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腰痛タイプ別チェックシートで自分の腰痛タイプを判別しよう

チェックする男

様々な原因で起きる腰痛ですが、その症状を細かく探ることでどのようなタイプの腰痛なのかをある程度判断することができます。ここでは、自分の腰痛がどのタイプかを判断するためのチェックシートを用意しました。

自分の腰痛がどのタイプでどのような特徴があるのかを見ていきましょう。

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症状を確認して腰痛のタイプを調べよう

まずは以下のチェックシートで自分の腰痛の種類を見ていきましょう。

  • ① 前かがみになると痛みがある
  • ② 足が痺れる
  • ③ 後ろに反ると痛みがある
  • ④ 足を組む時痺れる方の足を上にすると痛みが増す
  • ⑤ 腰の上下どちらかに痛みが偏っている
  • ⑥ しばらく同じ姿勢でいると痛みが増す
  • ⑦ 背骨の関節を押すと痛みがある
  • ⑧ 歩き続けると痺れが増す
  • ⑨ 背骨を探っていくと出ている個所がある
  • ⑩ 中高齢である

いかがですか?上記のチェックシートをもとに下記の症例を参照していきましょう。

該当する番号が以下の場合には、これらの病状が考えられます。
①②
椎間板ヘルニア

①②④
梨状筋症候群

①⑤
筋・筋膜性腰痛

①⑦
スプラングバック


椎間もしくは仙腸関節性腰痛

②③⑧
腰部脊柱管狭窄症

②③
重度椎間板性腰痛

③⑨
腰椎分離もしくは腰椎すべり症


軽度もしくは中度椎間板性腰痛

⑥⑩
姿勢性腰痛


変形性脊椎症

該当なし
心因性腰痛など

ご自分の症状に合ったものはどれかお分かりになりましたでしょうか。次に、それぞれの病名ごとに特徴などを解説していきましょう。

それぞれの病名での特徴

腰痛の原因となる病名ごとにその主な特徴を解説していきます。

椎間板ヘルニア

肩こりの男

椎間板ヘルニアは坐骨神経を圧迫するため下半身のどこかにしびれや痛みを感じるようになります。診断方法はレントゲン・CTやMRIの画像検査・SLRテストがあります。主な治療に鎮痛剤などの処方をしながら温熱療法をしたり、レーザー治療やブロック注射などの治療法があります。

梨状筋症候群

ウォーキングやマラソンなどの股関節に負担がかかるスポーツをしている人に多くみられる症状がこれです。脚全体に痺れと痛み、場合によっては知覚障害が現れることもあります。筋肉の疾患ですので画像検査はできませんが、フライングテストなど動かす検査で細かい症状を見ることができます。主な治療は温熱療法・ストレッチ・ブロック注射があります。

筋・筋膜性腰痛

ぎっくり腰は正式な病名ではなく、これがぎっくり腰が該当する正式な病名です。急激な運動や普段の筋肉にかかるストレスから筋肉が損傷したり断裂するとこの症状になります。主な治療は冷却・鎮痛薬投与・固定具の装着・電気療法・筋力強化・痛みがなくなってからは温熱療法があります。

スプラングバック

激しいスポーツや格闘技、または強くしりもちをついた場合にこの症状になるケースが多いです。診断は困難な症状で画像検査では詳細を調べることが困難でなかなか根本治療にたどり着くことが大変です。主な治療には消炎剤と鎮痛剤での投薬治療とゴムバンドやコルセットでの固定などがあります。

椎間・仙腸関節性腰痛

中腰で長時間作業をする方や、骨格上女性の方が多くこの症状にかかることがあります。画像検査では異常は確認できませんが、症状や痛みの部位で正確な診断ができます。主な治療には消炎剤や鎮痛剤の投薬・温熱療法・電気治療などがあります。

腰部脊柱管狭窄症

腰椎部の神経管や血管が通っている脊柱管が何らかの原因で圧迫されその空洞が狭くなるとこの症状を発症します。神経を圧迫しているためしびれや痛みがあります。レントゲンでは分かりづらいですが、CTやMRIで詳細な症状を確認することができます。投薬治療やブロック注射などで経過観察しながらの理学療法をとる場合と、重度な障害がみられる場合にはレーザー治療などの手術が治療方法として用いられることもあります。

重度椎間板性腰痛

椎間板ヘルニアをさらに細かく分類すると、軽・中・重度の異なる椎間板性腰痛に分けることができます。その中でもこの重度は椎間板の変形によって髄核が飛び出したり椎間板組織が外部に離れてしまっている状態を言います。レントゲンでも確認はできますが、CTやMRIでの細かい診断が必要です。神経ブロックへの注射やレーザー治療、手術療法による治療方法がありますが、軽度中度の症状に比べ治療は困難になります。長期間の治療が必要ですので、現状より悪化させないことが第一です。

腰椎分離・すべり症

脊椎から腰椎、尾てい骨とつながっている背骨のうち、腰椎が分離を起こしたり分離することで前方にずれた状態になるとこの症状を発症します。レントゲンで前後と左右、さらに両方斜めの角度から撮影することで分離症の診断を詳しくすることができます。子供のうちは運動をしないようにして固定することで半年~1年程度で完治します。大人の場合は骨癒合が難しいですが、筋力を上げることや固定して温熱療法を行うことで改善することができます。

軽度・中度椎間板性腰痛

椎間板ヘルニアの中で、椎間板に変形や圧迫がみられる場合に軽度、変形や亜pp句が進んで椎間板が飛び出してきた状態を中度としています。症状や治療法は重度と同じですが、早い段階で発見することができればそれだけ軽い段階治療で処置することができます。

姿勢性腰痛

基本的に日常の姿勢が良くなくて起こる症状です。最近では若い世代でもこの症状を発症する人が増えてきています。消炎剤や鎮痛剤の処方と理学療法での治療が一般的です。

変形性脊椎症

中高年になると多くみられるのがこの症状です。脊椎などの組織が老退化減少することで発症しますが、多くの場合は腰椎にみられます。レントゲンで患部を特定することができます。治療方法は投薬治療と理学療法が主ですが、適切な運動で筋肉を鍛えることで痛みを解消できるケースも多いのがこの症状です。

心因性腰痛など

未だ原因不明とされることが多いのが心因性の腰痛ですが、主に自律神経や知覚神経が失調することで現れる症状だという事がわかりつつあります。整形外科などの通院に合わせて、カウンセリングなどで精神的なストレスから解放されることも大切だとされています。

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まとめ:腰痛チェックをして正しい対処を心がけよう

今回紹介したチェックシートは自己診断の範囲です。正確な診断は専門医で診察してもらう必要があります。正しい症状の解明と今後の治療を確実に進めていくことで腰痛解消へと進んでいきましょう。

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