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のび、ストレッチ、男、ベッド
のび、ストレッチ、男、ベッド

イタ気持ちいい!けど効果無し?牽引と腰痛治療の効果と効能

のび

日本人の八割が、一度は経験するといわれる腰痛。2013年に発表された腰痛診療のガイドライン(指針)で、器具で腰を引っ張る「牽引療法」の推奨度が低いとされたことはご存知でしょうか。効果を疑問視する患者もいれば、異論を唱える医師もいます。今回は、牽引の腰痛治療の効果と効能について調べてみました。

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日本だけ?牽引治療

のび2

今回「有効という根拠に乏しい」とされた「牽引療法」は、欧米ではあまり行われていません。しかし日本では診療所を中心に、一般的な治療として定着しています。牽引は科学的根拠のある治療法だとして、日本では昔から多くの病院や接骨院で推奨されています。

牽引治療とは

腋を固定した状態で骨盤部にベルトを巻き重りや電力を利用して体重の3分の1ほどの負荷をかけます。そして足の方へ10分から15分程度引っ張るという治療法となっています。この腰痛の治療法である牽引療法は、腰椎間が狭くなった状態で圧迫を受けたことにより起きる椎間板ヘルニアなどの腰痛の治療に用いられています。 

牽引の種類

牽引することによって椎関節の間を広げるようにして、できるだけ痛みを和らげるという方法となっています。牽引療法には、腰を足の方へ引いてゆっくりと緊張状態になった筋肉をのばすようにして背骨を安定させる持続牽引と、1回10分から15分程度繰り返し行う間欠牽引の2種類の方法があります。

間欠牽引は同時にマッサージの効果も得られるので背骨周辺の筋肉をを持つことによって血行を良好にし痛みが和らぐ効果が期待できます。しかし、牽引療法は腰の痛みが強い時には、効果的ではありますが、長期の漠然とした牽引療法を行うことは症状を長引かせることもあるといわれています。

牽引で悪化?

さらに、牽引療法による治療には賛否両論の意見があります、海外においては牽引療法は腰痛治療としては使用されることはありません。一般的に牽引で引っ張ることによって、椎間板が神経を圧迫することがなくなり、痛みが和らぐと考えられていますが、引っ張ることによって周りの筋肉が伸びることで、余計に腰痛が悪化するという可能性もあります。

現在推奨される腰痛治療

現在、国内の2800万人が腰痛に苦しんでいることが、全国調査で判明したそうです。しかもその8割が原因不明であることも明らかになりました。今年から腰痛治療が変化しています。最新の治療法をご紹介しましょう。

◆腰痛診療指針の主なポイント 

・腰痛の発症や慢性化には心理的、社会的ストレスが関与している

・まず抗炎症薬や鎮痛薬を使う。慢性腰痛で十分な効果が得られない場合は抗不安薬や抗うつ剤を使う

・運動療法は慢性腰痛では有効性が高い。運動の種類による効果の差は認められない

・ものの考え方や行動を変える「認知行動療法」は亜急性や慢性腰痛に有効

・がんや骨折など重篤な疾患の疑いがない限り、すべての患者に画像検査をする必要はない

・けん引療法が腰痛に対して有効であるエビデンスは不足している

・安静は必ずしも有効な治療法とはいえない

腰痛の原因は、ストレス

最新の研究で、特定できない痛みの原因が、腰以外にあることも明らかになってきました。腰痛の原因は、ストレスによる脳の機能の変化にあるといいます。

人は、腰に刺激を感じると、痛みの信号が背中の神経を通って脳に伝わります。通常、脳の側坐核という部位が痛みを抑える物質を出すことで、必要以上の痛みを感じずに済むようになっています。しかし、側坐核はストレスを受けると、機能が変化します。痛みを抑える物質が少なくなり、僅かな刺激も痛みとして感じるようになってしまうのです。

仕事の収入に対する不満、あるいは職場関係で何か問題がある場合、ストレスや不安やうつ、それから、その方の生活環境というのが腰痛の発生に関係しているそうです。今まで注目されなかった心理社会的要因が、腰痛の原因といえます。

安静よりもストレッチ

ヘルニアなどの腰痛は絶対安静が基本でした。しかも腰痛を経験すると、体を動かすことを恐れてしまいます。ですから、最初はゆっくり小さな動きから始めましょう。体を動かしても痛むことはないと、自信を持つことが重要です。筋肉は動かさないと余計固まってしまいます。軽いストレッチを習慣にする事は、腰痛改善に効果的です。

牽引よりも薬物治療

腰痛の改善にはうつ病に使われる抗不安薬や抗うつ剤を使うと良いそうです。腰痛とうつ病の関連は、あまり世間的には、取りざたされていません。しかし、ストレスから腰痛の多くが発症しているとすれば、腰痛はうつ病に至る危険信号という面もあるのではないでしょうか。

原因不明な腰痛になったとしたら、メンタル面で何かあったかをチェックする必要があります。それを取り除かないと、メンタル面でより重い病気になる危険性があります。

健康直販 (kenkouchokuhan) 腰スッキリけん引機
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まとめ

現在の最新の報告書によると、腰痛の原因はストレスといえそうです。牽引は身体のゆがみを治す治療法ですから、ストレスの治療法にはなりません。海外でも、牽引による腰痛治療は行っていない様です。

しかし、日本の医師の間では牽引治療は有効だという見方も沢山あります。腰痛の原因は80%はよく分かっていないというのが実情ですから、自分が良いという方法を試してみてもいいかも知れません。

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