臨床整形外科57巻12号

2022年12月発行

最新基礎科学/知っておきたい

腰痛のメカニズム—加齢に伴う骨格筋減少と腰痛

著者： 酒井義人¹

所属機関： ¹国立長寿医療研究センター整形外科

ページ範囲：P.1476 - P.1480

はじめに

　有病率15.4％と報告される筋骨格系の慢性疼痛は，国内における患者数は推定約2000万人に及ぶとされる¹⁾．特に腰痛に関しては，男女とも75〜84歳で有病率はピークであり，加齢とともに増加する腰痛については，超高齢社会を迎えているわが国の現状に鑑みても看過できない大きな問題である．国民生活基礎調査では，疼痛の部位別では腰が最も多く，次いで肩，頚部と続いており，高齢になるほど腰痛が増加する原因の1つとして，加齢に伴う骨格筋の減少であるサルコペニアが挙げられる²⁾．

　近年，高齢者のサルコペニアと腰痛の関連の報告が散見され，新たな治療法の開発も期待されるが，骨格筋の減少による疼痛発現機序については未だ解明されていない点が多い．サルコペニアの病態を整理し，慢性疼痛，特に腰痛発生に関連する骨格筋減少の生理学的・分子生物学的メカニズムにつき解説する．

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