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ベッドに寝そべる女性

腰痛は冷やすのか温めるのか?症状による処置の違い

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腰痛が発症した時は通常腰を冷やすとよいとされており、温めるのはよくないといわれています。では、果たして本当にどんな腰痛でも冷やしたほうがよいのでしょうか?

実は腰痛の症状によっては冷やすことがよいとされている腰痛もあれば温めることが必要な腰痛もあります。ここでは、例を挙げてその二つの違いを見ていくことにしましょう。

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腰痛には大きく分けて2つのタイプがある

単に腰痛といっても症状の出方や原因は様々です。その中でも、大きく二つに分けて分類することが出きます。まずはその違いを説明したいと思います。

急性の腰痛

冷やす

ぎっくり腰や椎間板ヘルニア、脊柱管狭窄症、骨盤すべり症などの症状はみなこの急性の腰痛に当たります。激しい痛みとともに炎症を発していて、この炎症を抑えることが第一になってきます。

急性の腰痛の特徴は、放置すると時間が経つにつれて炎症が広がり、さらに痛みが強くなることがまず一つに挙げられます。またこの症状を繰り返すと筋肉組織の柔軟性が著しく低下してしまい、症状が発症しやすくなります。よくぎっくり腰をきちんと治さないと癖になるといいますが、これはまさに筋肉の柔軟性が低下し筋膜が炎症を起こしやすくなってしまっていることを的確に言い当てています。

さらに急性の腰痛の場合は固定して筋肉組織や関節組織を動かさないようにして安静することが必要になってきます。動かすことで炎症を広げたり慢性化させるのを防ぐためにこういった処置をします。

慢性の腰痛

慢性の腰痛には内臓疾患の関連痛からくる腰の痛みや、冷えや運動不足からくる腰痛があります。血流が衰え、代謝が低下した時に腰痛を発症する場合には、運動などで発する内熱がもっとも効果的といわれています。

長期間の筋肉の緊張により筋肉が緊張し続けた結果筋肉組織や関節への酸素や栄養分の供給がうまくいかなくなる結果、疲労物質が溜まって腰痛となります。
慢性の腰痛の特徴として、筋肉の緊張などからくる腰痛であればよほど我慢し続けるか相当の無理をしない限り激痛にはなりませんので、早期に対策をすればそれだけ早く腰痛を解消することができます。

逆に内臓疾患などの関連痛からくる腰痛の症状は腰を直接ケアしてもなかなか解消することができません。もともとの患部の疾患を改善しないことには腰痛を抑えることは難しくなってきます。痛みどめを使えば一過的な痛みは軽減できるでしょうが、元々痛くない部分に痛みどめを使うのは医学的にも好ましいこととは言えません。また、処方されている薬が効きにくくなってしまう可能性もありませので、このような原因で腰痛を抱えている方は掛かりつけの内科医に腰痛の症状を訴えて処置を考えてもらうようにしましょう。

腰痛のタイプで冷やす・温めるを判断する

先述の説明で腰痛には大きく分けて急性と慢性の二つのタイプがあることがお分かりいただけたことと思います。では、このタイプ別に冷やすのか温めるのかの処置を説明していきましょう。

急性の腰痛は冷やすのが正解

ぎっくり腰、椎間板ヘルニアなどに代表される急性の腰痛はとにかく炎症を抑えなければなりません。温めることによって炎症は広がってしまいますので、まずはそれを冷やすことによって抑える作用が働きます。

また、冷やすことで血流を遅らせて過敏になっている神経を静ませる効果もあります。神経の感覚が鈍くなると、緊張している筋肉も弛緩しやすくなり、緊張をほぐすことができます。マッサージやお風呂などの方法で筋肉の緊張を解こうとしても逆効果になってしまい炎症が広がってしまいますので、とにかく冷やして固定して安静にすることが重要です。

さらに、氷嚢で冷やすのがよいとされていますが、湿布薬を張っても構いません。ただし、湿布薬には冷感のものと温感のものがあり、温感のものは温める効果がありますからどちらの湿布薬化をよく確認してから使用するようにしましょう。

慢性の腰痛は温めるのが正解

慢性的に筋肉が凝っていたり冷えからくる腰痛などはゆっくりしっかりと温めて血行を促進して代謝を上げることが大切です。お風呂はなるべく湯船につかるようにし、シャワーだけで済ませないようにしてみるといいでしょう。また入浴後や外出時に冷やさないような工夫も大切です。せっかく温めたのに冷やしてしまうとまた逆戻りしてしまいます。

また、代謝を上げるためにリンパマッサージや運動もお勧めです。特に運動はない熱が発生し代謝能力を高め、自己治癒能力の向上効果がありますから、運動不足で発症している腰痛の方は無理をしない程度に適度な運動が一番効果的です。
内臓疾患の関連痛で腰痛を感じている方も、代謝や治癒能力を上げる意味で温めるとよいでしょう。冷えは体力を消耗し体力を奪いますので、闘病なさっている方は体を冷やさないように気遣いをして過ごしてください。

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まとめ:腰痛のときの冷やす・温めるの判断ポイント

  • 急性の症状の時は冷やす・固定する・動かさない
  • 慢性の場合は温める・代謝を上げる

この二つのポイントを押さえて、自分の腰痛がどちらのタイプかを判断したうえで腰痛解消への一歩を踏み出していただければ幸いです。

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