四十肩 五十肩
masuishoulder pain
肩関節の痛みと腕が上がらない、手が後ろに回せないなど症状を自覚して、整形外科を受診。レントゲンを撮ったあとに骨に異常なしで、四十肩が確定。骨に異常がないならばと安心してしまい放置。その後、夜間痛を発症して、痛さで眠れなくなり来院となりました。五十肩も、最近は、年齢層がさがり、四十肩もよく聞かれます。一般には片方の肩の発症で、両肩同時には発症することはあまりないようです。四十肩、五十肩は肩の血流障害や、加齢変性など老化を基盤としたもの、関節包の炎症などが原因となります。症状には、三つの病期があります、疼痛期、拘縮期、回復期です。それぞれの期間の流れは、個人差があります。疼痛期痛みは、腕を上げた時だけでなく、腕を横に伸ばした時、内側、外側などに伸ばした際に痛みがでます。痛みは次第に夜間痛にも派生します。 痛くて眠れないから、痛みで起きてしまうこともあり、睡眠障害になってしまうこともあります。硬縮期になると、関節や筋肉が収縮して肩の動きが悪くなった状態です。 この時期は、炎症の痛みや夜間痛などは落ち着いてきますが、肩を動かした時に、制限がかかり、動作の最後の部分で痛みが誘発されてきて、肩が完全には上がらないなど、動作が完成されない状態が見られます。また手が後ろに回らなくなることが多くなり、背中が痒いのに届かない、洋服を脱ぐとき、着る時など腕を大きく動かす時に痛みがでるなど、日常動作にも影響がでてきます。このあとに、回復期がきますが、患者様の中には、痛みや拘縮が後々まで、後遺症のように残ってしまい、肩関節の可動域が半減してしまうこともあります。今症例では、鍼灸治療としては、痛みが続くと肩動かせない期間も長くなるため、肩関節の可動域の低下する可能性がります、そのため、痛みをコントロールするために、鍼やお灸を用いて、神経に働きかけ、痛みを抑制していきます。痛みの症状が長く続くと、ストレスから、自律神経の調節が乱れ、血管が細くなり、血行不良を引き起し痛みも増し悪循環となります。今症例の鍼灸治療としては、筋肉の緊張緩和と、神経への疼痛緩和、自律神経の調節、血行改善を目的に施術いたしました。
He visited an orthopedic surgeon after noticing symptoms of shoulder joint pain and inability to raise his arm or rotate his hand backward. After taking X-rays, there was no abnormality in the bones, and it was confirmed that he had a 40-year shoulder. He was relieved that there was no bone abnormality and left it alone. Later, he developed nighttime pain and was unable to sleep due to the pain, so he came to our hospital. Recently, the age group of patients with frozen shoulder has been decreasing, and we often hear about frozen shoulder as well as frozen shoulder. Generally, the onset is in one shoulder, and it is not common for both shoulders to be affected at the same time. The 40- and 50-year-old shoulders are caused by impaired blood flow in the shoulder, aging-based conditions such as age-related degeneration, and inflammation of the joint capsule. There are three phases to the condition: the pain phase, the contracture phase, and the recovery phase. The course of each period varies from person to person. Painful phase pain occurs not only when the arm is raised, but also when the arm is extended sideways, inwardly, or outwardly. The pain gradually derives to nocturnal pain. The pain can keep you awake, and the pain can wake you up, which can lead to sleep disturbances. In the rigor phase, the joints and muscles contract and the shoulder becomes less mobile. During this period, inflammatory pain and nocturnal pain subside, but when the shoulder is moved, it becomes restricted, pain is induced at the end of the movement, and the movement is not completed, for example, the shoulder is not fully raised. In addition, the hands are often unable to turn back, the back itches but cannot be reached, and pain occurs during large arm movements, such as when removing or putting on clothes, and daily activities are affected. After this, there is a recovery period, but for some patients, the pain and contracture remain as an aftereffect until later, and the range of motion of the shoulder joint may be reduced by half. In this case, acupuncture and moxibustion treatment is used to control the pain by working on the nerves and suppressing the pain through the use of acupuncture and moxibustion. If the pain persists for a long time, the autonomic nervous system is disturbed due to stress, and the blood vessels become thinner, causing poor circulation, which increases the pain and leads to a vicious cycle. In this case, acupuncture and moxibustion were used to alleviate muscle tension, relieve pain in the nerves, regulate the autonomic nervous system, and improve blood circulation.
