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その腰痛、内科受診かも?腰痛を起こす3つの内科系疾患のタイプ

医師

腰痛は内科系の疾患でも起こることをご存知でしょうか?腰痛といえば筋肉疲労や、骨のゆがみなどで起こることがほとんどです。椎間板の異常や腫瘍などが原因のこともありますが、どれも整形外科へ受診されることが多いと思います。

しかし、実際には、腰痛は一つの症状に過ぎず、本来の原因が内科で受診すべき内臓疾患という場合もあるのです。腰痛はありふれた症状であるだけに、軽くみて放置される方もいらっしゃいます。内臓疾患からくる腰痛を放置すると、悪化した後が大変です。自身の腰痛がどんなタイプなのか、内科で受診すべき腰痛の3つのタイプとその特徴を紹介しましょう。

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腰痛に内科受診が必要かどうか、自覚できますか?

医師

腰痛が起こる時、原因が一つとは限りません。整形外科などの受診で原因をつきとめ、治療によって完治する場合は問題ありません。しかし、腰痛が続いたり、忘れた頃にぶり返すというのであれば、根本的な治療ができていないということになります。腰痛は慢性化しやすいため、できるだけ根本原因を突き止めることが大切です。

腰痛はよくある疾患であり、慢性化してしまうと「また起こってしまった」と深く考えることがなくなります。腰痛で内科受診が必要な場合、大抵は別の症状も同時に現れています。腰痛の痛みの種類がちょっと違ったり、他の場所に痛みが出たりということがあります。腰痛が当たり前になってしまうと、同時に胃の痛みが起こっても、別々の原因があると考えてしまうのではないでしょうか。腰痛と何らかの不調が同時に出る場合は、内臓からの信号かもしれません。

胃の不調を改善したいと内科で治療したら、長年の腰痛も改善してしまった、という場合もあり得ます。単なる腰痛だと思わずに、ちょっとした体調の変化にも敏感になっておきましょう。

腰痛を起こす内科系疾患の3つのタイプ

腰痛を起こしてしまう内科系疾患には、大きく3つあります。それぞれのタイプ別に紹介し、自分自身に当てはまるものがないか注意してみましょう。

ぎっくり腰の痛みにも似る「泌尿器系」の場合

腰痛が一番起こりやすい内科系疾患が、腎臓をはじめとする泌尿器系のものです。腎臓は背中側にある内臓であり、炎症が起こると背中の方に痛みが起こりやすくなります。背中から腰にかけて痛む事が多いようです。

泌尿器系内科が要因で腰痛が起こるのは、腎結石や急性腎盂炎、尿路結石などがあります。この時の腰痛は急激な痛みであることが多いようです。結石の場合は特にひどく、最初は腰痛や背中痛からはじまり、だんだんと吐き気がしたり発熱を伴うことがあります。この時点で、内科の受診をされるかと思いますが、必ず背中の痛みも訴えるようにしましょう。

また、腎臓に不調があるだけでも、背中から腰にかけて疲れやすくなり、腰痛が出やすくなります。尿量の変化などを確認しながら、食事や睡眠などの生活習慣を見直しましょう。

腹痛を伴う腰痛を起こす「消化器系」の場合

腰痛とともに、胃の痛みや胸やけなどを感じたら、消化器系の内科的要因が考えられます。例えば、十二指腸潰瘍や胃潰瘍、消化器系のガンなどです。胆石やすい臓の不調でも起こります。内臓も筋肉の一部であり、腹部の筋肉は腰とつながっています。内臓の炎症が起こることで腰に影響が出てしまうのです。

特に、腰痛と同時に吐き気や下血などが起こったら早目に受診を行いましょう。消化器系のガンの場合、初期の状態ではガンそのものに痛みが起こりません。消化不良が続いていたり、長引く腰痛がガンを知らせる場合もありますので、早目に内科受診を行いましょう。

月経がある女性は要注意「婦人科系」の場合

女性の場合、月経痛の症状でもあるため、腰痛に慣れている人が少なくありません。しかし、鈍痛が続くような腰痛は注意が必要です。月経による腰痛は一時的なものですが、同じような痛みが続く場合は、子宮に異常が起こっている可能性があります。子宮筋腫や、卵巣嚢腫、子宮外妊娠など、下腹部の炎症によって腰痛を起こしていることがあります。腰痛と同時に不正出血が起こることがあります。また、濁った分泌物が出る場合も注意しましょう。

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まとめ

たかが腰痛とはいえ、内臓からの影響もかなり大きく受けています。腰だけを独立して考えるのではなく、内科系の疾患がないかも注意しておきたいものです。長期化した腰痛は、念のために一度内科での受診を行うのも良いかもしれません。総合内科での受診を行うことで、より専門的な受診科を指示されると思います。泌尿器科、消化器系、婦人科系…内臓疾患は将来に不安を残します。早目の対策を行いたいですね。

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