Buerger’s Disease


What is Buerger’s disease?

Buerger’s disease (thromboangiitis obliterans) is a rare disease of the blood vessels in your arms, legs, fingers and toes. Inflammation in your blood vessels makes it hard for your blood to flow through them. Blood clots can form, which create obstacles inside your blood vessels. As a result, you can experience pain and damaged tissues starting in your fingers and toes and spreading to your legs and arms.

What is the difference between Buerger’s disease and Raynaud’s disease?

Raynaud’s disease (also called Raynaud’s phenomenon) can be a symptom of Buerger’s disease. With Raynaud’s disease, the blood vessels in your toes and fingers collapse because you’re feeling cold or you’re under stress. The lack of enough blood getting through your blood vessels makes your skin look white or blue. After a few minutes or hours, your skin looks red and can feel numb or tingly.

Simply warming up your hands, wearing gloves or wearing warm socks can help relieve the symptoms. Buerger’s disease is painful and has a lot more symptoms than Raynaud’s disease.

Who does Buerger’s disease affect?

Most people who get Buerger’s disease smoke cigarettes or chew tobacco. The disease is also more common in people whose families are from:

  • Parts of South Asia.
  • Israel.
  • Japan.

Buerger’s disease is most often found in men ages 20 to 40, but others can get it, too.

How common is Buerger’s disease?

With fewer people smoking, Buerger’s disease is rare. Out of every 100,000 people in America, only 12 to 20 people have it. Other countries with more tobacco use have more cases of Buerger’s disease.

How does Buerger’s disease affect my body?

You can get bad pain in your arms and legs when you’re at rest. Sores can show up on your fingers or toes, and you can have burning, numbness or tingling in your feet or hands. Over time, you could end up with muscle cramps or skin ulcers.

Symptoms and Causes

What causes Buerger’s disease?

The cause of Buerger’s disease is not known, but scientists think something in tobacco hurts the lining in your blood vessels. Most people with Buerger’s disease are tobacco users. Your genes may make you more likely to get Buerger’s disease. Some scientists think it’s an autoimmune disease.

How does Buerger’s disease start?

Often, severe pain in your legs and arms is the first clue that you have Buerger’s disease. This pain happens when your body is resting.

What are the symptoms of Buerger’s disease?

Buerger’s disease symptoms develop slowly over time. Symptoms include:

  • Hand or foot pain (burning or tingling feeling).
  • Sores on toes or fingers.
  • Ankle, foot or leg pain when you walk.
  • Raynaud’s phenomenon.
  • Skin color or texture change.

Other Buerger’s disease symptoms may happen after you’ve had it for a while. These include:

  • Muscle cramps.
  • Blood clots in blood vessels.
  • Red, blue or pale fingers or toes.
  • Blue in part of your face.
  • Cold or numb feet or hands.
  • Gangrene.
  • Skin ulcers.

What are the complications of Buerger’s disease?

Rare complications of Buerger’s disease (thromboangiitis obliterans) include:

Diagnosis and Tests

How is Buerger’s disease diagnosed?

Your healthcare provider will want:

  • A physical exam.
  • Your medical history.
  • Vascular tests.
  • Tobacco urine test.

What tests will be done to diagnose Buerger’s disease?

Your provider can look at your blood vessels with these tests:

Management and Treatment

How is Buerger’s disease treated?

There is no cure for Buerger’s disease, but stopping all tobacco use is the best way to keep Buerger’s disease from getting worse. Specific medicines can help with your symptoms.

Does Buerger’s disease go away?

When people with Buerger’s disease stop smoking, their symptoms usually get better. In some people, the disease goes into remission (becomes inactive) once they stop smoking.

What medications are used for Buerger’s disease?

Some medications are helpful in Buerger’s disease treatment. They include medicines that:

  • Make your blood flow better.
  • Help with pain.
  • Help new blood vessels grow.
  • Break up clots.

What treatments are used for Buerger’s disease?

You may get relief from Buerger’s disease symptoms with:

  • Exercise.
  • Arm and leg compression.
  • Surgery for pain or better blood flow.
  • Stimulation of the spinal cord.
  • Removal of fingers or toes when an infection or gangrene happens.

Are there risks with Buerger’s disease treatment?

Spinal cord stimulation has a number of risks, including:

  • Nerve damage.
  • Spinal headaches.
  • Issues with the stimulator.

How do I manage symptoms of Buerger’s disease?

The best thing you can do is quit smoking or chewing tobacco. Doing that helps a lot of people with their symptoms. Also, be sure to keep taking any medicines your provider ordered for you.


How can I reduce my risk of Buerger’s disease (thromboangiitis obliterans) or prevent it?

Don’t smoke or use tobacco of any kind.

Outlook / Prognosis

What can I expect if I have Buerger’s disease?

Since there is no cure for Buerger’s disease, you’ll keep having symptoms for as long as you smoke. You’ll also need medicines and possibly surgeries. But if you quit smoking, you can make your symptoms better.

How long will you have Buerger’s disease?

Symptoms last from 1 to 4 weeks at a time, but they usually come back. Quitting smoking is the best way to control Buerger’s disease symptoms.

What is the outlook for this condition?

Although there is no cure for Buerger’s disease, you can quit smoking to keep it from getting worse. If you keep smoking, you’ll need medicines and possibly surgeries to help you with your symptoms. If your condition gets really bad, your provider may need to remove one or more of your toes or fingers.

Living With

How do I take care of myself?

You need to stop using any type of tobacco to keep Buerger’s disease from getting worse. About half of the people with Buerger’s disease who keep using tobacco end up needing a finger or toe removed (amputation). People with Buerger’s disease who quit smoking hardly ever need an amputation.

Other recommendations include:

  • Don’t take medicines that make your blood vessels tighten or your blood clot.
  • Stay out of the cold.
  • Protect your affected arm or leg from getting injured.

When should I see my healthcare provider?

Get help if you have Buerger’s disease symptoms or if your symptoms get worse.

When should I go to the ER?

Call 911 if you think you’re having a heart attack or stroke. Also, you may need emergency surgery if Buerger’s disease has affected your intestines or if infection makes it necessary for a provider to remove your fingers or toes.

What questions should I ask my doctor?

  • Will quitting smoking be enough to take care of my symptoms?
  • Can you help me quit smoking?
  • What’s the best treatment for me?

A note from Cleveland Clinic

Buerger’s Disease is a rare problem with the blood vessels in your fingers, toes, arms and legs. While you can take medicines for your symptoms, the best treatment for Buerger’s disease is to quit smoking. Most people with Buerger’s disease get relief from their symptoms when they stop smoking. You can take control of Buerger’s disease yourself. Ask your provider to help you quit smoking so you can feel better.

Last reviewed by a Cleveland Clinic medical professional on 08/17/2021.


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  • Genetic and Rare Diseases Information Center. Buerger disease. (https://rarediseases.info.nih.gov/diseases/5969/buerger-disease) Accessed 6/30/2021.
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  • MedlinePlus. Raynaud’s Disease. (https://medlineplus.gov/raynaudsdisease.html) Accessed 6/30/2021.

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