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首、後頭部
首、後頭部

これは五十肩?!知っておきたい首のヘルニアの原因と症状

首

 
頚椎椎間板ヘルニアは、よほど大きな外傷によるものでなければ、なんとなく体調が優れない、肩こりがひどくなった、首の後ろがちょっと痛い、といった微細な症状が出てきます。

似たような症状を示すものが多いこと、四十歳代で発症することが多いので「四十肩、五十肩」と勝手に判定する人が多いようです。早めに対処しないと手術が必要になることも。

こちらでは、首のヘルニアの原因と症状などを詳しくご紹介します。

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頸椎ヘルニア

ヘルニア

肩こりの男

椎間軟骨は、中心部の骨髄核とその周辺を取り巻く繊維輪という部分で成り立っていますが、老化や過度の負荷などによって、亀裂を生じ、そこから骨髄核が突出したり、膨張した状態をヘルニアといいます。

ヘルニア椎間板の後ろ(後方正中部)は、後縦靭帯が強固なので、通常は左右どちらかに突出又は膨張し、その部分の骨髄神経を圧迫して、腰部ならば、腰痛や坐骨神経痛を起こし、頚部(首)ならば、上肢の神経症状や、まれに下肢の痺れ(痙性麻痺)を起こします。

首のヘルニアとは

腰部とは少し違って、「頸椎症」と呼ばれる骨の変形から生じることが多く、重症例になると、脊髄を圧迫する「頚椎症性脊髄症」と呼ばれる疾患になることがあります。

一般的な症状

首が動かせなくなるような痛みで始まる事が多いのですが、首の他にも、肩・上腕・肩甲部の痛みや痺れ、脱力感が生じます。また、痛みやしびれは、腕から手にもその症状があらわれます。

重度の場合には、両手や下半身にまでおよび、物がつかみにくい・物を良く落とす・足が突っ張る・歩きにくいなどの症状へ進行することもあります。その他にも、頭痛・めまい・吐き気・耳鳴りなどの症状がでる事もあります。下記の順にゆくほど症状は悪化しています。

  • 1.首痛・肩こり・背中の痛み
  • 2.手のしびれ、むくみ・腕が痛む、だるい・握力の低下
  • 3.頭痛・めまい・吐き気・耳鳴り
  • 4.歩行障害や尿失禁など

主な原因

加齢によるものと、外的要因によるものがあります。

加齢によるもの
椎間板は、体の中でも老化が早い部分で、40代を過ぎるとヘルニアの発症率がぐんと上がります。老化により水分が減り弾力性がなくなった状態になると、衝撃や運動に弱くなってしまいます。また、骨粗鬆症の人は、椎間板ヘルニアにかかる率が高くなります。

外的要因
腰椎椎間板ヘルニアでは珍しい外的要因によるヘルニア(外傷、打撲など)ですが、細い首に重い頭を抱えている頚椎ではヘルニアの原因の上位にきます。この際キズそのものは大きい必要はなく、小さなキズが時間をかけて悪化してくるパターンと、急激な力を加えられたために急性の症状をおこすヘルニアがあります。よく聞く「ムチ打ち」も頚椎椎間板ヘルニアの原因または遠因になりやすいものです。

ヘルニアの対策方法

さまざまな治療法

首痛・肩こり治療には、大きく分けて、手術をする治療と手術をしない治療があります。手術をしない治療は、保存療法といい、安静療法・理学療法・薬物療法があります。

手術をしない治療

  • 安静治療:温熱療法
  • 理学療法:マッサージ、針治療、牽引治療
  • 投薬による治療:飲み薬、ブロック注射

手術による治療
頸椎椎間板ヘルニアの場合、上記のような保存治療でも改善が見られない場合、ケースによっては手術を行うことがあります。

  • 全身麻酔による頸椎椎間板ヘルニア摘出手術
  • 経皮的レーザー椎間板減圧術(PLDD)

従来の頸椎椎間板ヘルニア摘出手術は全身麻酔による手術で大量の出血を伴います。また、術後約1ヶ月間の入院、リハビリ、後遺症の可能性、合併症など、非常にリスクの高い切開手術となります。さらに後になって痛みなどの後遺症が現れる恐れもあります。このような従来の手術法の悩みを解決したのが、レーザーを使ったPLDDによる椎間板ヘルニア治療法です。 PLDDは局部麻酔による手術で、所要時間も15分ほどです。

日常生活での対策

重症化させないように普段から気を付けましょう。

  • 正しい姿勢を身につける
  • カルシウム、コラーゲンやコンドロイチンを摂取する
  • 頚椎ヘルニア専用ストレッチをする

5つのストレッチ
①両掌をおでこに当て押しながら、同時に頭を前に曲げていき押し合うようにする。

②両掌を今度は後頭部に当てて押し、頭を後ろに倒しながら押し合うようにする。

③首を左側に倒して、できるだけ肩に近づけながら首の筋を伸ばして数秒間維持。右側も同様に行う。

④顎を喉につけるようなイメージで、頭を前に倒す。息を吐きながら、元に戻す。

⑤頭を正面にやや倒して、反動をつけないようにしながらゆっくりと左回りに首を回す。右回りも同様に行う。

これらのストレッチをそれぞれ10回くらいを目安に行いましょう。決して、頭を後ろに倒しすぎないように注意してください。

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: 148

まとめ:首のヘルニアに注意しよう

頚椎椎間板ヘルニアは初期は首の後ろがちょっと痛いといった微細な症状しかありません。「四十肩、五十肩」と間違えてしまうことも。しかし重症化させると厄介な病気です。症状をおさらいしておきましょう。

  • 1.首痛・肩こり・背中の痛み
  • 2.手のしびれ、むくみ・腕が痛む、だるい・握力の低下
  • 3.頭痛・めまい・吐き気・耳鳴り
  • 4.歩行障害や尿失禁など

思い当たるところがある方、すぐさま病院にかかってくださいね。

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