臨床整形外科52巻9号

2017年09月発行

誌上シンポジウム パーキンソン病と疼痛

—パーキンソン病と腰痛—どう治療するか

著者： 吉井文均¹

所属機関： ¹神奈川県済生会平塚医療福祉センター

ページ範囲：P.845 - P.850

　パーキンソン病では半数以上の患者で腰痛の訴えがある．Fordの疼痛分類に基づき，腰痛の原因を1．筋骨格性，2．神経根/神経障害性，3．ジストニア性，4．中枢性に分類した．治療方針を決めるうえでは，原因がどのタイプのものかを判断する必要がある．治療には薬物療法，手術療法，脊髄刺激療法，リハビリテーションなどがあるが，早期からの介入が望ましく，最初からL-dopaやその他の抗パーキンソン病薬で治療を試みることもある．腰痛を慢性化させないためには，腰部の変化のみならず，総合的な立場からのアプローチが重要になる．

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