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医者、男
医者、男

ぎっくり腰の判断基準と処置

医師

ぎっくり腰は年配の人ばかりがなるもので、放っておけば治ると思っていませんか。ぎっくり腰はどの年代にも起こりえる腰痛です。しかも、最初の処置を間違えば慢性化する危険性や、酷いときには命の危険にもさらされます。

ぎっくり腰の7割は筋肉や周辺組織の炎症が原因ですが、それ以外のものと区別する術を持っていますか?また、ぎっくり腰治療に必要な知識を知っていますか?

そこで、本記事ではぎっくり腰の応急処置や間違えやすい病気をご紹介していきます。正しいぎっくり腰の対処方法を知り、突然起こるぎっくり腰を処置していきましょう。

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ぎっくり腰とは

医師

ぎっくり腰は、突然急激な腰痛に襲われることだと思っていませんか。しかし、ぎっくり腰とは医学的には「急性腰痛症」といい、「椎間板ヘルニアなどのように原因がわかっているもの以外の腰痛で急性のもの」と捉えられています。

そのため、ぎっくり腰は症状が出る箇所が筋肉であったり、関節であったり、腰椎であったりと様々です。痛みを感じる箇所も人によって違い、お尻が痛む人や腰の中心が痛む人などがいます。

そのようなぎっくり腰ですが、見分ける方法があります。

  • 動けないほどの痛みを感じる
  • 痛みが出た原因がはっきりしている
  • 姿勢を変えると少し楽になる
  • 足や腰にしびれがない
  • 腰痛以外の症状がない

これらが当てはまるようなら、ぎっくり腰の可能性は高いでしょう。これにあてはまらず、寝ていていきなり腰痛が出た、姿勢を変えても痛みが取れない、腹痛や熱があるなどの場合は内臓の疾患である危険性もありますので、早めに病院で処置をする必要があります。

ぎっくり腰と間違えやすい病気

急に起こる腰痛でぎっくり腰と間違えやすいものは原因が外科的なものと内科的なものにわかれます。それぞれ処置方法は異なり、適切な対処をしないと腰痛は治まりません。そこで、外科的なものと内科的なものに分けてご紹介していきます。

外科的なもの

外科的なものには、足や腰のしびれが伴います。もし強い痛みがなくなっても足がしびれている、ということがあれば、病院へ行き、適切な処置をしてもらいましょう。こちらでは代表的な椎間板ヘルニアと坐骨神経痛をご紹介します。

椎間板ヘルニア
ぎっくり腰ともっとも間違われやすいのが椎間板ヘルニアです。椎間板は、24個の背骨が積み木のように連なっているその間にあり、クッションの役割をしています。その椎間板の中にある、髄核が突出してしまい、神経に刺激を与えるのが椎間板ヘルニアです。

坐骨神経痛
坐骨神経は背骨からお尻を通り、太ももの裏側やふくらはぎを通っています。椎間板ヘルニアや股関節疾患により坐骨神経が刺激をうけ、痛みを感じている状態です。背骨に症状がおこったとしても、しびれや痛みは太ももの裏やふくらはぎに感じます。

このほかにも腰の病気はいくつかありますので、ぎっくり腰とは違うと思ったらすぐに病院で検査を受けましょう。外科的なものであれば、レントゲンなどですぐにわかります。

内科的なもの

腰周りには多くの内臓があり、それらの異常でも腰に痛みを感じることがあります。内臓が原因で起こる腰痛は様々なものがあります。それぞれに合った適切な処置をしないと腰痛が治まるどころか症状が悪化するかもしれません。

内科的なものは、実に多岐に渡っています。

  • 消化器系:慢性胃炎、十二指腸潰瘍、急性膵炎、虫垂炎
  • 泌尿器系:尿管結石、腎臓結石、膀胱炎
  • 循環器系:動脈瘤解離、腹動脈瘤
  • 子宮系:子宮内膜症、子宮筋腫

これらは医師の診察を受け、適切な処置をしてもらうことが大切です。ガンや血液に関係のある動脈瘤は命に関わることもあります。「高熱がある」「原因不明の痛み」「どの体制になっても痛みが取れない」「腹の辺りに脈動を感じる」「背中やお腹も痛い」などの症状に気付いたらすぐに対処するべきです。

ぎっくり腰の応急処置

ぎっくり腰は最初の処置がその後を左右すると言われています。最初の痛みが強いときに適切な処置をしないと症状が慢性化し、治療期間が延びてしまいます。

通常のぎっくり腰であれば、最初の2~3日は「冷やす」「安静にする」が一番です。しかし、自宅以外の場所で起こることも少なくないでしょう。そこで、ぎっくり腰になったときの応急処置をご紹介します。

  • ①安全な場所に移動する
  • ぎっくり腰になるのは何も自宅だけではありません。野外の場合、二次被害を避けるためにも安全な場所を探し、移動しましょう。
  • ②安静にする
  • 自宅など横になれる場所がある場合は横になります。しかし、横になれない場合は、とにかく楽な姿勢をとれる場所をさがしましょう。
  • ③患部を冷やす
  • 氷枕やアイスノンで患部をしばらく冷やします。外出先であれば、缶ジュースやペットボトルで代用しましょう。
  • ④腰を固定する
  • ずっとそのままの場所にいるわけにもいきません。腰をコルセットなどで固定すると移動のときの痛みが和らぐので、外にいる場合は腰を回せるくらいのタオルやマフラーを腰に巻いて固定しましょう。これで移動が多少は楽になるはずです。位置は自分が楽になるところで構いません。ラップやビニール袋でも代用できます。
ALINCO(アルインコ)  エクササイズ フロアマット 厚さ 9mm EXP150
ALINCO(アルインコ) (2012-04-05)
売り上げランキング: 162

まとめ:ぎっくり腰の適切な処置を知ろう

ここまででぎっくり腰の症状と似た病気、応急処置をご紹介してきました。急な腰痛は、ほとんどがぎっくり腰で、家庭で処置することも可能です。(その後のぎっくり腰治療に関しては突然のぎっくり腰のための治療方法をご覧ください)

ただし、ぎっくり腰だと決める前に自分の腰痛がぎっくり腰かどうかを判断してからにしましょう。ぎっくり腰だと思っていくら対処しても一向に良くならない場合、原因は違うところにあるかもしれません。

腰痛と一言で言っても、原因は様々です。突然の腰痛イコールぎっくり腰ではなく、腰痛の中でも本記事のチェック項目に当てはまるようなものがぎっくり腰に該当するのだと理解し、適切な処置をしていきましょう。

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