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救急車

あなたの腰痛は病気が引き起こしているものかを知るための5つの知識

救急車

腰痛は、日本人の約2000万人以上が抱えていると言われている決して珍しくないものなので、腰が痛いと思っても、腰を痛めたのかなと軽く考えて、適当にマッサージをしながら我慢したり、放置したりしてしまいがちです。

しかし実は腰痛を一つの症状として伴う病気はたくさんあり、中には命の危険にもかかわる重篤な病気の可能性もあります。その場合、いくらこの先、腰を労わっていっても腰痛は治らないことはおろか、サインを見逃したことによって取り返しのつかない状態に陥ることにもなり兼ねません。

ただ、病気が隠れている場合には単なる腰の痛みだけではない場合が多いので、併発している症状や痛み方によってその原因を知ることが出来ます。

そこで本記事では、腰痛を伴う病気の一例をご紹介していくと共に、それらを見分けるための症状などを詳しくお教えしていきたいと思います。

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腰痛を起こす代表的な病気

腰痛の男

まずは、単なる慢性的な腰痛とは異なり、整形外科などでの特別な治療が必要な病気を4つご紹介します。

1.腰椎椎間板ヘルニア

背骨を構成しているうちの一つで、衝撃を吸収するクッション材の役割をしているのが「椎間板」と言われる部分で、椎間板の中央には「髄核」というゼリー状のものがあり、それが外に飛び出てしまうことを「ヘルニア」と呼びます。

この病気は咳やくしゃみでも増悪するほどの激しい腰痛の他に、お尻や太ももなどにも痛みやしびれを感じ、歩行が難しくなる場合があります。程度により自然と症状が回復することもありますが、医師の指示で治療をすることが望ましいです。

2.腰部脊柱管狭窄症

背骨には脊髄神経が通るトンネルとなる部分、「脊柱管(せきちゅうかん)」があります。この脊柱管が狭くなることによって神経が圧迫されて、痛みとしびれ、脱力感が出てしまい、歩き続けるのが困難になることがあります。

少し休憩すると症状が緩和されて再び歩けるのですが、また少し歩くと症状が出るという繰り返しが起こるのが特徴です。重症になると排尿にも障害をきたします。

3.変形性腰椎症

背骨は「椎骨(ついこつ)」と呼ばれる骨が24個積み重なって出来ているのですが、そのうちの、下から数えて5個までの部分が「腰椎」、その骨の一つ一つの間にあるのが椎間板です。

主に加齢に伴って、背骨の関節や椎骨に「骨棘(こっきょく)」というトゲのような骨が増殖し、椎間板の状態を悪くすることが原因で起こる病気です。

起床時などの動作開始時に強い痛みが現れ、動いているうちに軽減していきます。また、長時間の同一姿勢でも痛みが増強します。進行すると腰が曲がって背中が丸くなり、神経を刺激し、下肢のしびれや痛み、脱力感といった症状を引き起こすので、長時間立っていることが困難になってきます。

4.腰椎分離・すべり症

腰椎の一部が切れて分離してしまうのが腰椎分離症。分離した部分の上の骨が前に滑ってしまうことをすべり症と言います。

激しいスポーツをしている子供などによくみられ、成人であれば長時間の立ち仕事や重労働の後に鈍く重い痛みがあります。体を後ろに反らせると痛みが強くなるのが特徴です。

症状が軽度であれば心配する必要はないのですが、手遅れになりすぎると改善が得られにくい場合があるので、特に注意が必要な病気です。X線検査を行ってもらうことによりすぐに発見できます。

腰痛から考えられるその他の病気

次に、腰痛に潜む思わぬ病気の中でも、特に腰の痛みが外科的疾患と混同しやすい病気を4つ挙げてみたいと思います。

1.子宮内膜症・子宮筋腫・子宮がん・卵巣嚢腫・卵巣炎

これらは月経のときに腰の痛みが強くなる場合や腰が常にずっと痛むような女性が当てはまる病気です。

中でも子宮筋腫は婦人科で一番多い病気で、その発生頻度は30歳以上の女性で30%にも上り、初経前や閉経後に発生することはないと考えられていますが、非常に小さな筋腫も含めると過半数の女性にあると言われています。

症状は腰痛の他に月経時の出血の増量、下腹部の膨満感、動悸・息切れなどの貧血症状、月経以外の性器出血、おりものの増加などがあります。進行がんでは下肢痛や血尿、血便、排尿障害が現れることもあります。

2.尿管結石(にょうかんけっせき)

男性に多く、腎臓で形成された石が尿管に降りていく際に痛みが起こります。それはもう激痛が生じることで有名ですが、石の詰まった場所にも相違します。

併発する症状は冷や汗や不安感、血尿や排尿困難、頻尿や残尿感などです。

3.十二指腸潰瘍(じゅうにしちょうかいよう)

空腹時や夜間に腰痛が起きることが多く、食事をすると少し治まる傾向にあります。腰痛以外では吐き気や嘔吐、食欲の減少、げっぷが多くなるなどの症状が出ます。

4.腎盂腎炎(じんうじんえん)

腎盂や腎臓そのものに細菌が感染して化膿し、腰だけでなく背中全体が痛み、寒気や震えを伴った38度以上の高熱や、尿の濁りや頻尿、残尿感などの膀胱炎の症状などが認められるほか、尿に血液が混じることもあります。悪化すると敗血症というさらに恐ろしい病気を発症します。

まとめ:腰痛は体からの何らかのサインと心得る

腰痛を伴う病気は他にも、ここでは紹介しきれないほどたくさんあります。

それら一つ一つを疑って症状を確かめていくのは実際難しいとも思いますので、とりあえず腰痛の他に以下の5つのうちのどれかに当てはまるような症状がある場合にはそのままにせずに一度病院へ行って医師に相談してみて下さい。

  • 動作に関係なく、体を動かさずにじっとしていても、横になって休んでいても腰が痛み、緩和策がない
  • 発熱している
  • 脱力感、麻痺、しびれがある
  • 排尿、排便の際に何らかの異常がみられる
  • 日ごとに腰痛が悪化している

明確に覚えなくても結構です。要はおかしいと思ったらすぐに病院へ行ってみるということが自分の体を守るための何よりも大切な心がけです。

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