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妊婦がなりやすい腰痛のタイプと対処方法

女子

妊婦の5~8割が腰痛を経験します。妊娠期骨盤痛は妊娠18週頃に始まるのが通常ですが、妊娠8~12週から始まる場合もあります。腰痛はだいたい産後6か月くらいまでにはよくなるものですが、慢性化したり、体に障害を及ぼしたりする場合もあります。特に夜間に痛みが強くなるという傾向があります。

約6割の妊婦が夜間の腰痛に悩んでいるというデータがあります。そこで、妊婦がなりやすい腰痛のタイプとその対策方法を紹介します。自分に当てはまる腰痛のタイプを探して、腰痛の改善をしてみてください。

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恥骨結合機能不全

悩む女性

恥骨は繊維と軟骨の混合である繊維軟骨であり、左右の骨盤をつないでいるものです。妊娠中は、出産に備えて骨盤輪が広がることで恥骨結合は平均2~5ミリ程度広がります。
しかし、関節が弛みすぎて骨盤がぐらぐらと不安定になると、恥骨結合機能不全が起こります。重症の場合には、恥骨結合が一部または全部裂けて10ミリ以上離開してしまうこともあります。

恥骨結合機能不全は、一般的には妊娠15~28週に置きます。痛みは徐々に増していき、出産後数か月にわたって痛みが続く人もいます。

症状としては、恥骨結合の刺すような痛みや鈍痛、電流が走るような痛み、ズキズキする痛み、きしみがあります。また、下腹部や足の付け根、もも、足の他にも腰に広がる痛みがあります。

対処方法としては、ものを持ち上げたり長時間立ったりなど、負担のかかる運動を避けるということがあります。また、頻繁に快適な姿勢で休んだり、膝を曲げた姿勢で横になったりするのもいいでしょう。股を開く動作を避けることも大切です。車の乗り降りの際にも、膝をくっつけて行い、ベッドに横になったり起き上がったりするときにも足を開かないようにしましょう。

腰椎と仙骨の痛み

腰椎と仙骨に痛みがある、いわゆる腰痛は、妊娠中の体重増加によってお腹を突き出して反りかえるような姿勢に変化し、腰が過度に湾曲することで起こります。体重負荷の配分の変化により、椎間板や靭帯、関節面にストレスがかかり、神経幹や骨盤の筋肉組織の限界を超えて痛みが発生します。また、子宮の拡大のために腹筋が伸ばされ、腹筋力が弱まり、腰の筋肉にストレスがかかって鈍痛や刺すような痛みが出てきます。

症状としては、腰の真ん中あたりや太腿の後ろに痛みを感じます。長時間立ったり、同じ姿勢を続けたり、重のを持ち上げたりすると痛みが悪化します。

対処法としては、妊婦帯や妊婦用の骨盤ベルトでお腹を支えることで、腰への負担を減らすことができます。

仙腸関節痛

約2割の妊婦に起こると言われているのが、仙腸関節痛です。後部骨盤痛とも呼ばれています。
仙腸関節は体重を支えるための丈夫で安定した関節です。普段はほとんど動くことはなく、歩いたり走ったりするような動作の時に足から背骨への衝撃を吸収してくれます。

この症状が起こる原因は、出産に備えて骨盤を拡張させる弛緩ホルモンの影響によって身体の靭帯が緩みます。子宮の成長によって骨盤の周りの体幹の筋肉が引き伸ばされ腹筋が弱まって症状が起こります。また、妊娠に伴う体重増加や歩行姿勢の変化によって仙腸関節や仙腸骨関節への負荷が増加し、不安定化します。

症状は、骨盤や仙腸骨周りの深い位置での鈍痛、足の付け根やももの後ろ辺り、お尻の頻繁な痛みが挙げられます。立ったり座ったり、ものを持ち上げたりするとより痛みが強まり、横になると痛みが軽くなります。仙腸関節に腫れや神経痛がある場合には、骨盤に凝りや激痛を感じることもあります。

対処法としては、日常生活での姿勢ごとに気を付けることがあります。
横になる姿勢の時には、膝の間とお腹にしたに枕を挟んで横向きに寝るようにしましょう。このことで、胎盤への血流を減らさずに腰への負担を減らすことができます。もし、腰がベッドに沈むようであれば、ベッドと腰の間にタオルを巻いたものを入れましょう。特に、妊娠19週後は長時間上向きに寝ることは避けましょう。長時間の仰向けの姿勢は、赤ちゃんと子宮の重さが血管や背骨を圧迫して、胎盤や赤ちゃんへの血流を減らしてしまいます。

座った姿勢の時には、背もたれがまっすぐになっている椅子を選びましょう。膝とお尻が同じ高さになるようにして猫背にならないように気を付けましょう。

立った姿勢の時には、真っ直ぐに立つように心がけ、お腹とお尻を引っ込めて腰の湾曲を減らすようにしましょう。

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まとめ:腰痛のタイプに合わせて、腰に負担のかからない対処法をしよう

妊娠すると、お腹が大きくなる分腰にかかる負担が大きくなったり、姿勢が変化したりします。そのため、腰痛に悩まされる妊婦も多いです。
妊婦の腰痛のタイプには3通りあり、姿勢や休息などによって対処することもできます。

自分の腰痛のタイプに合わせて、腰に負担のかからない方法を見つけて対処するようにしましょう。

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