母指の痛み
masuipain in the thumb
母指の手前にある第1中手骨と手首の小さい骨である大菱形骨の間には、第1手根中手骨関節（親指のCM関節）があります。親指のCM関節は、柔軟に動きやすくなっているため、物を掴んだり、握ったりする動作が可能です。また、母指が他の指と向き合ってつまみ動作ができる、大きな動きのある関節です。その分使い過ぎや、老化に伴って、関節軟骨の摩耗が起き易く、進行すると関節が腫れ、亜脱臼してきて母指が変形してきます。母指のCM関節の間には、骨と骨を繋ぐ関節をクッションのような役割で覆っている軟骨あり、これがすり減り、骨同士がぶつかることで、痛みや骨の変形が生じます。最初は、重だるい痛みから始まり、軟骨のすり減りが進んでいくと、親指に力を入れた際に、ズキッとした強い痛みが出ます。親指に力を入れる動作で痛みを感じたり、親指の付け根が開きにくくなったり、親指の付け根あたりが膨らんできたら要注意です。そのまま、使い続けると進行して、親指の指先の関節が曲がり、付け根側の関節が反ってしまいます。白鳥の首変形・スワンネック変形のような形になり、亜脱臼ぎみになります。母指CM関節症は他の変形性関節症（腰や膝）に比べて、中年女性が多いですこれは、更年期以降は、加齢による老化現象として、関節軟骨がすり減りやすく、骨粗鬆症にもなりやすくなります。また、若い人でも、ゴルファーなどは、CM関節部分を痛めることもあります。母指CM関節症の発症は、加齢変性、荷重の負荷の蓄積、女性ホルモンの影響などが影響してきます。今症例は、中年女性で、親の介護で、体を抱えたり、起こしたりと、親指の付け根の関節に関節の柔軟さを超えた負荷がかかり続け際に痛めたと考えられました。鍼灸治療としてはCM関節を温めて、疼痛緩和と、血行を促進して、筋腱骨に、栄養を与えて、症状の改善をしていきます。
The first carpometacarpal joint (CM joint of the thumb) is located between the first metacarpal bone in front of the thumb and the greater rhomboid bone, a smaller bone at the wrist. The CM joint of the thumb is flexible and easy to move, allowing for grasping and gripping movements. It is also a joint with great mobility, allowing the thumb to face the other fingers and make pinching motions. As a result, the articular cartilage tends to wear down with overuse and aging, and as the condition progresses, the joint swells and subluxation occurs, resulting in deformity of the thumb. Between the CM joints of the thumb, there is cartilage covering the joint that connects the bones, acting as a cushion. The pain starts out as a heavy ache, but as the cartilage wears away, a strong throbbing pain occurs when the thumb is strained. Be careful if you feel pain when exerting pressure on the thumb, if it becomes difficult to open the base of the thumb, or if the area around the base of the thumb becomes swollen. If you continue to use it, it will progress and the joint at the tip of the thumb will bend and the joint at the base of the thumb will warp. The joint becomes subluxated, similar to a swan neck deformity or swan neck deformity. Compared to other osteoarthritis (hip and knee), thumb CM arthropathy is more common in middle-aged women. This is because, after menopause, the articular cartilage tends to wear away and osteoporosis is more likely to occur as a result of aging. Even younger people, such as golfers, may also suffer from CM joint area. The development of thumb CM arthropathy is influenced by age-related degeneration, accumulated load, and the influence of female hormones. In the present case, a middle-aged woman was taking care of her parents, and it was thought that she had suffered pain when the joint at the base of her thumb was continuously loaded beyond its flexibility due to holding and raising her body. Acupuncture and moxibustion treatment was performed to warm the CM joint, relieve pain, promote blood circulation, and nourish the musculoskeletal system to improve symptoms.
