The most important manifestation of thromboangiitis obliterans is pain. To the physician its severity and persistence may present a problem that exhausts his ingenuity. To the patient it may mean not only great suffering but also incapacity for work, sleepless nights, anorexia, loss of weight, mental breakdown and finally loss of a limb. In the majority of cases in which amputation of a limb is required in thromboangiitis, it is done not because of extensive gangrene, ascending infection or septicemia but because of pain—severe, prolonged, uncontrollable, unbearable pain. Furthermore, the great majority of patients who have this disease are not "neurotic" or hypersensitive; their tolerance for pain is somewhat above the average.
Goldsmith and Brown1 have analyzed the types of pain in thromboangiitis obliterans and have grouped them under the following headings: (1) vascular inflammatory pain, (2) pain of acute arterial occlusion, (3) intermittent claudication, (4) pretrophic pain, (5)
BARKER NW. LESIONS OF PERIPHERAL NERVES IN THROMBOANGIITIS OBLITERANS: A CLINICOPATHOLOGIC STUDY. Arch Intern Med (Chic). 1938;62(2):271–284. doi:10.1001/archinte.1938.00180130092006
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