膝裏の痛み

back of the knee pain

膝裏の痛みで来院。膝を伸ばすと痛み、膝をまっすぐに伸ばせない。正座をする時やしゃがむ時など膝を深く曲げると圧迫されたような感じがある、歩き始めや椅子から立ち上がる時にこわばった感じがする。 膝の関節液が大量にたまると、膝の裏側にある関節包から袋状に突出します（ベーカー嚢腫）。皮膚から触るとゴムボールのような触感で小さな場合は押さえても痛みはありません。しかし、大きくなると膝が曲げにくくなり、曲げると膝の痛みが強くなって正座ができない、階段の昇り降りがつらいなどの症状が出てきます。原因は、変形性膝関節症がほとんどであり、膝の前ではなく裏に水が溜まる状態になります。鍼灸治療は筋肉の硬さを緩めて膝関節のバランスを取ることで膝の関節軟骨の摩耗を抑えることができるため、変形性膝関節症による膝の痛みにも効果的です。膝自体は非常に冷えやすいため、鍼治療と併せて、灸治療で温熱刺激を与えると膝の血流が改善し、膝周辺の新陳代謝が活性化することで、治療効果の増大が期待できます。

Patient comes to hospital with pain in the back of the knee. Pain when extending the knee and inability to straighten the knee. Feeling of pressure when bending the knee deeply, such as when sitting upright or squatting, and stiffness when starting to walk or getting up from a chair. When a large amount of joint fluid builds up in the knee, it protrudes from the joint capsule on the back of the knee in a bag-like shape (Baker's cyst). When touched through the skin, it feels like a rubber ball to the touch and, if small, is not painful when pressed down. However, when larger, it becomes difficult to bend the knee, and when bending, the knee becomes more painful, making it difficult to sit upright or go up and down stairs. The cause is mostly osteoarthritis of the knee, which causes water to accumulate in the back of the knee instead of the front. Acupuncture is also effective for knee pain caused by osteoarthritis, as it can reduce wear and tear on the articular cartilage of the knee by relaxing muscle stiffness and balancing the knee joint. As the knee itself is very susceptible to cold, in conjunction with acupuncture, moxibustion therapy can be used to provide heat stimulation, which improves blood flow to the knee and activates the metabolism around the knee, thereby increasing the effectiveness of the treatment.