Medical Questions » Smoking Questions » Question No. 936
| Question: | Have you heard of cigarette smoking as a cause of pain in the calf when walking. I heard it was called ' smoker' s foot' ? |
| Answer: | Smoker' s foot, or Buerger' s disease, is a cause of peripheral vascular disease (narrowed arteries in the extremities). Other causes include hardening of the arteries, high blood pressure, excess cholesterol and diabetes.
The other technical name for Buerger' s disease is thromboangiitis obliterans, which when translated into English means ' clotting, inflammation and obliteration of arteries' . Dr. Buerger, who first described the disease, was an American urologist (urinary tract specialist) who worked in New York and Los Angeles in the first half of the twentieth century.
Smoker' s foot is a dreadful disease which causes the loss of fingers, toes, then arms and legs; and it occurs only in smokers (thus the common name), nearly always in men, and often young men.
Due to the influences of toxins within tobacco smoke, segments of the small arteries in the hands and feet become inflamed. This inflammation causes a clot to form in the artery, which becomes completely blocked. The tissue beyond this blockage is then starved of blood, becomes painful, white and eventually gangrenous.
The process starts in the fingers and toes, and slowly moves along the arteries, further and further up the arms and legs. A limb may eventually be totally amputated, but often over several operations, as each successive area becomes deprived of blood.
The first symproms are a pain in the foot when walking which settles with rest, red tender cords caused by involved blood vessels may be felt under the skin, and a finger or toe may be white and have reduced sensation.
The next stage is characterised by pain at rest, loss of pulses in the hands and feet, and ulcers around the nails. Cold weather may aggtavate the symptoms. If the disease progresses further, gangrene results.
Treatment involves trying to stop these patients from smoking, but because they are even more addicted to their habit than the average smoker, this is extremely difficult. If smoking is stopped, the disease usually does not spread any further.
If the disease progresses, surgery to die nerves supplying the arteries to make them totally relax and open up as much as possible may be tried, but progressive amputation of the limbs is often necessaty. If the patient cannot stop smoking, clots may form in vital otgans and cause death.
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