Comparison
Raynaud's vs poor circulation
The two get treated as one complaint, and they aren't one. One of them is a blood vessel spasm that comes and goes over minutes, and the other is an artery that has grown tighter over years and stays that way. The difference decides almost everything that follows.
What the research found.
In one trial, an extract cut Raynaud's attacks per week from 13.2 to 5.8, which is a fall of 56 percent. On placebo the fall was 27 percent. Blood flow measures showed no real difference between the two groups, which is worth holding alongside the headline figure.
One review looked at behavior treatments for Raynaud's phenomenon, covering eight studies and 495 people between them. The middle study held 29 people. It concluded there's no evidence either way on whether those treatments work at all.
One trial compared silver-lined gloves against ordinary gloves, and the two performed alike. There was no difference in the Raynaud's score between the glove types. Both of them cut the score from 6.4 to 3.9, so the warmth is doing the work.
One trial gave 12 weeks of interval training in limited cutaneous systemic sclerosis, and peak oxygen uptake rose in both exercise groups. Oxygen at the skin rose too, at a large effect size. That rise didn't reach significance, and the trial had 34 people in it.
Mitropoulos and colleagues, Arthritis Research and Therapy, 2018
The short answer.
They're different problems with different causes. Raynaud's is a spasm, where small arteries in the fingers or toes clamp down and then reopen, set off by cold or by stress. It comes in episodes, and between those episodes the circulation is normal.
Poor circulation in the usual sense means a lasting drop in blood flow, and most often that's an artery that has grown tighter. It doesn't come and go, and it doesn't produce a sharp color change with a clean edge. It tends to affect a whole limb rather than particular fingers.
The telling feature is the color change and its edges. Raynaud's classically goes white, then blue, then red on rewarming, with a visible line between affected and unaffected skin. Cold hands without that picture are more likely to be cold hands.
Side by side.
| Raynaud's phenomenon | Poor circulation | What it tells you | |
|---|---|---|---|
| What it is | A spasm of small arteries, and it reverses | A lasting drop in flow | One comes and goes, one doesn't |
| Timing | Episodes of minutes, under an hour | Constant, and worse on exertion | Episodes are the clue |
| Color change | White, then blue, then red on rewarming | No sharp change with a clean edge | The clean line is the giveaway |
| Between episodes | Normal | Still reduced | Full recovery points to spasm |
| What sets it off | Cold, and stress | Exertion, or nothing in particular | Stress setting it off points to Raynaud's |
| What's affected | Particular fingers or toes | A whole limb, more often the legs | Picking out single digits points to Raynaud's |
| Why it's worth telling apart | It can be the first sign of a rheumatic disease | It points to a heart and vessel check | They send you to different clinics |
Two different problems that feel similar
Cold hands send people looking for one answer, and the two commonest causes behave differently enough that telling them apart changes what's worth doing. Raynaud's phenomenon is a spasm of the small arteries that feed the fingers or toes. They clamp down, flow drops sharply, and then they reopen.
Poor circulation in the ordinary sense means a lasting drop in blood flow, usually from arteries that have grown tighter over years. It doesn't come and go over minutes, and it's often worse with walking rather than with cold. It tends to affect a whole limb rather than picking particular fingers, and that difference is what the rest of this page turns on.
The two also lead to different checks, which is the practical reason for sorting them out. One raises questions about connective tissue disease and about antibodies, while the other raises questions about heart and vessel risk. Being sent down the wrong path wastes time in both directions.
What the color change tells you
The most useful telling feature is one you can see for yourself. A classic Raynaud's attack runs through a sequence of colors, going white as flow shuts down, then blue as the blood left behind gives up its oxygen, then red as the vessels reopen and flow returns. Not everyone gets all three phases.
The edge tells you even more than the colors do. Raynaud's makes a visible line between affected and unaffected skin, and it often sits partway along a finger, because the spasm happens in particular vessels rather than across the whole hand. Ordinary cold hands shade off slowly instead, and they don't make that line.
Recovery is the third clue. Between attacks, circulation in Raynaud's is entirely normal, and the fingers look and feel like anybody else's. So a problem that never fully recovers is pointing somewhere else, and it's worth saying so to whoever assesses you.
What the evidence supports doing
Here a reader deserves candor, because there's a lot of advice about Raynaud's and there aren't many trials behind it. One review looked at behavior treatments, meaning relaxation, biofeedback, and the like, across eight studies and 495 people, and it found no evidence either way. The middle study held 29 people, and all but one were at high risk of bias.
Gloves are better studied, and the result is worth knowing before spending money. One trial compared silver-lined gloves against ordinary ones and found no difference between the glove types, with both cutting the Raynaud's score from 6.4 to 3.9. The warmth is doing the work rather than the technology.
One trial of an extract cut attacks per week from 13.2 to 5.8, a fall of 56 percent against 27 percent on placebo. That's a real result from a real trial, and it's also one trial, and that trial found no real difference in blood flow measures between the groups. So a single positive trial is a reason to be interested rather than a reason to be confident.
Why the difference is worth making
New Raynaud's after the age of forty makes a second cause more likely, meaning a connective tissue disease behind it rather than the primary form. Three other features do the same, which are attacks affecting the two hands differently, sores at the fingertips, and an abnormal antibody test. Those are what turn a nuisance into something worth investigating.
Raynaud's can come years before a connective tissue disease, so take it seriously rather than managing it with gloves alone. Now take somebody with cold fingers plus joint pain, a rash, dry eyes, or reflux, which is a different situation from cold fingers on their own. The whole set is what a rheumatologist wants to hear about.
Nothing in that applies to ordinary poor circulation, which points toward a heart and vessel check instead. Getting the two mixed up sends people to the wrong clinic. Both clinics have something useful to offer the right patient.
When each one fits.
- Think Raynaud's if attacks come and go, if cold or stress sets them off, and if the color changes with a visible line between affected and unaffected skin.
- Think about circulation more widely if the problem is constant, if it's worse with walking, or if it affects a whole limb rather than particular fingers.
- Take new Raynaud's after the age of forty to a doctor, because a second cause behind it becomes more likely with a later start.
- Take sores at the fingertips seriously and promptly, whichever of the two you think you have.
- Ask about the rest of the picture too, meaning joint pain, a rash, dry eyes, or reflux, because Raynaud's can come years before a connective tissue disease.
Questions patients ask.
How do I tell which one I have?
The color change and its timing do most of the work. Raynaud's comes in attacks that start and finish, running white, then blue, then red on rewarming, with a visible line between affected and normal skin, and it fully recovers in between. Poor circulation is constant instead, so it doesn't come in attacks and it doesn't make that sharp edge. If you're unsure which you have, take a photograph during an attack, because that's genuinely useful to whoever assesses you.
Does Raynaud's mean I have an autoimmune disease?
Usually not, sometimes yes, and that's why it's worth checking rather than ignoring. Raynaud's on its own is common and it's often primary, meaning no disease behind it ever gets found. It can be the first sign of a connective tissue disease, though, sometimes years ahead of anything else, and a later start makes that more likely. So a first visit brings blood tests that can seem out of scale with cold fingers.
Do gloves help?
Yes, and the expensive ones don't beat the ordinary ones. One trial compared silver-lined gloves against plain gloves and found no difference between the glove types, with both cutting the Raynaud's score from 6.4 to 3.9. So ordinary warmth is doing the work, and keeping your whole body warm counts for more than warming the fingers alone, because the response is to your core temperature as well as to local cold.
Is there anything proven to reduce attacks?
Less than you'd expect from the amount written about it. One trial found an extract cutting attacks per week from 13.2 to 5.8, which is a 56 percent fall against 27 percent on placebo, though the blood flow measurements didn't change. One review covered behavior treatments across eight studies and 495 people and concluded there's no evidence either way. So that's a thin evidence base rather than a settled one.
Will exercise improve it?
The evidence is thin without being discouraging. One trial gave 12 weeks of interval training to patients with limited cutaneous systemic sclerosis, where peak oxygen uptake rose in both exercise groups and oxygen at the skin rose too, at a large effect size. That rise didn't reach significance, and the trial had 34 people in it. So exercise has good reasons behind it here, and cutting Raynaud's attacks isn't one the data supports yet.
Does smoking matter here?
Stopping is the best change open to anyone who smokes, and that holds whichever of the two problems you have. Smoking affects blood vessels directly, and it's one of the few things here that you can change. The reason it works is clear, so deal with that one first.
References.
- Muir A; Robb R; McLaren M et al. The use of Ginkgo biloba in Raynaud’s disease: a double-blind placebo-controlled trial. Vascular Medicine. 2002;7:265-267. 10.1191/1358863x02vm455oaDouble-blind
- Daniels J; Pauling J; Eccleston C. Behaviour change interventions for the management of Raynaud’s phenomenon: a systematic literature review. BMJ Open. 2018;8:e024528. 10.1136/bmjopen-2018-024528Systematic literature review of RCTs with narrative synthesis
- Liem S; Hoekstra E; Bonte-Mineur F et al. The effect of silver fibre gloves on Raynaud’s phenomenon in patients with systemic sclerosis: a double-blind randomized crossover trial. Rheumatology. 2022;62:SI74-SI81. 10.1093/rheumatology/keac243Multicentre
- Mitropoulos A; Gumber A; Crank H et al. The effects of upper and lower limb exercise on the microvascular reactivity in limited cutaneous systemic sclerosis patients. Arthritis Research & Therapy. 2018;20. 10.1186/s13075-018-1605-0Randomised controlled trial
This page gathers the published research on this subject into one place. The studies behind it were published between 1989 and 2026, and every figure links to the paper it came from. Those studies were peer reviewed. This summary of them was not. Dr. Sarah Luebker is reviewing these pages one at a time and has not reached this one yet, so it carries no medical review date and nothing here is her opinion or her advice to you. Each page gets updated as she reaches it. It is here in the meantime because the science is worth having in one organized place that is easy to find and easy to read. Talk to your own clinician before acting on any of it.