Neuropathy

By Qineng Tan, L.Ac., Ph.D. and Xiaomei Cai, L.Ac. Ph.D.

Fingers numb? Numbness in fingers and toes? Fingers turning white, poor circulation in fingers, cold fingers and toes? Raynaud’s disease, or Raynaud’s phenomenon, causes poor circulation in the extremities due to constriction of the blood vessels, usually triggered by cold weather or stress. Acupuncture can help relieve Raynaud’s disease symptoms.

Raynaud’s disease is a condition characterized by occasional narrowing of the blood vessels, primarily in the fingers and toes. The small arteries that supply blood to the skin of the fingers and toes (and sometimes, to the ears and the tip of the nose) become constricted in cold conditions.

Raynaud’s syndrome causes the tips of the fingers and/or toes to turn white due to the lack of circulation, and there may be numbness in fingers or tingling in toes. A “Raynaud’s attack” or episode lasts until the person warms up, at which point, there may be a burning sensation, and the affected skin may flush and turn red as blood flow returns.

Raynaud’s can occur in two forms: primary and secondary.

Primary Raynaud’s, also called Raynaud’s disease, is the more common form and isn’t usually related to another medical condition. Raynaud’s is considered to be an exaggerated response to cold, emotional stress or anxiety, leading to spasms in the small arteries.

People with primary Raynaud’s phenomenon usually begin to experience symptomatic episodes during their teenage years. Women are more likely to have Raynaud’s. 

Secondary Raynaud’s is less common but more serious. It is associated with other diseases, typically autoimmune diseases or connective tissue disorders, like scleroderma, rheumatoid arthritis, thyroid disorders, or lupus. 

Secondary Raynaud’s can be linked to conditions that directly damage the arteries or affect blood flow, like carpal tunnel syndrome. In these cases, it is considered a symptom rather than a separate condition.

Raynaud’s Syndrome Causes

For most people with Raynaud’s syndrome, there is probably a combination of genetic, physiological, and environmental factors at play.

Vascular abnormalities, or dysfunction in the blood vessels, involving excessive narrowing (vasospasm) and poor dilation in response to stimuli, may be involved.

Overactivity of the nerves controlling the blood vessels (sympathetic nervous system) may cause spasms.

Raynaud’s can tend to run in some families. If someone is already susceptible, then the numbness in fingers and toes may be triggered by cold temperatures, or a stressful situation. Smoking cigarettes can also cause Raynaud’s symptoms.

In secondary Raynaud’s, underlying autoimmune conditions can lead to inflammation and damage to blood vessels.

An injury to one of the limbs, like a broken wrist, or damage to the tissues from frostbite, could also trigger Raynaud’s phenomenon.

Some prescription medications, such as beta blockers, ADHD medications, medications for migraine headaches, and even some cold and flu medicines, could cause Raynaud’s symptoms.

Acupuncture treatment can help to relieve Raynaud’s syndrome symptoms and also address the underlying condition that may cause Raynaud’s. 

 Top 10 Raynaud’s Disease Symptoms 

Raynaud’s symptoms may show up differently for each person. Symptoms of Raynaud’s disease can vary in severity and may include:

1. Skin changes color: pallor (pale skin, white skin, or yellow skin) in the affected fingers or toes during an episode
2. In rare cases, Raynaud’s phenomenon can affect other areas, such as the nose, ears, and lips.
3. Some people may experience Raynaud’s in their nipples, which can cause a severe throbbing pain.
4. Bluish discoloration (Cyanosis) as blood flow decreases
5. Affected areas feel cold and/or numb during an episode
6. Throbbing or tingling in the fingers or in the toes
7. Sensitivity to cold temperatures, leading to more frequent episodes in cold weather.
8. In severe cases, recurrent or persistent episodes of reduced blood flow can lead to skin sores or ulcers, particularly on the fingertips or toes.
9. Changes in the texture and color of the nails, including nail beds that turn white and then blue during an episode.
10. Some individuals may experience joint pain, particularly if there is an underlying connective tissue disorder.

Emotional stress, anxiety, or rapid changes in temperature can trigger Raynaud’s symptoms.

Raynaud’s disease is generally considered a benign condition, but repeated episodes can lead to more serious problems, like skin sores, chilblains, or even gangrene, which can cause permanent damage to tissues.

Raynaud’s Syndrome Treatment

Diagnosis of Raynaud’s disease may involve a test called nailfold capillaroscopy. This is a non-invasive test that allows the doctor to see the capillary size and action in the tips of the fingers and nail bed. This can help to determine whether the person has Primary Raynaud’s, or may have a connective tissue disorder, like lupus or Sjogren’s syndrome.

The standard medical treatment for Raynaud’s phenomenon aims to manage symptoms, improve blood flow, and prevent complications. While there is no cure for Raynaud’s, various medications and lifestyle modifications can be employed to alleviate symptoms and enhance circulation.

Medications that relax and widen blood vessels, known as vasodilators, are commonly prescribed. Calcium channel blockers, such as nifedipine, are often used to help dilate the small blood vessels in the extremities, reducing the frequency and severity of Raynaud’s episodes.

Phosphodiesterase inhibitors like sildenafil (which is also commonly prescribed to help erectile dysfunction, ED) can sometimes be beneficial in promoting blood vessel dilation and improving blood flow.

In some cases, topical nitroglycerin cream may be prescribed to increase blood flow to the affected areas.

Endothelin receptor antagonists, such as bosentan, may be considered in cases where blood vessel constriction is severe. These medications target endothelin, a substance that can cause blood vessels to narrow.

Antiplatelet agents like aspirin may be recommended to reduce the risk of blood clots and improve blood circulation.

If Raynaud’s is secondary to another condition, treating the underlying cause is crucial. For example, if it is associated with an autoimmune disorder, immunosuppressants might be considered.

Lifestyle changes play a significant role in managing Raynaud’s symptoms. Patients are typically advised to dress warmly.

Quitting smoking is strongly recommended, as smoking constricts blood vessels.

Can Acupuncture Help Raynaud’s Syndrome?

TCM has acknowledged Raynaud’s phenomenon as a condition of severe cold in the limbs for centuries. According to TCM theory, a deficiency of Qi and blood circulation is the root cause of Raynaud’s symptoms. In TCM, we consider that Qi (life force energy) and blood work together; Qi moves the blood throughout the body, and blood carries the Qi throughout the body.

In TCM, we are always looking at both external factors and internal factors that contribute to a condition. In the case of Raynaud’s disease, cold acts as a pathogenic factor that can be already present inside the body, and then, when a person is exposed to cold temperatures as an external factor, this triggers an extreme reaction.

So, in many cases, a person suffering from Raynaud’s is already dealing with too much cold and poor blood circulation. Herbs can be used to help warm the body internally and increase blood flow.

Some people develop Raynaud’s symptoms in response to stress. In this case, the liver may be involved. In TCM, the liver is associated with strong emotions, and when the liver is distressed, it can trigger muscular contractions that squeeze the blood vessels, restricting blood flow. In these cases, we will use herbal formulas and acupuncture points to help restore balance in the liver.

When there is an autoimmune disease also present, such as scleroderma or lupus, then there may also be blood stasis, and a thickening of the blood and tissues. TCM can address those conditions at their roots, as well.

An acupuncturist will make careful observations about how each individual is experiencing Raynaud’s symptoms, and address it according to the pattern presenting.

Top 3 Tips for Managing Raynaud’s Syndrome Symptoms

You can help prevent Raynaud’s attacks by keeping your whole body warm, especially your hands and feet. 

1. Protect your hands and feet. Wear mittens or gloves, thick socks and lined boots, and use hand and foot warmers in cold weather. Consider wearing gloves or oven mitts when reaching into the refrigerator or freezer.
2. Exercise regularly, both to stimulate healthy blood circulation, and to help manage stress levels. 
3. If hands and/or feet do begin to feel cold or numb, take action to warm them up immediately by wiggling them, running them under warm water, massaging them, or putting your hands in your armpits or against your abdomen under your clothing.

Acupuncture Near Me for Raynaud’s Syndrome in West Los Angeles

It is important to address Raynaud’s disease to avoid damage to the nerves and skin tissue in your extremities, and to be sure whether or not Raynaud’s symptoms are related to an underlying autoimmune disorder. The acupuncturists at Art of Wellness Acupuncture in West L.A. have over 35 years of experience helping people with autoimmune conditions, circulatory problems, and nerve pain and tingling. The combination of herbs and acupuncture treatment can help relieve Raynaud’s phenomenon symptoms and address any autoimmune disease or nerve conditions.

*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.