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It more commonly affects the legs than the arms, with the initial symptom often being severe pain in the distal parts (parts far from the torso - hands and feet) during periods of rest. Patients may also experience cramps during walking, which can lead to limping. In rare cases, ulcers may develop on the extremities, along with numbness, tingling, and reduced blood flow in the fingers when exposed to low temperatures. In severe cases, the disease can lead to inflammation and blockage of veins and even tissue death (gangrene) in the affected limbs.

The exact cause of Buerger's Disease is still unknown, but it is most commonly associated with heavy tobacco use. Smoking is considered the primary trigger for its onset and development. Existing research has shown that quitting smoking significantly influences the course of the disease and is one of the main factors for recovery.

Vacuum Therapy for Buerger's Disease Treatment at Fizionova

At the Fizionova Center, we successfully treat numerous diseases that directly or indirectly limit freedom of movement. Buerger's Disease is one such condition, and among other treatments, we recommend hypobaric therapy to our patients to address the problems arising from this disease. This method involves applying a low-pressure vacuum to the hands and feet, which has proven to be highly effective after various injuries and fractures and in cases of Buerger's Disease.

Hypobaric/Vacuum therapy generates alternating pulsed pressure changes in the extremities, leading to improved circulation, accelerated oxygenation, and faster oxygen transfer to tissues. The therapy is carried out using a special vacuum bag and ventures, with different applicators available for treatment on various surfaces and even hard-to-reach parts of the body. The goal of hypobaric (vacuum) therapy for Buerger's Disease is to significantly reduce pain and swelling, with relief often noticeable after the first treatment.

Buerger's Disease and Atherosclerosis

Buerger's Disease and atherosclerosis are often confused, although they are different conditions.

Buerger's Disease typically starts before the age of 40, while atherosclerosis generally begins after the age of 40. Buerger's Disease affects the distal parts of the extremities and veins, while atherosclerosis typically involves larger arteries and the lower extremities. The main risk factor for Buerger's Disease is smoking, while atherosclerosis is influenced by genetic factors, hypertension, obesity, and smoking.

Disease Progression

The disease begins under the influence of exogenous factors (smoking, infection). Accumulation of antibodies and the formation of immune complexes in the walls of blood vessels occur. Activation of the complement system (a component of the human immune system) leads to structural changes in the blood vessel walls, inflammation cells accumulate, and vascular inflammation occurs. As a result of these processes, the blood vessel wall thickens, its lumen narrows, and blood flow is reduced. If the disease continues to progress, the blood vessel is completely occluded, disrupting blood flow through the affected segment. Tissue distal to the site of occlusion begins to deteriorate, leading to gangrene. If the disease is diagnosed late, in an advanced stage, amputation of the affected limb may be necessary.


The first sign of Buerger's Disease is often pain in the hands or feet, which can extend to the arms and legs. Pain may occur during activity or at rest. Stress or having a cold can intensify the pain. Other symptoms that may be present include:

  • Pale, red, or bluish fingers on the hands.
  • Cold hands or feet.
  • Pain in the hands and feet that may also feel like tingling or pins and needles.
  • Pain in the legs, ankles, or feet while walking, often in the arch of the foot.
  • Skin changes or small painful sores on the fingers of the hands or feet.

Causes of Buerger's Disease

Although smoking is a significant factor in the development of Buerger's Disease, the exact cause is still unknown, and it is unclear how tobacco contributes to the condition. One hypothesis is that chemicals in tobacco irritate the mucous membrane of blood vessels, leading to swelling. There is also suspicion that some people may be genetically predisposed to developing Buerger's Disease, and it could involve an autoimmune response where the body's immune system mistakenly attacks healthy tissue.

How Is the Diagnosis Established?

The diagnosis is based on the patient's medical history and physical examination. Treatment for Buerger's Disease involves quitting smoking. Additionally, measures such as avoiding cold and medications that constrict blood vessels are needed. Patients must also take precautions against thermal, chemical, and mechanical injuries to the extremities.

Treatment for Buerger's Disease with Advanced FSWT Therapy

Quitting smoking is one of the first pieces of advice you will receive from your doctor for the treatment of Buerger's Disease. Even a few cigarettes a day can significantly worsen the initial condition. In addition to smoking cessation, other treatments that aim to increase blood flow and alleviate pain are helpful. One such treatment is the application of focused FSWT therapy

These treatments may involve:

  • Medications to dilate blood vessels or dissolve clots.
  • Walking exercises.
  • Intermittent compression of the hands and feet.

In cases where the disease has significantly progressed, a doctor may suggest sympathectomy, a minimally invasive surgical procedure. In the most severe cases, when the area is highly infected, amputation may be necessary.

There are also other treatments that are still in the research phase. Studies are being conducted to investigate how growth factors affect pain relief and healing in Buerger's disease, as well as the action of stem cells that can assist the body in forming new blood vessels..

Treatment outcome

The primary determinant for the treatment outcome is the elimination of tobacco products. With smoking cessation and regular therapy, this disease can be effectively managed. If you stop using tobacco products, symptoms associated with Buerger's disease can simply disappear with minimal therapy, and the best way to ensure that this therapy is less invasive is to consult a doctor promptly when you notice the first signs of the disease to avoid all possible complications.




Leading center for innovative therapies in the region


Dr Jelena Kluz-Đurđević, a specialist in physical medicine

After a conversation with the patient, Dr. Jelena will conduct an examination to obtain a more comprehensive view of your health status, helping to determine whether it's an injury or a diagnosis.

The examination lasts for 30 minutes and includes:

Schedule a specialist examination by calling 011 2100 588 for the cost of 4,000 RSD.