If you use tobacco or smoke and have pain and swelling in your limbs, you may have Buerger's disease. The quicker you are diagnosed, the better your outcome.
In Buerger’s disease, or thromboangiitis obliterans, small blood vessels in your hands and feet become inflamed and may become blocked by blood clots. Eventually, this can block the flow of blood to your extremities, leading to infections and gangrene (tissue death).
Causes and Symptoms of Buerger's Disease
Most patients with Buerger's disease, which is a type of vasculitis, have a history of heavy tobacco use, smoking, vaping or using tobacco products (such as chewing tobacco). But scientists also think Buerger's disease may be an autoimmune disorder. Something in tobacco may trigger the immune system to mistakenly attack your blood vessels.
Symptoms of Buerger’s disease include the following:
- Pain in the legs, ankles or feet when walking
- Cold fingers or toes
- Low or missing pulse in hands or feet
- Pain in the hands and feet
- Burning or tingling
- Often occurring at rest
- May be worse with cold exposure or with emotional stress
- Ulcerations or sores on your fingers and toes
If you have any of the symptoms above, talk to your primary care doctor. If your doctor suspects Buerger's disease, you may benefit from the expertise of a rheumatologist.
Buerger's Disease Care at Rush
Rush rheumatologists specialize in diagnosing and treating all types of vasculitis, including Buerger's disease.
Testing: There is no single test for Buerger’s disease. But we need to rule out other conditions that cause similar symptoms as Buerger's disease. To do this, we may order various tests, including one or more of the following:
- Angiography to look for blocked or constricted blood vessels, sometimes shaped like a corkscrew
- Ultrasound to check for blood clots
- Blood tests to check for other causes of vasculitis and inflammation
- Biopsy of the blood vessel to confirm our diagnosis
Treatment: There is no cure for Buerger's disease. The goal of treatment is to control your symptoms and to prevent disease progression.
The single most important step you can take is to stop using all tobacco products. This is the best way to slow the disease. If you continue to smoke, your chance of needing to get a limb amputated almost doubles. We view amputation as the last resort. However, if you have severe ulcerations in your fingers and toes, the joints may need to be removed to stop the spread of an infection or gangrene.
Other treatments that we may recommend including the following:
- Medications to open the blood vessels
- Corticosteroids to reduce inflammation and provide pain relief
- Surgery to cut nerves, which can help control pain and improve circulation
- Lifestyle changes, including applying warmth to affected areas, exercise to increase circulation and avoiding cold temperatures
Rush Excellence in Buerger's Disease Care
- Vasculitis expertise: Many of the rheumatologists at Rush specialize in treating patients with vasculitis, such as Buerger's disease. They also conduct research, including clinical trials, aimed at identifying new treatments. This means you will have access to promising new therapies as they become available.
- Behavior change support: Our clinicians can guide you on how to stop smoking or using tobacco products, which is critical to treating Buerger's disease. We can connect you to many helpful resources at Rush, including the Rush Prevention Center, which provides counseling on how to change unhealthy behaviors, including tobacco use, and adopt healthy habits.
- Limb preservation: The Rush Center for Limb Preservation aims to save the limbs of patients with serious wounds. The physicians at the center use advanced reconstructive techniques and technologies, which may increase your chances of keeping a limb that looks like it might have to be amputated due to Buerger's disease.