by EBSCO Medical Review Board
(Thromboangiitis Obliterans)


Buerger disease is the inflammation and blockage of blood vessels. This reduces blood flow and can lead to tissue damage. It mainly affects the vessels in the hands and feet.


The exact cause is not known. It is strongly linked to tobacco use. The link is not well understood.

Risk Factors

This risk of this problem is higher in people who smoke, especially young males. This includes smoking cigarettes , using chewing tobacco, smoking cigars, or using any other type of tobacco.


Poor blood flow to the hands and feet may cause:

  • Pain, numbness, burning, and tingling
  • Cold hands and feet
  • Changes in skin color (white, red, or bluish hands or feet)

Buerger disease can lead to sores and swelling under the skin. People with severe symptoms may have 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 is similar to other health conditions.

Your blood may be tested to rule out other problems.

Your blood vessels may be checked. This can be done with an angiogram.


There is no cure. The goal of treatment is to stop the disease from getting worse. To do this, all tobacco products must be stopped. There are many methods that can help a person quit.

Other treatments include:

  • Medicine to:
    • Improve blood flow
    • Dissolve clots
    • Lower blood pressure
  • Wound care to help with skin healing
  • Surgery to control pain and increase blood flow

People with severe disease may need to have an amputation to remove dead tissue. This is more common in people who do not stop smoking.


The risk of this health problem can be lowered by avoiding 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 August 3, 2021.

Buerger’s disease. Vasculitis Foundation website. Available at: Accessed August 3, 2021.

Buerger’s disease (thromboangitis obliterans). UC Davis Health System website. Available at: Accessed August 3, 2021.

Smoking and Buerger's disease. Centers for Disease Control and Prevention website. Available at: Accessed August 3, 2021.

Thromboangiitis obliterans. EBSCO DynaMed website. Available at: Accessed August 3, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 07/2021
  • Update Date: 08/03/2021