その痛みは侵害受容性疼痛か神経障害性疼痛どっち？
＜侵害受容性疼痛か神経障害性疼痛なのか、
痛みの原因がわかれば適切な治療が判断できる＞
「痛み」の原因となる病気は多種多様ですが、
治療方法を選択するために必要な分類は、
それほど多くありません。
多くの痛みは、侵害受容性疼痛か神経障害性疼痛に分類できます。
両方が原因のこともあります。
痛みの原因がどちらにもあてはまらない時、
犯人の隠れ場所は、脳のことが多いです。
侵害受容性疼痛は殴られたりした時の痛みです。
殴られると、皮膚の下で炎症がおきて、痛みをおこす物質が出てきます。
それが神経の侵害受容器を刺激して痛いと感じるので、
侵害受容性疼痛というのです。
肩関節周囲炎、関節リウマチ、歯痛なども、侵害受容性疼痛に分類されます。
侵害受容性疼痛に使われる薬の代表は、非ステロイド性消炎鎮痛薬（NSAIDS）であり、
アセトアミノフェンが使われることもあります。
神経障害性疼痛の原因は、糖尿病や帯状疱疹などです。
炎症がないのに、神経が障害されて痛みます。
頚椎症の痛みや座骨神経痛も、神経障害性疼痛です。
神経障害性疼痛に使われる薬は、リリカやサインバルタなどです。
腰痛は、侵害受容性疼痛と神経障害性疼痛の両方が原因となります。
原因がどちらでもないのは、末梢から神経で脳へ伝えられる痛みではなく、
脳の中で発生している痛みです。
繊維筋痛症による痛みは、このどちらでもない痛みであると言われています。
神経を伝わる痛みには神経ブロック療法が行われることもあります。
神経の周辺に局所麻酔薬を注射するのです。
押すと痛む圧痛部位に注射するのは、トリガーポイント注射と言います。
これらの他に、癌の末期には、麻薬が使われることもあります。
麻薬は脳に直接作用して痛みをなくすのです。
痛みの情報サイト 疼痛.jp
https://toutsu.jp/
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