Buerger’s disease is a rare vascular disease that affects people worldwide of any age, group, or race. It often occurs in men located in Middle Eastern and Asian countries where smoking is most prevalent. It spreads in the age of 40 and 45 among those who are heavy users of tobacco products.  The small and medium-sized arteries and veins get inflamed. This leads to narrowed or blocked vessels. The lack of blood flows to the tissues results in pain and tissue damage. The specific cause of this disease is unknown.  Consuming tobacco is the main cause of developing this disease in men. Diagnosis is usually made by eliminating other conditions with similar symptoms. Some treatments can help control the disease, but there is no permanent cure. Patients need to stop all use of or even exposure to tobacco products. This helps to remit and to avoid amputation.

1. Decreased blood flow

This disease causes arteries and veins to become inflamed and cause swelling. Blood clots cause them to block up. When this happens, it restricts normal blood flow. Lack of blood flow ensures that tissues will no longer receive oxygen and nutrients.



Exercise can help to improve circulation in arms and legs. It is so because it raises the heart rate and gets the blood pumping. Massages and warmth also increase circulation. Sitting or standing in one position for longer duration decreases circulation. Drinking plenty of fluids also helps to increase circulation.


2. Pain in affected areas

Pain usually starts in the extremities like the fingers and toes.  It sometimes feels like burning and radiates to other parts of the body. It occurs when the patients stop doing hand activities. As the conditions get worse, patients start experiencing the pain even while resting. The benefit of bypass surgery is controversial. A surgery called surgical sympathectomy involves cutting nerves to the affected area. Small incisions allow the tiny nerves around the blood vessels to be stripped away. This type of surgery has not been that successful. The new techniques to unblock individual arteries of fingers or toes are developing.


3. Numbness and tingling

In early stages, patients may experience tingling in their toes and fingertips. This tingling may even start to feel like burning. They may experience numbness and tingle even during minimal exercise. There are many possible causes of numbness and tingling. Some of these are pressure on a nerve or use of certain medicines.


Any supportive care at this stage is to try and maximize blood flow to the area. Treatment of these symptoms will depend on the cause. As numbness leads to a decrease in feeling, a patient may be more likely to suffer accidental injury. Protection from bruises, cuts, burns, and other injuries is important. 


4. Inflammation

Buerger’s disease is a type of vasculitis, and acute inflammation of the blood vessels occurs. Inflammation is a defense mechanism employed by the immune system. It alerts us that damage exists and healing needs to take place.


The usual anti-inflammatory treatments like steroids do not seem to be very effective. Taking supplements rich in plant enzymes helps to break down by-products of inflammation. This allows helps in cell repair. Some experimental treatments are spinal cord stimulation and vascular endothelial growth factor gene therapy.


5. Non-involvement of organs

In many other forms of vasculitis, damage to other bodily organs may occur. In the case of Buerger’s disease, this does not happen. Despite the lack of blood flow, organs like lungs, gastrointestinal tract, and brain remain unaffected.


The most important factor that can affect the progression of this disease and severity of symptoms is smoking. Even a cigarette a day can worsen the disease. Only when patients stop using tobacco products completely, their symptoms will disappear. They can even avoid any further need for treatment.


6. Ulcers and open sores

Skin ulcers are open craters with layers of eroded skin. The skin surrounding the ulcer may be swollen, tender and red. Patients complain of constant pain with chronic ulcers, and they tend to take a long time to heal.


In patients with symptoms like ulcers, drug use may improve circulation in the affected areas. This helps to heal ulcers and relieve pain. In clinical trials, various drugs seem to improve symptoms. It slows down the progression of the disease. Intravenous use of the drugs helps to relax the blood vessels and improve blood flow.


7. Raynaud's Phenomenon

This is the color change in toes and fingers after exposure to cold. This occurs due to lack of blood flow to the local tissues. At first, the extremities turn white because of the lack of blood flowing to them. If they continue to receive less oxygen, they may turn blue. When the blood vessels dilate again, they turn red.


Treatment involves avoiding cold temperatures as far as possible. It’s important to cover when going out into the cold. Don’t take medications that can increase constriction of blood vessels. It may help to take an oral medication that dilates blood vessels such as a calcium channel blocker. Avoid compression of blood vessels by wearing tight-fitting clothing, rings, wristbands, and footwear.


8. Thrombosis (clots)

An angiogram helps a physician to see what’s happening inside of the blood vessels. A blockage in an artery also results in narrowing of vessel and cork-screwing of arteries around it. 


Clinical trials show that anti-clotting medication does not appear to be very effective. Trying to thin the blood with medications or other agents to prevent clots does not seem to help much. Using intra-arterial thrombosis therapy for pre-gangrenous lesions has been successful in some patients.


9. Infection

When you develop open sores on your hands or feet, it is easier for infection to occur. Infection results when a foreign organism like a virus, bacteria, or parasite enters the system. Infected sores or ulcers become red and tender. It may develop an unpleasant odor.   


Wearing well-fitting, comfortable, protective shoes, and gloves help to protect hands and feet. This can help to avoid infection. When signs of infection exist, antibiotic treatment is often necessary. Painkillers may also be necessary.


10. Gangrene

Gangrene occurs when skin and tissue at the end of the toes or fingers die. Symptoms of gangrene include blackish skin, loss of feeling, and a foul smell. It is a very serious condition that may require amputation of the affected toe, finger, or limb.  When patients continue to smoke, more blockage and ulceration occurs. Gangrene may develop requiring amputation of fingers or toes. Some people may even have to undergo a whole foot or a leg below the knee amputated. Patients who stop using tobacco can often manage to avoid amputation. If they continue, it is likely that they will lose digits or even part of a limb. 



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