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Raynaud’s Phenomenon

Raynaud’s phenomenon is when the small blood vessels in the fingers and toes narrow too much in the cold or under stress, so the skin turns white or blue, feels numb or painful, and then turns red as blood returns. It is usually mild and is managed mostly by keeping warm, but sores that will not heal, blackened skin, symptoms on one side only, or joint pain or rashes need a clinician promptly.

Get medical care promptly — the same day if you can — if you have Raynaud’s-type color changes together with any of these:

  • A sore (ulcer) on a finger or toe, or a black area on the skin. Arthritis UK lists ulcers or black areas on the fingers or toes among the signs that Raynaud’s has become more severe and may need urgent attention, and says severe secondary Raynaud’s can cause loss of tissue at the fingertip, although it calls this very rare (Arthritis UK (opens in a new tab)). MedlinePlus notes that people with the secondary type may develop skin ulcers (open sores caused by poor blood flow) or skin infections (MedlinePlus (opens in a new tab)), so MBHA suggests getting any sore checked quickly. The American College of Rheumatology adds that severe Raynaud’s can cause fingertip or toe ulcers from tissue death when blood flow is cut off (ACR (opens in a new tab)).
  • Color change that does not go away as quickly as usual (Arthritis UK (opens in a new tab)). The ACR says that if an episode lasts for hours, or persists despite attempts at rewarming, it can suggest more serious disease (ACR (opens in a new tab)).
  • Symptoms on only one side of the body — one hand, for example. The NHS and Arthritis UK both list this (NHS (opens in a new tab), Arthritis UK (opens in a new tab)). Arthritis UK says problems like these are uncommon and are not usually experienced by people with primary Raynaud’s, so one-sided symptoms are a reason to be checked (Arthritis UK (opens in a new tab)).
  • Joint pain, skin rashes or muscle weakness — the NHS and Arthritis UK both list these as reasons to see a doctor, and the NHS says a GP may arrange tests if Raynaud’s could be a sign of a more serious condition such as rheumatoid arthritis or lupus (NHS (opens in a new tab), Arthritis UK (opens in a new tab)).
  • Attacks that are very bad or getting worse (NHS (opens in a new tab)).
  • Attacks that begin for the first time after age 30. The NHS lists first symptoms after age 30 as a reason to see a doctor, and a child under 12 with symptoms should also be seen (NHS (opens in a new tab)). MedlinePlus notes that primary Raynaud’s usually starts before age 30, often in the teenage years (MedlinePlus (opens in a new tab)). MBHA suggests treating first-ever attacks after about 40 as a reason for an evaluation.

MBHA suggests going to urgent care or an emergency room the same day if a finger or toe turns black, hurts severely, stays white or blue and numb after you warm up, or an open sore looks infected. Do not wait for a chiropractic, acupuncture or massage appointment, and do not try an herb or supplement first, if you have any of these signs.

What is Raynaud’s phenomenon?

Raynaud’s phenomenon (also called Raynaud’s disease or syndrome) is a condition in which the blood vessels narrow, which decreases blood flow; this is called an episode or “attack.” Attacks usually affect the fingers and toes, making them cold and numb, and the skin may change color, usually to white or blue. They happen in response to cold temperatures or stress (MedlinePlus (opens in a new tab)). As blood flow returns the skin may tingle, throb or turn red, and an attack may last a few minutes or a few hours. If you have darker skin, you may not easily see the color changes (MedlinePlus (opens in a new tab)); the NHS notes that fingertips may look paler (NHS (opens in a new tab)). Some people also find that their ears, nose, lips or nipples are affected (NHS (opens in a new tab)).

Researchers do not know exactly why some people develop it, but they understand how attacks happen. In cold, the body narrows the blood vessels in the top layer of skin to hold in heat. With Raynaud’s, the vessels in the hands and feet react to cold or stress by narrowing quickly and staying narrowed for a long time (MedlinePlus (opens in a new tab)). Raynaud’s cannot be prevented, but attacks can often be reduced (MedlinePlus (opens in a new tab)), and for many people the symptoms are mild.

Primary and secondary Raynaud’s

There are two types, and doctors consider it crucial to tell them apart early in an evaluation (Curtiss et al., 2024 (opens in a new tab)).

  • Primary Raynaud’s is the more common type and its cause is unknown. It is linked to being female, to starting before age 30 and to having a family member with it (MedlinePlus (opens in a new tab)). Attacks can be unpleasant and a nuisance but do not usually damage the fingers, and most people with primary Raynaud’s do not go on to develop further problems (Arthritis UK (opens in a new tab)).
  • Secondary Raynaud’s is usually caused by another disease or problem, such as lupus or scleroderma, and can be more serious. Other causes include exposure to cold or certain chemicals (MedlinePlus (opens in a new tab)). MedlinePlus lists lupus, scleroderma, rheumatoid arthritis, carpal tunnel syndrome and other connective-tissue disorders (MedlinePlus (opens in a new tab)); the ACR adds Sjögren’s syndrome and thyroid disease (ACR (opens in a new tab)), and Arthritis UK notes that an extra rib at the base of the neck can also be a cause (Arthritis UK (opens in a new tab)). People with the secondary type often have more severe symptoms and may develop skin ulcers or infections (MedlinePlus (opens in a new tab)).

Arthritis UK says primary Raynaud’s is a fairly common condition, while the secondary form is linked with other conditions such as scleroderma and, less commonly, lupus. Having Raynaud’s does not mean you will go on to develop scleroderma or another connective-tissue disease, although people with scleroderma are likely to get Raynaud’s symptoms at some stage (Arthritis UK (opens in a new tab)). For related conditions see our guides to lupus, arthritis and carpal tunnel syndrome; MBHA is planning separate guides to scleroderma and Sjögren’s syndrome. For general blood-flow questions see our circulation guide.

What sets off an attack?

When to see a provider (not an emergency): the NHS advises seeing a doctor if symptoms are very bad or getting worse, if Raynaud’s is affecting daily life, or if you have it for the first time after 30 (NHS (opens in a new tab)). Arthritis UK says that if you have recently developed symptoms it is best to get checked, and that an early diagnosis helps show whether it is primary or secondary (Arthritis UK (opens in a new tab)). There is no single test for Raynaud’s: a provider takes your history, examines you and may order blood or other lab tests to look for other conditions and to decide which type you have (MedlinePlus (opens in a new tab)). Arthritis UK also describes nailfold microscopy, or capillaroscopy (looking at the small blood vessels in the fingers under a microscope), and a cold stress test used in some hospitals (Arthritis UK (opens in a new tab)). You may be referred to a rheumatologist (MedlinePlus (opens in a new tab)).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

Raynaud’s Phenomenon: six approaches compared
ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Find out whether it is primary or secondary; keep warm, avoid triggers and quit smoking; if that is not enough, medicines (most often a calcium channel blocker) and, for severe cases, injections or nerve surgery. Treat the underlying condition in secondary Raynaud’s. Cost estimate being researched. Most people keep symptoms under control by avoiding cold. A Cochrane review found calcium channel blockers reduce attack frequency and probably severity, with headache, dizziness and ankle swelling the common side effects. Procedures are reserved for severe cases and the evidence is limited.
Chiropractic No chiropractic treatment is established for Raynaud’s. A chiropractor can help most by recognizing warning signs and referring you for medical evaluation. About $55 to $100 per follow-up visit paying cash, per The Pricer. Medicare covers only spinal adjustments for a subluxation (20% coinsurance after the deductible). We found little research on chiropractic care for Raynaud’s. It should never delay evaluation of sores, blackened skin or one-sided symptoms.
Acupuncture A course of needle treatments, often over several weeks, alongside keeping warm and medical care. About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture only for chronic low back pain, so Raynaud’s is not covered. Small trials and a 2023 review suggest it may reduce attacks, but the review rated the evidence very low quality, and a sham-controlled trial in secondary Raynaud’s found no significant effect.
Herbal medicine No herb has been proven for Raynaud’s. Ginkgo has been tested in several small trials; results are mixed. Cost estimate being researched. Two placebo-controlled ginkgo trials disagreed (one positive, one not significant). NCCIH says ginkgo has not been shown effective for any condition studied, and it may raise bleeding risk with blood thinners.
Massage therapy Gentle hands-on work for comfort and relaxation, in a warm room. Massaging the hands and feet is also a common way to help warm up during an attack. One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer. Medicare doesn’t cover massage therapy. We found little research on massage for Raynaud’s itself. It may help with stress, a known trigger, but is not a treatment for the condition.
MBHA Wellness Coach Warmth planning, a trigger diary, stress-management and breathing skills, gentle regular exercise, a quit-smoking plan, and help preparing questions for your doctor. Cost estimate being researched. Supports — never replaces — medical care. Keeping warm, not smoking and managing stress are the first-line advice from every source we read.

Approach 1 of 6

Conventional medicine (AMA)

MedlinePlus says most people with Raynaud’s can keep their symptoms under control by avoiding getting cold; if that is not enough, medicines and, in some cases, surgical procedures can help. Secondary Raynaud’s is more likely to be serious and to need more treatment, and it is also important to treat the condition causing it (MedlinePlus (opens in a new tab)). A 2024 review in the Journal of the American Academy of Dermatology likewise says first-line management should include lifestyle changes for everyone, while some people with primary and most with secondary Raynaud’s need medicines (Curtiss et al., 2024 (opens in a new tab)).

1. Self-care first

The NHS advice is to keep your home and body warm (especially hands and feet), avoid sudden changes in temperature, exercise regularly, try breathing exercises or yoga to relax, eat a healthy balanced diet, not smoke, and limit caffeine (NHS (opens in a new tab)). During an attack, put your hands or feet in a warm (not hot) place such as under warm water or a heating pad (MedlinePlus (opens in a new tab)). The ACR suggests tucking hands under the armpits, wiggling fingers and toes, running them under warm water or massaging them (ACR (opens in a new tab)). See the Wellness Coach section for more.

2. Looking for a cause

Because secondary Raynaud’s can come from another health condition, certain medicines or long-term work with vibrating tools (NHS (opens in a new tab)), a provider takes your medical history and asks about your symptoms (MedlinePlus (opens in a new tab)). Blood tests can help tell the types apart and check for other conditions (Arthritis UK (opens in a new tab)). Arthritis UK notes that Raynaud’s caused by a beta blocker can improve when that medicine is stopped, but you must ask your doctor before stopping any regular medicine (Arthritis UK (opens in a new tab)).

3. Medicines (by class — we don’t list doses)

  • Calcium channel blockers (the nifedipine and amlodipine family) work by making the blood vessels wider (Arthritis UK (opens in a new tab)). The NHS says a GP may prescribe one such as nifedipine when symptoms are very bad or getting worse; some people take it every day and others only to prevent attacks, for example in cold weather (NHS (opens in a new tab)). A Cochrane review of 38 trials (982 people) found moderate-quality evidence that these medicines reduce attack frequency, though the reduction in severity was small and may not be clinically meaningful. Headache, dizziness, nausea, palpitations and ankle swelling were the most common side effects, and no serious adverse events such as death or hospitalization were reported (Rirash et al., 2017 (opens in a new tab)). Grapefruit and grapefruit juice can increase the risk of side effects from nifedipine (NHS (opens in a new tab)).
  • Other blood-pressure-type medicines such as angiotensin receptor blockers or ACE inhibitors can also help control symptoms, and the antidepressant fluoxetine is sometimes prescribed for its effect on circulation (Arthritis UK (opens in a new tab)). The ACR lists angiotensin receptor blockers alongside calcium channel blockers (ACR (opens in a new tab)).
  • For more severe symptoms or ulcers: phosphodiesterase 5 inhibitors (such as sildenafil) or prostacyclins (ACR (opens in a new tab)), and intravenous iloprost, which Arthritis UK says is used in severe cases, almost always secondary Raynaud’s (Arthritis UK (opens in a new tab)). A 2024 review also names endothelin antagonists (Curtiss et al., 2024 (opens in a new tab)).
  • Nitrate creams or gels applied to the skin: a meta-analysis of 7 placebo-controlled trials (346 people) found a moderate-to-large treatment effect overall, with the authors noting that the trials used different products and measured different outcomes (Curtiss et al., 2018 (opens in a new tab)).

The sources we read describe these medicines as a way to improve circulation and control symptoms, not as a cure; Arthritis UK says most people with Raynaud’s will always have the condition, although it can improve with time (Arthritis UK (opens in a new tab)). Medicines that widen blood vessels also act elsewhere in the body, so flushing, headaches or dizziness can occur (Arthritis UK (opens in a new tab)). If you are planning a pregnancy, are pregnant or breastfeeding, talk to your doctor before taking any of these (Arthritis UK (opens in a new tab)).

4. Injections and nerve surgery

For people with severe disease or who do not respond to medicines, botulinum toxin injections and surgery on the nerves around the finger arteries (sympathectomy) are options; see the section below (Curtiss et al., 2024 (opens in a new tab)).

What it costs

Visits, tests, prescriptions and procedures: cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

We found little research on chiropractic care for Raynaud’s phenomenon, and none of the medical or patient-information sources we read lists spinal manipulation as a treatment for it. MBHA therefore does not present chiropractic as a treatment for the condition.

Where a chiropractor can help

  • Recognizing when to refer. Ulcers, black skin, one-sided symptoms, joint pain, rashes or weakness need medical attention first (see the top of this page).
  • Neck and shoulder problems. Arthritis UK notes that a doctor may use an X-ray to look for an extra rib at the base of the neck (a cervical rib), which can cause Raynaud’s by putting pressure on the blood vessels that supply the arms (Arthritis UK (opens in a new tab)). MBHA suggests that if you have one-sided arm symptoms, you ask for a medical evaluation rather than assuming it is a spinal problem.
  • General musculoskeletal care for a coexisting back or neck problem, if you have one (see our neck and back pain guides).

Safety

Mild side effects — more pain, stiffness or headache, mostly gone within 24 hours — are common after spinal manipulation. Serious problems are very rare but possible, and may be more likely in people who have underlying health problems; tell the practitioner your health history (NCCIH (opens in a new tab)). If you have secondary Raynaud’s, make sure your chiropractor knows about the underlying condition and your medicines. MBHA suggests asking for a warm treatment room.

Medicare coverage

Part B covers only spinal adjustments by a chiropractor to correct a subluxation, by hand or with a device called an activator. It does not cover X-rays, massage or acupuncture ordered by a chiropractor. After the deductible you pay 20% of the Medicare-approved amount (Medicare.gov (opens in a new tab)).

What it costs

Paying cash, a follow-up visit typically costs about $55 to $100 and a first appointment about $90 to $200 (The Pricer (opens in a new tab)). Ask how many visits to expect.

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is a technique in which practitioners insert fine needles into the skin; in the United States it is most often used for pain (NCCIH (opens in a new tab)). Some people try it for Raynaud’s. The research is small and mixed.

What the research says

  • A 2023 review: six randomized trials (272 people) found that acupuncture was associated with more remissions and slightly fewer daily attacks than comparison groups. The authors cautioned that the samples were small, the quality of evidence very low and the risk of bias high, and called for larger trials (Zhou et al., 2023 (opens in a new tab)).
  • A small early trial in primary Raynaud’s: 33 people were randomly assigned to seven acupuncture treatments or to a control group over a winter. The treated group had a larger drop in attacks (63% versus 27%), and the authors called it a reasonable alternative (Appiah et al., 1997 (opens in a new tab)).
  • A sham-controlled trial in secondary Raynaud’s: licensed acupuncturists treated people weekly for eight weeks in a double-blind trial. Both groups improved, but there was no significant difference in attacks or skin circulation, and the authors said much larger studies would be needed to find a possible small benefit (Hahn et al., 2004 (opens in a new tab)).

In short: acupuncture may reduce attacks in primary Raynaud’s, but the evidence is weak, and a careful trial in secondary Raynaud’s found no clear benefit. It is a reasonable option to discuss alongside — not instead of — keeping warm and medical care.

Safety

Relatively few complications have been reported, but non-sterile needles or improper treatment can cause infections, punctured organs and nervous-system injury. The FDA requires needles to be sterile and single-use (NCCIH (opens in a new tab)). MBHA suggests telling your acupuncturist about any fingertip sores, a blood thinner or pregnancy, and asking that the room be kept warm.

Medicare coverage

Part B covers acupuncture (including dry needling) only for chronic low back pain, so Raynaud’s is not covered. Where it does apply, Medicare covers up to 12 treatments in 90 days from a doctor or other practitioner with the required degree and license, and you pay 20% after the deductible (Medicare.gov (opens in a new tab)).

What it costs

Published cash prices run about $125 to $230 for a first private visit and $90 to $185 for follow-ups; community clinics can be near $50 to $90 a visit (The Pricer (opens in a new tab)). Ask about package prices and insurance.

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herbal remedy has been proven to treat Raynaud’s. Arthritis UK says some people find that vitamin supplements, evening primrose oil, fish oils, ginger or ginkgo help, but that there is no good evidence to support their use (Arthritis UK (opens in a new tab)). A 2009 review of complementary approaches found that most trials were negative or of poor quality and called the literature inconclusive, with a few exceptions (Malenfant et al., 2009 (opens in a new tab)).

Ginkgo — trials so far

  • A placebo-controlled trial of a ginkgo extract in people with Raynaud’s disease with no associated condition found the extract reduced the number of attacks per week by 56%, versus 27% with placebo; no other measure differed significantly (Muir et al., 2002 (opens in a new tab)).
  • A later placebo-controlled pilot trial of 41 people with primary Raynaud’s found no significant difference in the frequency, duration or severity of attacks, though ginkgo was well tolerated (Bredie & Jong, 2012 (opens in a new tab)).
  • In a Korean trial of 93 people with primary Raynaud’s, a nifedipine product improved the attack rate more than a ginkgo extract (about 50% versus 31%) (Choi et al., 2009 (opens in a new tab)).
  • A 2009 review of complementary approaches for Raynaud’s found only one ginkgo trial and no significant differences among the nutritional supplements studied; the literature was inconclusive (Malenfant et al., 2009 (opens in a new tab)).

The trial results disagree, and NCCIH says ginkgo has not been shown to be effective for any of the conditions for which it has been studied (NCCIH (opens in a new tab)).

Chinese herbal formulas

A 2020 review of eight trials (674 people) in primary Raynaud’s found that some Chinese herbal formulas improved global symptoms more than nifedipine in a few trials, but the quality of the trials was generally poor, none reported attack frequency or adverse events, and the authors called the benefit inconclusive (Zhang et al., 2020 (opens in a new tab)).

Safety

  • Ginkgo may increase the risk of bleeding in people who take anticoagulant drugs such as warfarin, may interact with other drugs, and may be unsafe in pregnancy. The most common side effects are dizziness, digestive symptoms and headache (NCCIH (opens in a new tab)).
  • Supplements in general can interact with medicines, and some products sold as supplements have been found to contain prescription drugs or unlisted ingredients (NCCIH (opens in a new tab)). Grapefruit is a known problem with nifedipine (NHS (opens in a new tab)).

Before you take any herb or supplement, show it to your doctor or pharmacist — especially if you take a blood thinner or a Raynaud’s medicine, or are pregnant, breastfeeding or planning surgery. We don’t list doses, and no herb should delay care for the warning signs at the top of this page.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage can feel soothing and may help you relax, but we found little research on massage for Raynaud’s itself, and no source we read presents it as a treatment for the condition.

What we can say

  • The ACR lists massaging the hands and feet as one way to rewarm during an attack (ACR (opens in a new tab)). That is self-care you can do yourself, not a professional treatment.
  • Stress is a known trigger, and the ACR recommends stress reduction to help decrease attacks (ACR (opens in a new tab)). A relaxing massage may help with stress, though we did not find studies testing that for Raynaud’s.

Safety

The risk of harm from massage appears low, though rare serious problems — a blood clot, nerve injury or broken bone — have been reported, sometimes with vigorous deep-tissue massage or in people at higher risk (NCCIH (opens in a new tab)). MBHA suggests: ask for a warm room and warm hands and oils; keep to gentle pressure; avoid massaging over any sore, ulcer or blackened skin; and tell the therapist you have Raynaud’s and which medicines you take. A therapist is not a substitute for evaluating the warning signs above.

What it costs

One national chain charges about $70 to $90 a month on a 12-month membership (The Pricer (opens in a new tab)); prices elsewhere vary. Medicare does not cover massage therapy (Medicare.gov (opens in a new tab)).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Most of what helps Raynaud’s happens between appointments. An MBHA Wellness Coach can help you build these habits — alongside, never instead of, medical care. A coach does not diagnose or treat.

Plan for warmth

Arthritis UK says several layers of clothing trap heat better than fewer thick ones, and that warm socks, a hat, warm gloves outdoors and small portable hand warmers can help (Arthritis UK (opens in a new tab)). The NHS advises avoiding sudden changes in temperature (NHS (opens in a new tab)). The ACR adds oven mitts or gloves for taking food from the freezer and not setting the air conditioning too low in summer (ACR (opens in a new tab)). Arthritis UK also recommends keeping your core warm as well as your hands and feet, warming your hands before putting gloves on, and not warming back up too quickly if your fingers or toes are painful (Arthritis UK (opens in a new tab)). A coach can help you build a “go bag” and routines for winter, travel, the grocery store and work.

Keep a trigger diary

Arthritis UK suggests an attack diary, which may show a pattern that helps you control symptoms (Arthritis UK (opens in a new tab)). MBHA suggests bringing it to your doctor, along with photos of color changes, since an attack may be over by the time of the visit.

Stress and breathing skills

Stress and anxiety can trigger an attack (NHS (opens in a new tab)). Arthritis UK says there are often ways to reduce or avoid a source of stress or to manage it better, and that talking to people and good planning can help (Arthritis UK (opens in a new tab)); the NHS suggests breathing exercises or yoga (NHS (opens in a new tab)). See also our anxiety guide.

Thermal biofeedback, in which you are taught hand-warming skills, is sometimes offered by trained therapists. The evidence is divided: a 2006 expert panel review judged thermal biofeedback “efficacious” for primary Raynaud’s based on three randomized trials, but noted the positive trials were small and one large trial with negative results did not effectively teach hand warming (Karavidas et al., 2006 (opens in a new tab)). A 2009 review of five biofeedback trials found it negative for attack frequency, duration and severity, even favoring the sham (Malenfant et al., 2009 (opens in a new tab)). The note that the negative trial did not teach hand warming effectively suggests that how well the skill is taught may matter, but we cannot say for certain; ask a clinician before paying for a course. Cost estimate being researched.

Movement

Regular exercise improves circulation (NHS (opens in a new tab)). Arthritis UK adds that keeping active outdoors on a cold day improves blood flow to the hands and feet, and that if you are new to exercise you should start gradually, build up and choose something you enjoy so you keep doing it (Arthritis UK (opens in a new tab)). MBHA suggests dressing in layers and being careful in cold or air-conditioned spaces.

Quitting smoking

The NHS, ACR and Arthritis UK all advise not smoking (NHS (opens in a new tab), ACR (opens in a new tab), Arthritis UK (opens in a new tab)). Arthritis UK says smoking can damage your circulation, and that your doctor can provide advice and support and put you in touch with groups that can help you quit (Arthritis UK (opens in a new tab)). A coach can help you set a quit date, line up cessation services and plan around cravings.

Everyday hand care and work

Arthritis UK suggests moisturizing after your hands have been wet, wearing protective gloves for water, and using vibrating tools correctly and no longer than necessary (Arthritis UK (opens in a new tab)). Arthritis UK also says no particular food or diet has been proven to help Raynaud’s, though a healthy balanced diet is still important (Arthritis UK (opens in a new tab)).

Another approach

Medicines and work that can trigger Raynaud’s

MedlinePlus says medicines that treat high blood pressure, migraines and ADHD may cause similar symptoms to Raynaud’s or make symptoms worse, and that repeated use of vibrating machinery, such as a jackhammer, and exposure to cold or certain chemicals are work-related causes (MedlinePlus (opens in a new tab)). Arthritis UK names beta blockers, which are used to treat high blood pressure and angina, and describes the form caused by vibrating machinery such as pneumatic drills, hammer drills and hedge cutters as hand-arm vibration syndrome, or vibration white finger (Arthritis UK (opens in a new tab)). The NHS says working with vibrating tools for a long time can be a cause (NHS (opens in a new tab)).

None of the sources we opened named decongestant cold medicines as a trigger, so we make no claim about them either way. MBHA suggests asking your pharmacist about any new prescription, over-the-counter medicine or supplement, and mentioning Raynaud’s. Do not stop a prescribed medicine on your own; ask your doctor first (Arthritis UK (opens in a new tab)). See our medication safety guide.

Another approach

Nerve procedures & botulinum toxin

When medicines are not enough, doctors sometimes try other approaches. MedlinePlus says that in some cases surgical procedures can help (MedlinePlus (opens in a new tab)). A 2024 review lists botulinum toxin injection and digital sympathectomy as options for people with signs of critical ischemia (dangerously low blood flow) or whose symptoms do not respond to medicines (Curtiss et al., 2024 (opens in a new tab)). Distal periarterial sympathectomy is a surgical procedure that has been studied for chronic digital ischemia (Cereceda-Monteoliva et al., 2024 (opens in a new tab)).

What the research says

  • Botulinum toxin: a 2023 review of 13 studies found the effect “promising,” with reduced pain scores, but called for more and larger randomized trials; the two most common complications were injection-site pain and weakness of the small muscles of the hand (Zhou et al., 2023 (opens in a new tab)).
  • Sympathectomy: a 2024 review of 21 studies (337 people) with various causes of poor finger blood flow found reduced pain in 94.7% of patients and complete healing of ulcers in 73%, but 28% needed a later amputation and 24.1% had other complications. The authors said more research is needed before it can be considered a valid treatment option (Cereceda-Monteoliva et al., 2024 (opens in a new tab)). The patients had a mix of causes, including scleroderma, lupus and atherosclerosis as well as Raynaud’s disease, so the numbers say little about what to expect in mild primary Raynaud’s.

These are specialist decisions. Ask about the expected benefit, the risks and what happens if it does not work. Cost estimate being researched.

Another approach

Children, pregnancy & breastfeeding

The NHS advises seeing a doctor if a child under 12 has symptoms of Raynaud’s (NHS (opens in a new tab)). Arthritis UK notes that Raynaud’s can affect the nipples, especially during or just after breastfeeding, and that this is often misdiagnosed as a fungal infection. It suggests warming the nipples before feeds, covering and gently drying them afterward, and talking to a midwife or health visitor; nifedipine can be prescribed while breastfeeding, and you should talk to your doctor if you have concerns (Arthritis UK (opens in a new tab)). If you are pregnant or planning a baby, talk to your doctor before taking any Raynaud’s medicine (Arthritis UK (opens in a new tab)). MBHA is planning a separate pregnancy guide.

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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