Buerger disease is inflammation of the blood vessels. This condition mainly affects the vessels in the hands and feet. Inflammation and blood clots can form and block blood flow. This leads to pain, tissue damage, and even tissue death.


The exact cause is not known.

Risk Factors

Buerger disease is linked to tobacco use. This includes smoking cigarettes, using chewing tobacco, smoking cigars, or using any other type of tobacco.

It's more common in:

  • Men
  • People aged 20-40 years old
  • Those who live in Eastern Europe and Asian countries

Buerger disease is not common in the US.


Poor blood flow causes problems. It usually starts in the hands and feet, causing:

  • Pain, numbness, burning sensation, and tingling
  • Cold hands and feet
  • Skin discoloration (white, red, or bluish hands or feet)—These changes may be triggered by certain conditions such as exposure to cold. This is called Raynaud phenomenom.

Buerger disease can lead to swelling under the skin, sores, and ulcers. The most serious complication is tissue death ( gangrene). Gangrene causes skin in the hands and feet to turn black.

Tissue Death in the Foot
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The doctor will ask about your symptoms and health history. Buerger disease is hard to diagnose because it’s similar to other health conditions. You may have:

  • A physical exam
  • Blood tests
  • An angiogram to check your blood vessels


This first thing you’ll have to do is quit smoking. This can help to lower the chances the disease will worsen. Your doctor will help you find the best way for you to quit.

Other treatments:

  • Proper wound care—You will need to take special care of your skin. If your feet are numb you may not realize that you have a cut. Your doctor may ask you to carefully inspect your skin daily.
  • Medicines
  • Exercise
  • Surgery

Amputation may be needed to remove dead tissue in those with severe disease. People who continue to smoke are at a greater risk of amputation.


The best way to prevent Buerger disease is to not use tobacco products.


National Heart, Lung, and Blood Institute

Vasculitis Foundation


Health Canada

When it Hurts to Move—Canadian Orthopaedic Foundation


Buerger’s disease. The Johns Hopkins Vasculitis Center website. Available at: Accessed July 10, 2018.

Buerger’s disease. Vasculitis Foundation website. Available at: Updated September 2012. Accessed July 10, 2018.

Buerger’s disease (thromboangitis obliterans). UC Davis Health System website. Available at: Accessed July 10, 2018.

Smoking and Buerger's disease. Centers for Disease Control and Prevention website. Available at: Updated March 22, 2018. Accessed July 10, 2018.

Thromboangiitis obliterans. EBSCO DynaMed Plus website. Available at: Updated December 12, 2017. Accessed July 10, 2018.

Last reviewed May 2018 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC  Last Updated: 7/10/2018