Buerger’s Disease

Buerger’s disease (thromboangiitis obliterans) is a rare disease most often found in those who smoke. The blood vessels in their legs, arms, feet and hands get inflamed, making it hard for blood to travel through. Clots make the issue worse, leading to pain and damaged tissue. Quitting smoking is the best way to make symptoms better.


With Buerger’s disease, inflammation in your blood vessels limits blood flow in your fingers, toes, arms and legs.
With Buerger’s disease, inflammation in your blood vessels limits blood flow in your fingers, toes, arms and legs.

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 have pain and damaged tissues starting in your fingers and toes and spreading to your arms and legs.

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.


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Symptoms and Causes

What are the symptoms of Buerger’s disease?

Early signs of Buerger’s disease include severe pain in your legs and arms. This pain happens when your body is resting.

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 syndrome.
  • 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.
  • Cold or numb feet or hands.
  • Gangrene.
  • Skin ulcers.

What causes Buerger’s disease?

The cause of Buerger’s disease isn’t known, but scientists think something in tobacco hurts the lining in your blood vessels. Most people with Buerger’s disease use tobacco.

Your genes may make you more likely to get Buerger’s disease. Some scientists think it’s an autoimmune disease.

What are the risk factors for Buerger’s disease?

Buerger’s disease risk factors include:

  • Smoking cigarettes, chewing tobacco or using marijuana.
  • Making your own cigarettes.
  • Being male or assigned male at birth.
  • Being age 20 to 45.


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 consider results from:

  • A physical exam.
  • Your medical history.
  • Vascular (blood vessel) tests.
  • 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’s no cure for Buerger’s disease, but stopping all tobacco, marijuana and nicotine use is the best way to keep Buerger’s disease from getting worse. Providers also recommend avoiding secondhand smoke (other people’s smoke).

The disease can keep getting worse even if you only smoke one cigarette each day.

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.

Specific medicines can help with your Buerger’s disease symptoms.

What medications are used for Buerger’s disease?

Some medications are helpful in Buerger’s disease treatment, including:

What treatments are used for Buerger’s disease?

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

Complications/side effects of the treatment

Quitting smoking has no side effects. It improves your health in many ways.

All medications have possible side effects, and they vary by drug. Your provider will carefully consider the best medication for you.

Amputation of a finger or toe may lead to swelling, pain or infection.

Spinal cord stimulation has a number of risks, including:

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


How can I lower my risk of Buerger’s disease?

To avoid getting Buerger’s disease, don’t smoke or use tobacco of any kind. You should avoid nicotine patches and marijuana as well.

Outlook / Prognosis

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

As there’s 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 Buerger’s disease lasts

Symptoms last from one to four weeks at a time, but they usually come back. Quitting all tobacco products, nicotine and marijuana is the best way to control Buerger’s disease symptoms.

Outlook for Buerger’s disease

Although there’s no cure for Buerger’s disease, you can quit using tobacco products to keep it from getting worse. If you keep using tobacco products, 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?

The best thing you can do is to stop using any type of tobacco to keep Buerger’s disease from getting worse. You should also avoid nicotine patches and marijuana, as these may allow Buerger’s disease to continue or worsen.

About 50% of the people with Buerger’s disease who keep using tobacco end up needing to have 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.
  • Keep taking any medicines your provider ordered for you.

When should I see my healthcare provider?

Get help if you have Buerger’s disease symptoms or if your symptoms get worse. If you have Buerger’s disease, you should have regular check-ups with your provider.

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?
  • Is there a support group for quitting smoking?
  • What’s the best treatment for me?

Additional Common Questions

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

Raynaud’s disease or syndrome 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 many more symptoms than Raynaud’s disease.

A note from Cleveland Clinic

Buerger’s disease is a rare issue 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. Ask your provider to help you quit smoking so you can feel better.

Medically Reviewed

Last reviewed on 05/03/2023.

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