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腰痛
腰痛

腰痛を感じる部位別の症状と原因

腰痛の男

一言で腰痛とくくられてしまう病状の中には色々な症状があります。腰痛を引き起こす原因で後発部位や痛みの感じ方、処置の仕方などは大きく変わってきます。

では、腰痛を発症する部位にはどのような違いがあるのでしょうか?今回はその特徴について詳しく見ていきましょう。

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腰そのものに痛みを感じる

布団

腰といわれる場所には腰椎がありますが、この腰椎は5つの骨から形成されています。この腰椎のうちのどれか、あるいは腰椎をつなげる軟骨いわゆる椎間板が何らかの原因でずれたり変形したりするとこの腰の部分に痛みを感じるようになります。

特に腰の上部が痛むようであれば上の方の腰椎に、下部が痛むのであれば下の方の腰椎に原因があると言えます。

更に、どのように動かしたりすると痛みが出るかで詳しい病状を判断することができます。後ろに反った姿勢になったときに痛みを強く感じる場合は第1腰椎に原因があると思われます。逆に前かがみで痛みが強く感じるようであれば第5腰椎に原因があると思われます。第3腰椎に原因があると、上下の腰椎と連動していますので、どちらの症状も出る場合があります。

また、第1腰椎が原因と思われる腰痛は、急激な痛みを感じる場合は少なく大抵がいつもジワジワと痛いと感じます。多くのケースでレントゲンでの診察は困難といわれていますが、腰の緊張や硬直が見られる場合にはこの症状を改善するだけで痛みを感じなくなってしまうケースもあります。
主に考えられる病状は椎間板ヘルニアや腰椎滑る症などがあります。

腰から足にかけて痛みがある

腰の痛みに加え、臀部や足にかけての痛みも感じる場合には第4・5腰椎に原因があると思われます。このケースの特徴は主に第5腰椎周辺の筋肉が硬直あるいは弛緩しているために腰の可動域が限定されてしまっている場合が多いです。

また、足に痺れや痛みを感じるという事は、多少の個人差はあるものの坐骨神経に何らかの影響が出ていると思われます。この症状を坐骨神経痛といいます。坐骨神経は下部腰椎から臀部、そして足の運動や感覚をつかさどる神経であるため、この神経を圧迫することで腰から足にかけての痺れや痛みを感じることになります。主な病状として椎間板ヘルニアや脊柱管狭窄症のほか、梨状筋症候群などがあります。

特に骨盤に痛みを感じる

骨盤が痛いという症状は男性よりも女性の方がはるかに多い症状です。なぜなら骨盤の坐骨に当たる部分の幅が男性より女性の方が広くできているからです。この坐骨の幅が広いと常に大きな動きをしますので、特に出産後に骨盤が正常に閉じなくなり腰痛の原因になります。

そのほかに骨盤周辺の臓器や骨盤そのものの疾患、例えば骨盤に腫瘍があるなどの原因も考えられます。関節や骨盤周辺の筋肉や神経に何らかの障害が生じている場合に加え、これらの原因もあるので一概に病状を特定することはできませんし、重大な疾患がある可能性が高いのもこのタイプの腰痛の特徴です。一度きちんとした審査を受けることを強くお勧めします。

主な病状として考えられるものは、筋性腰痛や仙腸・腸骨関節性腰痛のほか、内臓疾患や腫瘍などです。

特に尾てい骨に痛みを感じる

強くしりもちをついた時などに尾てい骨に痛みを感じますが、このように直接的な衝撃が加わったなどを除くとその原因は意外にも腰椎と骨盤のバランスや動きに大きく関係がある場合が殆どです。

尾てい骨は腰椎からつながる最下部の背骨として役割を果たしていて、腰椎と尾てい骨の角度やバランスをとるために骨盤と連動しています。そのため、骨盤と腰椎の前後あるいは左右のバランスが崩れることで尾てい骨に痛みを感じるようになるケースが多いのです。

腰痛胃のうち、第4腰椎と骨盤の位置関係を改善することで、この尾てい骨の痛みが解消することもあります。

日常の姿勢に問題があるとこの尾てい骨の角度や位置がずれていきます。正しい姿勢をとったり適度な運動を心がけることで痛みを和らげることができたり病状を改善することができるのもこのタイプの腰痛の大きな特徴の一つです。

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まとめ:腰痛は発症部位で原因が大きく異なる

大きく4つのタイプに分けて腰痛の発症部位ごとにその原因や特徴を見てきましたが、腰痛の原因には骨や関節そのものの位置やバランスの崩れ・変形などからくる場合や骨の腫瘍などが原因の場合のほか、内臓疾患などによるものが起因している場合など様々なケースがあることがわかっています。

どの病状に関してもそれぞれ専門医の適切な処置が必要ですし、解消するためには日常生活でできることをやっていく必要があることも大切だという事が言われています。

腰痛を部位別に病状を大まかに説明してきましたが、腰痛を感じるようになったらできるだけ早く診察を受け、早期解消に向けて行動に移すようにすることを強くお勧めします。

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