指の変形

Finger deformation

中年期に、親の介護をしているうちに、両手指（第1関節）の特に示指と中指に強い痛みがあった。痛みと同時に、違和感もあり、しびれ感がでることもあったが、忙しくてj放置してしまった。自分では湿布を貼っていた。介護は長期に渡り、介護中も痛くても指は動きはするので放置したら、指は太くなり腫れがひかない状態になった。老齢期に入ると、指は完全に曲がっていて、杖や通路のてすりが握れない状態になってしまったので改善したいということで来院。この患者さんように、指の関節は、ケガや、リウマチ、痛風などの症状がなくても、加齢変性により、自然と軟骨が摩耗したり、骨が脆弱性になってしまったり、靭帯がゆるんだりして変形することがあります。これを退行性病変とも言います。指の靭帯のゆるみ、軟骨のすり減り・摩耗で関節の変形が原因となります。これを変形性関節症（Osteo Arthritis, OA）と呼びます。指の先端の方の関節は遠位指節間関節・DIP関節で、この部分の変形をへバーデン結節と呼びます。更年期以降の女性に多いです。DIP関節の次の関節、近位指節間関節・PIP 関節の変形は、ブシャール結節と呼びます。やはり、中高年以降の女性に多発します。症状としては、初期には痛みがるくらいですが、歳を重ねるにつれ、強く握ることが困難になります。また、痛みが抜けた頃には、指の変形も、かたまり治りづらくなります。今症例での鍼灸治療としては、中指の第1関節に腫れが顕著であったため、関節に施灸しました。指の筋や靭帯・結節を温めて緊張を緩め、指先に負担をかけないようにマッサージを致しました。慢性的な症状になると治癒期間が長くなることがあります。指の結節の痛みが抜けたからと治療しないでいると、変形が悪化する可能性がありますので、定期的に治療を継続し、動きを取り戻しながら関節の位置や、機能性を戻していく事が大切です

In middle age, while taking care of my parents, I had strong pain in both fingers (first joint), especially in the index and middle fingers. At the same time as the pain, I felt discomfort and sometimes a sense of numbness, but I was so busy that I left j alone. She applied compresses to herself. I was taking care of her for a long time, and even though it hurt, she could still move her finger, so I left it alone, and the finger became thicker and the swelling did not go down. When she reached old age, her fingers were completely bent and she could no longer hold a cane or walkway railing, so she came to the hospital for improvement. Like this patient, the joints of the fingers can become deformed due to natural wear of cartilage, fragile bones, and loosened ligaments as a result of age-related degeneration, even in the absence of injury, rheumatism, gout, or other symptoms. This is also called a degenerative lesion. Loosening of finger ligaments and wear and tear of cartilage can cause joint deformity. This is called Osteo Arthritis (OA). The joint at the tip of the finger is the distal interphalangeal joint or DIP joint, and deformity in this area is called Heberden's nodes. Deformity of the next joint after the DIP joint, the proximal interphalangeal (PIP) joint, is called Bouchard's node. It is also more common in middle-aged and older women. Symptoms include pain in the early stages of the disease, but as one gets older, it becomes difficult to grip the joint tightly. When the pain subsides, the deformity of the fingers also hardens and becomes difficult to heal. As for the acupuncture and moxibustion treatment in the present case, since swelling was prominent in the first joint of the middle finger, we applied acupuncture and moxibustion to the joint. We warmed the muscles, ligaments, and nodes of the finger to loosen the tension, and massaged the fingertip so as not to put pressure on it. The healing period may be prolonged if the condition is chronic. If the pain in the finger nodules is not treated because the pain is gone, the deformity may worsen. It is important to continue regular treatment to restore the position and functionality of the joints while regaining movement!