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腰痛と熱の関連性

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腰痛の代名詞と言えばぎっくり腰に代表される関節や骨の障害が真っ先に思い浮かびますが、発熱を伴う腰痛の場合、実にその原因は様々で症状だけで特定することは難しいとされるくらいです。

では、放っておくと大変なことになりかねないと言われるその症状は、一体何が原因で起こるのでしょうか?

今回は、腰痛と熱の二つの症状を同時に発症した場合、なぜ関連痛の疑いがあるのか、またどのような病気が疑われるのかについて、紹介していきたいと思います。

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関連痛とは一体何なのか?

まずは、関連痛とは一体どのようなものなのかを見ていくことにしましょう。

関連痛が発症する原因

脳レントゲン

腰痛を感じる神経というのは当然腰にありますが、この神経がある場所に関連痛を引き起こすメカニズムがあります。

体の隅々にまで張り巡らされている神経はすべて脳につながっています。神経は脳がコントロールして機能するようにできていますので、どんな末端神経でも最終的には必ず脳にたどり着きます。でも、その神経一本一本が直接脳につながっているわけではありません。体の中を脳に向かっていくにつれ、他の神経と合流しながら脳にたどり着いていきます。

特に脊椎にはその神経が合流した大きな束が格納されています。脊椎の中でも腰椎には下半身の神経から臓器の神経まで、様々な神経が合流して入り組んでいます。

腰以外の場所に何らかの症状が発症した場合に、脳サイドでその信号が出ている場所を勘違いしてしまう結果、その神経が集中している腰に痛みを感じるという結果になるのです。これが関連痛の正体です。

関連痛と判断するには?

腰痛の診察は大抵の場合は整形外科に診察を受けに行くでしょう。整形外科では、腰痛などの関節や筋肉などの専門科ですので、レントゲンを撮ったりMRIを使ったり、あるいは問診だけでもある程度の原因を特定することができます。

その腰痛が腰本来の原因なのか、それとも関連痛が疑われるのかは整形外科で判断ができるという事です。ですので、まずはちゃんと医師に診察してもらう事が大切です。

整形外科でこれは関連痛が原因だと判断されれば、その原因が臓器などの期間にある場合には内科を紹介してくれますし、結石などであれば泌尿器科に紹介されます。腰そのものや脊椎などに原因がある場合には整形外科の専門になります。

熱を伴う腰痛で考えられる病気とは

では、ここからは発熱を伴う腰痛で考えられる病気を見ていきましょう。

臓器に原因がある場合

膵炎
膵炎の原因はアルコールの摂取と胆石に大きな要因がありますが、この病気になると腰痛と熱を発症するほかにお腹に強い痛みを感じ、時には嘔吐することもあります。内臓疾患の中でも、症状を自覚すると大変なことで知られています。日ごろから食生活をコントローすることが大切だと言われています。

腎盂炎
腎盂炎を患うのは圧倒的に女性が多いと言われています。腸内細菌が尿管から腎臓に入り込んでしまうことで炎症を起こすことがこの病気の特徴で、その症状は腰痛と発熱が主なものです。症状が悪化すると吐き気や悪寒を感じることがあり、感染した腎臓が腫れ上がることでより痛みと熱が強くなります。

腰以外の脊椎に原因がある場合

脊椎炎
体内に黄色ブドウ球菌や大腸菌などの細菌が入ると炎症を起こしますが、この細菌が脊椎に感染した場合には背中や腰に強い痛みを感じるようになります。炎症から発症する熱もあり、ぎっくり腰などとは異なり安静にしていても痛みが軽減されることは難しく、辛い症状が特徴です。

発症しやすいと言われているのは免疫力が低下してきている40~50代の人が多く、また生活習慣病や成人病にかかっている人にも患者が多いと言われています。

骨腫瘍
特にがんの経験がある人にはこの注意が必要だと言われています。症状は微熱と強い痛みが特徴だと言われていますが、骨ががん細胞に侵されることで脆くなり、骨折しやすくなるのも特徴の一つです。造血の機能がある骨盤に転移してしまうと、貧血に悩まされることになります。

脊椎カリエス
カリエスというのは結核菌に侵される病気ですが、この結核菌が脊椎に入り込むと微熱と共に腰痛や背中痛を発症します。全身がだるくなり疲れやすいのもこの病気の特徴です。脊椎炎に比べると症状は軽いのですが、腰の曲げ伸ばしの際に腰が硬く感じるのもこの病気の特徴と言えます。

その他の原因の場合

インフルエンザ
インフルエンザに感染すると、体内で増殖するウィルスに対抗する免疫能力の影響で、急な発熱を起こします。その際に、腰などの関節に痛みを感じることがあります。高熱と共に全身の関節や筋肉が痛むようであればインフルエンザの可能性が高いと言えますが、流行時期でない場合にはそのほかの病気を疑います。

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まとめ:腰痛と熱の症状を侮らない

今回説明してきたとおり、腰痛と熱を伴う症状を発症する病気は、早期に治療をすればそれだけ治療もしやすく軽度の段階で治せますが、放っておくと重大な症状に発展してしまうという事がお分かりいただけたと思います。

たかが腰痛、たかが熱と思わず、体の異常を感じたらなるべく早く医師の診察を受けることを強くお勧めします。

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