膝痛 関節水腫
masuiKnee pain Arthritic edema
膝関節に水が溜まる関節水腫の既往歴あり。膝関節は、大腿骨、脛骨、腓骨で構成されていて、骨と骨がつながっている部分のことを膝関節といいます。膝の関節面は関節軟骨で覆われています。関節の周りは関節包で覆われています。その関節包の内側に滑膜があります。滑膜では、滑液の生産と吸収がおこなわれ、関節腔の中へ分泌されます。この滑膜によって包まれている空間を関節腔と呼びます。関節腔の中は滑液で満たされていて、関節面の摩擦を軽減する循環油になると共に、関節軟骨に栄養を与えます。膝に溜まる水は、この滑液のことで、これを、関節水腫と呼びます。通常は3ml前後含まれていますが、膝の炎症などで関節腔が膨らんでしまい、皮膚の下がぶよぶよしたりすると、関節の動きが制限されたり、違和感がでたり、熱感、炎症や痛みがでたりします。炎症を起こすと滑液の量が増え、滑膜で滑液を吸収する能力が低下し、結果的に関節腔の滑液の量が溜まってしまい多くなります。関節水腫になった場合は、整形外科で溜まった水を抜き、抗炎症薬やヒアルロン酸の注射を打ち、炎症を抑えていきます。水を抜かないと、膝関節の筋力低下が起こる可能性があります。関節水腫のまま、膝のトレーニングを続けると、膝関節自体が炎症しているため、悪化することもあります。症状が落ち着いても、関節内の炎症が残っていると、免疫が落ちた時や、体力が落ちた時に、再度、関節内に水が溜まるりやすくなります。関節腔内の滑液は、先に述べたように、節面の摩擦を軽減する循環油になり、関節軟骨に栄養を与える大事な必要なものですので、水を抜けばいいと言うものではありません。鍼灸治療としては、血行を促進して、血液中の白血球で炎症を抑え、筋力低下による大腿四頭筋の硬さに対しては筋に柔軟性を与えていく目的で施術しています。
There is a history of arthritic edema, which is the accumulation of water in the knee joint. The knee joint is composed of the femur, tibia, and fibula, and the knee joint is the area where the bones are connected. The articular surface of the knee is covered with articular cartilage. The joint is surrounded by an articular capsule. Inside that joint capsule is the synovial membrane. The synovial membrane produces and absorbs synovial fluid, which is secreted into the joint cavity. The space enclosed by the synovial membrane is called the joint cavity. The joint cavity is filled with synovial fluid, which acts as a circulatory oil to reduce friction between the joint surfaces and nourishes the articular cartilage. The water that accumulates in the knee is this synovial fluid, which is called joint edema. Normally, it contains about 3 ml, but when the joint cavity swells due to inflammation of the knee, causing blubber under the skin, joint movement may be restricted, discomfort, heat, inflammation, and pain may occur. Inflammation increases the amount of synovial fluid and reduces the ability of the synovial membrane to absorb synovial fluid, resulting in a buildup of synovial fluid in the joint cavity, which becomes more. If joint edema occurs, an orthopedic surgeon will drain the accumulated water and inject anti-inflammatory drugs or hyaluronic acid to reduce inflammation. If the water is not drained, muscle weakness in the knee joint may occur. Continued knee training while the joint edema is still present can worsen the inflammation in the knee joint itself. Even after symptoms subside, residual inflammation in the joint makes it easier for water to accumulate in the joint again when the immune system is compromised or when strength is lowered. As mentioned earlier, synovial fluid in the joint cavity serves as circulating oil to reduce friction between joint surfaces and is an important and necessary source of nourishment for the articular cartilage, so draining the fluid is not the answer. Acupuncture is used to promote blood circulation, reduce inflammation with the white blood cells in the blood, and provide flexibility to the quadriceps muscle when it is stiff due to muscle weakness.
