指の変形　変形性関節症

Finger deformity Osteoarthritis

ゴルフ愛好者。指の第一関節がまっすぐ伸びなくなったのと、指が横に曲がって、指同士に隙間ができてしまうので来院。人差し指が、横に流れてしまい、ティーカップの柄なども上手につかめず落としてしまい。ストレスになることが多いとのことでした。指の関節には、骨と骨の間に、骨同士の衝突を防ぐためにクッションのような役割をする軟骨があります。この軟骨はコラーゲンなどを含み、弾力性がありますが、指を酷使したり、加齢変性などが理由で、弾力性は徐々に衰えます。ゴルフなどで、指の関節を痛めても、プレーをそのまま続けていると、指の関節のクッション役である軟骨は、どんどん薄くなり、ついにはクッションの役目を果たすことができなくなります。骨同士が衝突して、摩擦し、骨の形や関節周囲の構造が変化して炎症や痛みを起こします。さらに悪い事に、指の第一関節がごつごつとまっすぐ伸ばせなくなったり、曲げれなくなると、骨と骨とを結んでいる靭帯が緩んで、指が横に流れやすいくなったり、骨同士がぶつかってしまいます。DIP関節は指の中で一番小さな関節なので、正常でも関節の隙間は１ｍｍ以下だそうです。関節は、関節包という袋におおわれており、関節包の中を関節液という水分で満たされています。関節が破壊され骨棘が出来ることで、関節液の出し入れがうまくいかなくなり、コブのように関節が飛び出して関節自体も破壊が強くなります。第1関節の動きも悪くなり、強く握ることが困難になってきます。第1関節の近くに水ぶくれのようなでっぱりのようコブは、ミューカスシスト（粘液嚢腫）と呼ばれます。鍼灸治療では、痛みの疼痛緩和、指の靭帯や腱の硬縮や緊張を取り除き、手指へのストレスを少なくすることにより、変形の進行を遅れさせたり、悪化への予防をしていきます。

Golf enthusiast. He came to our hospital because the first joint of his finger was no longer straight and his fingers were bent sideways, leaving a gap between them. His index finger was often dropped because it was not able to grasp the handle of a teacup. She said that she often felt stressed. In the joints of the fingers, there is cartilage between the bones that acts as a cushion to prevent bones from colliding with each other. This cartilage contains collagen and is elastic, but due to overuse and age-related degeneration, the elasticity of the cartilage gradually deteriorates. If a golfer continues to play golf after injuring a finger joint, the cartilage that serves as a cushion for the finger joint becomes thinner and thinner, and eventually becomes unable to fulfill its role as a cushion. Bones collide and rub against each other, changing the shape of the bones and the structure around the joint, causing inflammation and pain. Worse, when the first joint of the finger becomes stiff and cannot be straightened or bent, the ligaments connecting the bones loosen and the finger tends to drift sideways, or the bones collide with each other. The joint is a pouch called an arthrodesis. The joint is covered by a pouch called an articular capsule, which is filled with fluid called joint fluid. When joints are destroyed and bone spurs form, the joint fluid does not flow in and out properly, the joint pops out like a bump, and the joint itself is strongly destroyed. The first joint also becomes less mobile, making it difficult to grip tightly. A blister-like bump near the first joint is called a mucous cyst. Acupuncture treatment can delay the progression of the deformity or prevent it from worsening by relieving pain, removing stiffness and tension from the finger ligaments and tendons, and reducing stress on the fingers.