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2 2 手
2 2 手

腰痛としびれのタイプと原因

手

腰痛は日本人にとって風邪と同じくらいおなじみの症状です。日本人の8割が生涯のどこかで腰痛を感じているのです。単なる筋肉疲労であれば時間の経過とともに楽になりますが、腰痛になる原因がある場合はそうはいきません。最初は腰痛だけであったものが徐々にしびれを伴うようになり、痛みで歩けなくなることもあります。腰痛と、そこから続くしびれの原因にはどんなものがあるでしょうか。

この記事では腰痛としびれの原因について、しびれの種類から解説しています。ただし1種類の腰痛に1種類のしびれ方ではなく、たいていは複合した形で現れます。腰痛やしびれについて気になっているならば、この記事をご参考にしてみてください。

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腰痛には2種類あります

2

腰痛とは読んで字のごとく腰が痛いことですが、実は85%は特にどこが悪いと特定できない非特異的腰痛といわれるものです。たいていは休養を十分とってセルフケアをきちんとしていれば軽くなっていくものです。問題は残りの15%ですが、これには2種類の腰痛があります。じっとしていれば痛くないが何か特定の動きで痛くなるタイプと、何もしていなくても横になってもどうにも痛いといったタイプのものです。

前者のタイプが圧倒的に多く、たいていは神経の圧迫を伴うため足のしびれや痛みにまで至ります。そして後者の腰痛は大きな病気が隠れていることがあります。どちらにしても専門医の診察を受けることが大前提です。

しびれのタイプ別に原因を考えよう

腰痛はあるものの湿布などでごまかしながらすごしているうち、だんだんと足のしびれや痛みが出てくることがあります。どんなしびれ方があるのかをご紹介します。

太ももから足先にかけてしびれる

一番多い症状はお尻から太ももにかけてしびれがあり、だんだんと足先にまで広がっていくタイプです。たいていは左右どちらかに出る場合が多いのですが、両足に起きることもあります。坐骨神経痛と言われる症状がこれです。そして原因のほとんどは椎間板ヘルニアが占めています。椎間板からはみ出した髄核がヘルニアとなって神経根を圧迫して腰痛が起こるのですが、腰から足先まで通っている坐骨神経まで圧迫されると足のしびれと痛みが起こります。

ヘルニア自体は半年ほどで自然に体内に吸収されることが多いのですが、出てくる場所によって軽くしびれる程度であったり激痛を伴ったりと症状はかなり差があります。いずれにしても整形外科を受診すればMRIで部位や状態を特定できるため、様々な治療法を組み合わせることで9割の人は症状が軽快します。改善されない場合は手術となります。

歩くうちにしびれてくる

腰痛はあるけれど普段はしびれや痛みがない、けれど歩き出すとだんだんとしびれや痛みが出てくるタイプです。休憩して前かがみになっていると楽になってくるのですが、歩きだしてしばらくするとまたしびれや痛みが出てきます。こういう症状を間歇性跛行(かんけつせいはこう)と言います。これは脊柱管狭窄症に特長的な症状です。

中身が飛び出してしまう椎間板ヘルニアとは逆に、神経の通っている脊柱管の内部が狭くなって神経を圧迫するために起こります。長い時間をかけて脊柱管の内部が狭くなっていった結果このような症状が出ます。高齢者に多いのですが、高齢者だけの症状でもありません。ある程度の距離を歩いて、休めばまた歩き出せます。そしてまたしびれや痛みで休んでとなりますが、だんだんと歩ける距離が短くなっていきます。椎間板ヘルニアと同様に、お薬などで様子をみながら良くならない時は手術になります。

足先からしびれる

手の先や足の先など、体の末端部分からしびれや痛みが起きる場合があります。腰痛がある人は腰痛のせいかと思いがちですが、実はこれは糖尿病の初期症状です。腰痛からのしびれは圧迫された坐骨神経に近いところから起こります。腰や太ももがしびれるのはそのためです。けれど糖尿病によるしびれや痛みは神経の一番先端である末梢神経から始まります。もしも足先の違和感が続くことがあったなら、腰痛の程度に関係なくすぐに受診するべきです。

腰痛、肩こり、手足のしびれ (別冊NHKきょうの健康)
伊藤 達雄 戸山 芳昭
NHK出版
売り上げランキング: 26,221

まとめ:腰痛もしびれも早期に適切な治療を受けましょう

もしも腰痛を感じて1週間たっても軽くならなかったら、腰痛はそんなにひどくないけれどお尻から太ももあたりに違和感を感じるようになったら、とにかく早急に整形外科を受診しましょう。腰痛には隠れた病気が潜んでいる場合が少なからずあります。そして腰痛もしびれや痛みも、早期に適切な治療を受けることで軽く済むことが多々あります。素人判断で悪化させることがないように、まずは受診して医師の指示を仰ぎましょう。

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