PT on the Net Research

Buergers Disease


Question:

I have a new client who has been diagnosed with Buerger's disease. Apparently this disease inhibits circulation to his hands and feet. I have read that it is ok to do light to moderate exercise to improve this condition. Can you give me some guidance on how to proceed with this new client?

Answer:

Buerger’s Disease, also called thromboangiitis obliterans, refers to acute inflammation and clotting in small and medium-sized arteries of the legs or arms.

The cause is unknown, but one theory is that it’s an autoimmune reaction activated by nicotine or some other chemical in tobacco. Another theory is that tobacco triggers inflammation and constriction of arteries. Most patients are males (at least 75 percent), 20 to 40 years old and heavy smokers. However, only a small number of smokers develop Buerger's disease.

Early signs include tingling, numbness, burning, pain, inflammation and swelling in the legs, feet and sometimes hands. These early symptoms may be aggravated by exercise.

The only way to prevent the progression of the disease is by abstaining from all tobacco products (including smokeless tobacco). Patients who continue to smoke often end up requiring amputation of their fingers or toes.

Your client may be susceptible to cramps in his calves or feet, or in his forearms and hands. If he allows the disease to progress, these cramps will become more painful and last longer.

He also needs to avoid cold environments and should be careful about using certain drugs including pseudoephedrine (common in OTC headache and cold remedies) that cause vasoconstriction.

Similar to working with diabetics, make sure that your client’s shoes fit well, he wears comfortable socks that “breathe,” and that he regularly inspects his feet for cuts or abrasions. Also, any corns and calluses should be treated by a podiatrist.

Although it may be necessary to restrict strenuous exercise in extreme cases of Buerger’s Disease, exercise is generally recommended. Walking or jogging for 15 to 30 minutes once or even twice a day is often effective in establishing collateral blood flow and alleviating symptoms.

There are also special exercises called Buerger-Allen exercises that help ease pain, relieve swelling and promote circulation. These are simple, but you should still get complete instructions on these from your client’s health care professional.