Causes
Buerger's disease is greatly associated with heavy to moderate tobacco use (both cigarette and smokeless). Smoking triggers an autoimmune response in which the immune system produces antibodies that attack the body's own tissues. The arteries in the leg, hand and sometimes those in the arms become inflamed, reducing blood supply to the tissues.

Who is affected by Buerger's disease?
Buerger's disease usually affects men between ages 20 to 40, who smoke or chew tobacco. Recently, however, more women and men over the age of 50 have been diagnosed with Buerger's disease. Socioeconomic conditions, working environment may also play in etiology of the disease. It is seen more in out door and manual workers. Hepatitis B Virus and rickets may contribute to the pathogenesis. This disorder is still very uncommon in children, but it may occur in those with autoimmune diseases. . Though "passive smoking" has adverse effect on cardiovascular system, non smokers should never develop the disease.

Symptoms
Symptoms of reduced blood supply to the arms or legs develop gradually, starting at the fingertips or toes and progressing up the arms or legs, eventually causing gangrene. People may feel coldness, numbness, tingling or burning before their doctor sees any signs of the disease. Patients often have get muscle cramps in the arches of their feet or in their legs but rarely in their hands, arms or thighs. With more severe obstruction, the pain is worse and lasts longer. Early in the disease, ulcers, gangrene or both may appear. The hand or foot feels cold, sweats a lot and turns bluish; this is due to the crying of dying nerves. Symptoms may worsen with exposure to cold or emotional stress. Pain may increase with activity such as walking and decrease with rest .Pulse may be decreased or absent in the affected limbs.

Diagnosis
Buerger's disease is often masked by a wide variety of other diseases that cause diminished blood flow to the hands and feet. Because of this, other disorders must be ruled out with aggressive evaluation. An angiogram or an arteriogram of the upper and lower limbs or Doppler ultrasound may detect blockage of blood vessels in the hands and feet. Skin biopsies are also done. Active smokers can be identified by measuring levels of nicotine.

Prevention and treatment
To avoid the onset of Buerger's disease, men should avoid tobacco use. Avoiding cold will reduce the risk of symptoms developing in those who already have the disease. There is no cure for Buerger's Disease. The only effective treatment is to stop smoking. If an affected individual continues to smoke they're very likely to need amputation of toes or fingers. Infections should be treated promptly.

Do's and don't
The goal of the treatment of Buerger's disease is to control the symptoms. We can take some measures to manage the disease and reduce the severity. We should massage the affected area gently and keep it warmth to increase circulation. Always we should avoid cold. Because it reduces circulation to the limbs, Sitting or standing in one position for long periods can also enhances the severity of the disease. We should not walk barefoot and do not wear tight or restrictive clothing.

As a final point, always consult a doctor and report all injuries for appropriate treatment.