primary and secondary forms:

1. Primary Raynaud’s — idiopathic vasospasm — in primary Raynaud’s, the cause is an intrinsic hypersensitivity of the digital arterial smooth muscle to vasoconstrictive stimuli; the small digital arteries overreact to cold or sympathetic nervous system activation (triggered by stress or emotion), producing sudden, severe vasospasm that is disproportionate to the stimulus. The underlying mechanism involves abnormal sympathetic innervation of digital vessels, altered endothelial function and dysregulation of vasoactive mediators including serotonin, endothelin and nitric oxide
2. Secondary Raynaud’s — associated conditions — secondary Raynaud’s occurs as a manifestation of another condition that structurally or functionally compromises the digital vessels or the autonomic regulation of peripheral circulation. The most common associations are autoimmune connective tissue disorders (systemic sclerosis/scleroderma, lupus erythematosus, mixed connective tissue disease, Sjögren’s syndrome, dermatomyositis), rheumatoid arthritis and hypothyroidism
3. Cold exposure — the most universal trigger for attacks; even mild cold (such as reaching into a refrigerator or going out on a cool day) can provoke an attack in sensitive individuals; the central thermoregulatory response to whole-body cooling also triggers digital vasospasm even without direct local cold exposure
4. Emotional stress and anxiety — sympathetic nervous system activation during stress or anxiety releases catecholamines that cause vasoconstriction; because the digital vessels in Raynaud’s are hypersensitive to sympathetic stimulation, emotional events reliably trigger attacks; this explains why managing stress is an important component of treatment
5. Smoking — nicotine causes direct vasospasm and impairs endothelial nitric oxide production, worsening peripheral circulation; smoking is both a trigger for individual attacks and a contributor to the underlying vascular damage that drives the condition
6. Medications and occupational factors — certain medications can precipitate or worsen Raynaud’s, including beta-blockers, ergotamine preparations, some chemotherapy agents and stimulant medications; repeated vibration from tools or instruments (vibration white finger) can cause secondary Raynaud’s through direct vascular damage; caffeine and alcohol affect peripheral vascular tone

4. Raynaud's disease in Chinese medicine

In traditional Chinese medicine, Raynaud’s disease is described as Jue (afflux) or Jue Ni (counter-afflux) in the ancient medical texts — a pathologic obstruction or reversal of Qi and Blood flow in the extremities, most commonly arising from Cold invading the channels when the body’s Yang Qi is insufficient to warm and move the Blood to the fingers and toes. The condition is always understood to have an identifiable underlying pattern, which guides the precise selection of treatment. The most common TCM patterns in Raynaud’s disease are:

1. Kidney Yang deficiency with cold extremities — the most fundamental pattern underlying primary Raynaud’s in TCM; the Kidney Yang is the root of all Yang in the body — the warming, activating force that drives circulation to the extremities and maintains peripheral warmth; when Kidney Yang is deficient, the warming force fails to reach the fingers and toes, and Cold (Kidney Yin) fills the void, producing the cold, pale, numb extremities of Raynaud’s; constitutional Yang deficiency is often associated with a general sensitivity to cold, fatigue, low libido and a deep, weak pulse. Treatment tonifies Kidney Yang using GV4 (Mingmen, the “Gate of Life”), CV4 (Guanyuan), KI3 (Taixi), KI7 (Fuliu) and BL23 (Shenshu) with strong moxibustion
2. Cold invading the channels — Blood stagnation in the collaterals — the most important pattern driving the acute vasospastic attacks of Raynaud’s; when external Cold invades the channels of the hands and feet (the San Jiao/Triple Warmer, Pericardium, Large Intestine, Small Intestine, Bladder and Kidney channels all pass through the digits), it constricts the channels and collaterals, preventing Qi and Blood from flowing freely to the extremities; the resultant stagnation produces the white, blue and then red colour sequence of a Raynaud’s attack as the channels are obstructed, Blood stagnates and then surges back when the Cold is expelled. This pattern is worsened by cold weather and improved by warmth, precisely mirroring the clinical behaviour of Raynaud’s. Treatment warms the channels, expels Cold and moves Blood in the collaterals
3. Liver Qi stagnation transforming to channel Cold — the pattern underlying stress-triggered Raynaud’s attacks; in TCM, the Liver governs the smooth flow of Qi through all channels and regulates the emotional life; when emotional stress, frustration or suppressed emotions cause Liver Qi to stagnate, the free flow of Qi and Blood throughout the body is impaired, and the peripheral channels — already vulnerable to Cold — become more easily obstructed; the Liver channels run through the hands and feet and their stagnation contributes directly to the digital vasospasm of stress-triggered attacks. Treatment spreads Liver Qi, calms the Shen and warms the peripheral channels
4. Heart Yang and Qi deficiency — the Heart governs the Blood and controls the circulation throughout the entire body; when Heart Yang and Qi are deficient, the driving force behind peripheral circulation is weakened and Blood fails to reach the extremities adequately; this pattern produces cold hands and feet, palpitations, fatigue and a pale face alongside the Raynaud’s attacks. Treatment tonifies Heart Yang and Qi using CV14 (Juque), HT7 (Shenmen) and PC6 (Neiguan) with moxibustion
5. Blood deficiency with malnourished channels — in women in particular, Blood deficiency (from heavy menstruation, post-partum depletion, or constitutional insufficiency) leaves the channels insufficiently nourished and the extremities without adequate warmth and supply; the channels, being empty, are more easily invaded by Cold; this pattern often coexists with the Kidney Yang or Liver Qi patterns and produces thin, brittle nails, dry skin on the fingers, and poor colour recovery after attacks. Treatment nourishes Blood, warms the channels and supports circulation

5. Acupuncture for Raynaud's disease

Traditional acupuncture effectively reduces the frequency and severity of Raynaud’s attacks by improving peripheral circulation, regulating sympathetic vasomotor tone and addressing the underlying TCM patterns driving the condition. Acupuncture works to treat Raynaud’s through several complementary mechanisms:

1. Modulating sympathetic nervous system activity to reduce the exaggerated vasoconstrictive response to cold and emotional stress — the core mechanism driving Raynaud’s attacks; acupuncture at points such as LI4 (Hegu), PC6 (Neiguan), ST36 (Zusanli) and SP6 (Sanyinjiao) have well-documented vasodilatory and autonomic regulatory effects
2. Stimulating the release of endorphins and vasoactive neuropeptides (including calcitonin gene-related peptide, CGRP) that produce local vasodilatation in the peripheral vessels of the hands and feet, directly counteracting the vasospasm of Raynaud’s attacks
3. Reducing circulating levels of vasoconstrictive mediators including serotonin and endothelin that contribute to digital arterial spasm, whilst supporting nitric oxide-mediated vasodilation in the endothelium
4. Improving the microcirculation and capillary blood flow in the nailfold capillaries of the digits, directly addressing the reduced peripheral perfusion that causes the pallor, cyanosis and pain of Raynaud’s attacks
5. Reducing co-morbid stress, anxiety and emotional tension that trigger attacks via sympathetic activation; calming the Shen and regulating the Heart-Liver axis is an important component of acupuncture treatment for stress-triggered Raynaud’s

Research evidence

A systematic review and meta-analysis by Zhou et al. (2023), published in Acupuncture in Medicine, identified 6 RCTs involving 272 participants and found that acupuncture was associated with increased remission incidence (RR=1.21; 95% CI: 1.10–1.34), a decreased daily number of attacks (WMD=−0.57; 95% CI: −1.14 to −0.01), and an increased incidence of positive cold stimulation tests (RR=1.64; 95% CI: 1.27–2.11); the network meta-analysis ranked manual acupuncture combined with moxibustion as the highest-ranked treatment approach by SUCRA score. A comprehensive review by Wang et al. (2024) in the Journal of Multidisciplinary Healthcare reviewed the current pathophysiology and management strategies for Raynaud’s phenomenon, confirming the role of complementary therapies including acupuncture in addressing the vascular and neurogenic components of the condition. Clinical evidence from Appiah et al. (1997) and other early clinical trials demonstrated that acupuncture significantly reduces the number of daily Raynaud’s attacks and improves blood flow in the digital vessels. A minireview by Qureshi et al. (2019) reviewing 32 published studies on acupuncture for Raynaud’s disease further supported acupuncture as a patient-centred, holistic approach to a condition that lacks a standard medical cure.

6. Moxibustion for Raynaud's disease

Moxibustion — the application of heat from burning compressed mugwort (Artemisia vulgaris) to specific acupoints — is particularly well suited to the treatment of Raynaud’s disease and is often used alongside acupuncture. It is one of the most clinically important TCM treatments for any condition driven by Cold obstructing the channels. The network meta-analysis by Zhou et al. (2023) ranked manual acupuncture combined with moxibustion as the highest-ranked treatment modality in Raynaud’s syndrome by SUCRA score, reflecting the traditional Chinese medical understanding that moxibustion is essential for warming the channels and expelling Cold.

Moxibustion treats Raynaud’s disease by:

1. Directly warming the channels — the penetrating warmth of moxa disperses Cold from the channels and collaterals, directly addressing the Cold obstruction that drives the vasospasm of Raynaud’s attacks; the ancient medical texts specifically recommend moxa for “cold hands and feet from Cold invasion of the channels”
2. Tonifying Kidney Yang — moxibustion at GV4 (Mingmen — the Gate of Life, the primary source of Yang Fire in the body), CV4 (Guanyuan) and BL23 (Shenshu) tonifies the root Kidney Yang that warms and drives circulation to the extremities; this is the fundamental constitutional treatment for Yang-deficient Raynaud’s patterns
3. Improving peripheral circulation — the thermal effect of moxibustion promotes local vasodilation and increases peripheral blood flow to the hands and feet, counteracting the digital ischaemia of Raynaud’s attacks; moxa can be applied directly to the fingers and toes, the dorsum of the hands and feet, and the wrists to warm the local channels
4. Reducing attack frequency in cold weather — regular moxibustion throughout the autumn and winter months strengthens the body’s Yang Qi and resistance to Cold, reducing the frequency and severity of cold-triggered Raynaud’s attacks; many patients with Raynaud’s benefit greatly from regular moxa treatment in the months before and during cold weather

Moxibustion is also combined with heat therapy and can be self-administered at home using moxa sticks on the relevant points, providing ongoing treatment between clinic sessions.

7. Chinese herbal medicine for Raynaud's disease

Chinese herbal medicine treats Raynaud’s disease from the inside, prescribing individually tailored formulae that warm the channels, tonify Yang, move Blood and expel Cold to address the specific TCM patterns driving the condition. Herbal treatment complements acupuncture and moxibustion and is particularly useful for conditions like Raynaud’s where consistent, daily treatment between acupuncture sessions is beneficial.

Classical Chinese herbal formulae commonly used in the treatment of Raynaud’s disease patterns include:

1. Dang Gui Si Ni Tang (Tangkuei Decoction for Frigid Extremities) — the principal classical formula for Cold-obstructed channels in the limbs with cold hands and feet; warms the channels, nourishes Blood and expels Cold using Dang Gui (Angelica sinensis), Gui Zhi (Cinnamomum cassia twigs), Bai Shao (Paeonia lactiflora), Xi Xin (Asarum), Zhi Gan Cao (honey-fried licorice), Da Zao (jujube) and Tong Cao (Tetrapanax papyrifera); this formula directly targets the clinical presentation of Raynaud’s — cold extremities, pallor and cyanosis from Cold obstructing Blood flow in the channels of the limbs
2. You Gui Wan (Restore the Right Kidney Pill) modifications — for Kidney Yang deficiency patterns; powerfully tonifies the root Kidney Yang and Ming Men fire using Fu Zi (Aconitum), Rou Gui (Cinnamomum bark), Lu Jiao Jiao (deer antler glue), Shu Di Huang (prepared Rehmannia), Shan Yao (Dioscorea), Shan Zhu Yu (Cornus), Gou Qi Zi (Lycium), Tu Si Zi (Cuscuta) and Du Zhong (Eucommia); addresses the constitutional Yang deficiency underlying cold-sensitive Raynaud’s
3. Xue Fu Zhu Yu Tang (Drive Out Blood Stasis in the Mansion of Blood) modifications — for pronounced Blood stagnation patterns with fixed, purple-blue discolouration of the fingers; moves Blood, dispels stasis and opens the collaterals using Tao Ren (Prunus persica), Hong Hua (Carthamus tinctorius), Dang Gui, Sheng Di Huang, Chuan Xiong (Ligusticum chuanxiong), Chi Shao (Paeonia), Niu Xi (Achyranthes), Jie Geng (Platycodon), Chai Hu (Bupleurum), Zhi Ke (Citrus aurantium) and Gan Cao
4. Shu Gan Wan (Liver-Soothing Pills) modifications — for Liver Qi stagnation patterns with prominent stress-triggered attacks; smooths Liver Qi, moves Blood and reduces emotional tension to address the sympathetic hyperactivation driving stress-triggered vasospasm

Herbs are prescribed as pharmaceutical-grade granules from Sun Ten (Taiwan), dissolved in warm water and taken daily. An online Chinese herbal consultation is available for patients who cannot attend the clinic in person.

8. Self-care tips

The following lifestyle measures help reduce the frequency and severity of Raynaud’s attacks and complement acupuncture and herbal treatment:

1. Keep warm — the most important self-care measure; wear thermal gloves and thick socks in cold weather, and carry gloves at all times as even brief cold exposure (such as reaching into a freezer or going outside on a cool day) can trigger an attack; wear layers that retain body warmth and reduce the temperature differential between the body core and the extremities; electric heated gloves are available and provide excellent protection
2. Warm the whole body, not just the hands — because Raynaud’s is a thermoregulatory response to core cooling as well as local cold, keeping the torso and core warm is as important as protecting the hands; wear a warm core layer and hat, as significant heat is lost through the head; a warm bath or shower can reverse a mild attack and improve peripheral circulation
3. Hand warmers and heat therapy — chemical or reusable hand warmers worn inside gloves provide sustained peripheral warmth; a warm wheat bag or hot water bottle applied to the hands and feet improves local circulation and can be used preventively before going out in cold weather
4. Manage stress — because emotional stress is a major trigger for attacks via sympathetic nervous system activation, stress management is an important component of self-care; regular relaxation practices, mindfulness, gentle exercise and acupuncture all help to reduce stress-triggered vasospasm
5. Exercise regularly — regular aerobic exercise improves peripheral circulation and endothelial function, reduces sympathetic tone and increases overall body warmth; swimming (in a warm pool), walking, yoga and cycling are all beneficial; exercise also promotes the smooth flow of Qi and Blood through the channels, directly addressing the stagnation patterns underlying Raynaud’s in TCM
6. Stop smoking — smoking causes direct vasospasm in the peripheral vessels and significantly worsens Raynaud’s; stopping smoking is one of the most effective self-care measures available to smokers with Raynaud’s disease
7. Diet and warming foods — in TCM, warming foods support Yang Qi and improve peripheral circulation in Yang-deficient or Cold patterns; ginger (fresh or dried), cinnamon, lamb, prawns, walnuts and black beans all tonify Yang and warm the channels; avoid excessive cold foods and drinks, particularly in cold weather, as these deplete Yang Qi and worsen Cold obstruction in the channels. See Chinese food therapy for further guidance
8. Home moxibustion — moxa sticks can be used at home to warm GV4 (Mingmen), CV4 (Guanyuan), ST36 (Zusanli) and the local channel points on the hands and feet between clinic sessions, providing ongoing warming treatment that helps prevent cold-triggered attacks; your practitioner can demonstrate the correct technique

9. Treatment at my clinic

I treat Raynaud’s disease at my clinic in Wokingham, Berkshire. Treatment combines acupuncture, moxibustion and Chinese herbal medicine according to the individual TCM pattern, tailored to address the specific combination of Kidney Yang deficiency, Cold obstruction, Liver Qi stagnation or Blood deficiency driving the attacks. Both primary and secondary Raynaud’s are treated, and treatment is adapted appropriately for patients whose Raynaud’s is secondary to autoimmune conditions. Related conditions commonly co-treated alongside Raynaud’s include stress, anxiety, insomnia, fibromyalgia and nerve pain.

Visit the prices page for treatment costs or book an online Chinese herbal consultation if you cannot attend in person.

10. Frequently asked questions

Can acupuncture help Raynaud's disease?

Yes. A systematic review and meta-analysis published in Acupuncture in Medicine (2023), pooling 6 RCTs involving 272 patients, found that acupuncture is associated with increased remission incidence, a reduced daily number of attacks and improved responses to cold stimulation tests in people with Raynaud’s syndrome. Acupuncture works by modulating sympathetic vasomotor tone, stimulating peripheral vasodilation and addressing the underlying TCM patterns of Kidney Yang deficiency, Cold obstruction and Liver Qi stagnation that drive the condition.

What is the difference between primary and secondary Raynaud's disease?

Primary Raynaud’s (also called primary Raynaud’s disease) occurs when there is no identifiable underlying cause — the digital vasospasm is idiopathic and is the presenting condition in its own right. Secondary Raynaud’s (Raynaud’s phenomenon) occurs as a manifestation of another condition, most commonly an autoimmune or connective tissue disorder such as systemic sclerosis, lupus or rheumatoid arthritis. In TCM, both forms have identifiable and treatable underlying patterns, and acupuncture and moxibustion can address both, though secondary Raynaud’s requires treatment of the underlying constitutional pattern alongside the peripheral vasospasm.

Is moxibustion good for Raynaud's?

Yes — moxibustion is one of the most appropriate TCM treatments for Raynaud’s disease. It directly warms the channels and expels Cold — the core TCM pathology in Raynaud’s — and tonifies the Kidney Yang that drives peripheral circulation. The network meta-analysis by Zhou et al. (2023) ranked manual acupuncture combined with moxibustion as the highest-ranked treatment modality for Raynaud’s syndrome by SUCRA score. Moxa is applied to warming points on the lower back, abdomen and extremities and can also be self-administered at home between sessions.

What triggers a Raynaud's attack?

The two primary triggers for Raynaud’s attacks are cold temperatures and emotional stress. Cold exposure — even mild cold such as reaching into a refrigerator or holding a cold drink — provokes digital vasospasm in susceptible individuals. Emotional stress and anxiety trigger attacks through sympathetic nervous system activation, which causes vasoconstriction in the peripheral vessels. Other triggers include smoking, caffeine, certain medications (beta-blockers, ergotamine) and whole-body cooling. In TCM terms, attacks occur when exogenous Cold or emotional Liver Qi stagnation obstructs the flow of Qi and Blood through the channels of the extremities.

Can Chinese herbal medicine help Raynaud's disease?

Chinese herbal medicine is an effective complementary treatment for Raynaud’s disease, prescribed to address the specific TCM patterns driving the condition from the inside. The classical formula Dang Gui Si Ni Tang (Tangkuei Decoction for Frigid Extremities) is the principal formula for Cold-obstructed channels with cold hands and feet, directly matching the clinical presentation of Raynaud’s. Formulae are tailored to each patient’s pattern and can be modified to address Kidney Yang deficiency, Blood stagnation or Liver Qi stagnation as required. Herbs are taken daily as pharmaceutical-grade granules, providing continuous treatment between acupuncture sessions.

11. References

Zhou F, Huang E, Zheng E, Deng J. The use of acupuncture in patients with Raynaud's syndrome: a systematic review and meta-analysis of randomized controlled trials. 6 RCTs, 272 participants; acupuncture associated with increased remission incidence (RR=1.21), decreased daily attacks (WMD=−0.57), increased positive cold stimulation tests (RR=1.64); MA+moxibustion ranked highest by SUCRA. Acupunct Med. 2023 Apr;41(2):63–72. doi: 10.1177/09645284221076504. PMID: 35608095.

Wang S, Fang R, Huang L, Zhou L, Liu H, Cai M, Sha'aban A, Yu C, Akkaif MA. Comprehensive review of Raynaud's phenomenon: pathophysiology and management strategies. J Multidiscip Healthc. 2024 Jul 16;17:3459–3473. doi: 10.2147/JMDH.S476319. PMID: 39050695.

Qureshi N, Sharma S, Guru R, Kahlenberg A, Alharbi M. Raynaud’s Disease and Clinical Challenges: A Minireview of Literature with a Spotlight on Acupuncture. Journal of Advances in Medicine and Medical Research. 2019;29(7):1–10. doi: 10.9734/jammr/2019/v29i730104.

Bacchini M, Conci F, Roccia L, Carrossino R. Circulatory disorders and acupuncture. Minerva Med. 1979 May;70(24):1755–1757. PMID: 450314.

Anderson S, et al. Acupuncture — from Empiricism to Science: Functional Background to Acupuncture Effects in Pain and Disease. Medical Hypotheses. 1995;45:271–281.