PROBLEMS IN THE UPPER EXTREMITIES AND HANDS
As we have noted above, decrease in blood flow has its greatest effect upon peripheral tissues. Blood, which has been thickened and is oxygen poor, must travel through arteries which are more narrow than usual. All tissues in the human body are affected, but in general, the further away we are from the oxygen source (the lungs), the greater the consequence. The problem is magnified in the distant hands and feet.
In the hands, a condition which is known as Dupuytren’s Contracture can occur. Although this problem may arise in individuals who do not smoke, it is much more common among longstanding smokers.
An additional problem is Reflex Sympathetic Dystrophy (RSD) also known as Complex Regional Pain Syndrome (CRPS). This condition results in chronic pain which usually follows a traumatic injury. The injury may be minor or severe, but the pain becomes chronic, even after healing. The skin becomes overly sensitive and careful observation reveals changes in the skin, and on x-ray, in the bone.
The reasons for this problem are not entirely understood. Research indicates an increase in activity of the autonomic nervous system, and in particular, the sympathetic portion of this system of nerves. These nerves supply many tissues in the extremities, but primarily regulate blood flow. It is now well recognized that individuals who smoke are more susceptible to this condition.
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