四十肩・五十肩　症例 | 乃木坂YMクリニック

性別：女性　、年齢40代

現病歴：1年前から肩が上がらなくなった、整形外科へ受診し内服、ストレッチ指導を受けたが5ヶ月ほど経過しても改善ないため、他院整形外科受診　リハビリを2ヶ月間受けたが改善せず。さらに他院筋膜リリース注射をしてもらったが改善せず、ロキソニン飲むしかないと言われた。さらにその後鍼治療を受けていたが改善なし。現在も肩・腕が動くたびに痛く、パソコン仕事をするときに痺れがあり辛い。

経過：
初診日：痛みは39%(VAS)まで改善。関節可動域改善。
7日後：痛みは減った。睡眠時の痛みはかなり改善した。治療直後よりは固まった気がする
1ヶ月後：日常生活ではほとんど痛み感じない、痺れも感じない。まだ関節可動域の制限がある。

現在：日常生活の辛さはほぼなくなった。回復期に入ったため、悪化しないようストレッチ指導し1ヶ月毎にフォロー中。

症例：40代男性

現病歴：18歳の頃から右肩関節の痛みがあった。それ以降ずっと肩は痛い。40歳になって子供も野球を始めて一緒に野球をしたら肩の痛みが強くなった。近医整形外科通院し、MRI撮影施行。インピンジメントと言われ、2-3年近医整形外科また都心の有名なDrがいる整形外科にも言ったが変わりなく子供のキャッチボールは下投げしかできなかった。子供とキャッチボールなんとかキャッチボールしたいため当院受診。

罹患期間：約30年

直近治療期間：2-3年

肩関節可動域：

初日治療前：右肩関節　外転　130°、屈曲145°、後方内旋T12

初日治療後：右肩関節　外転　155°、屈曲164°、後方内旋T12

２回目(2ヶ月後)治療前：右肩関節　外転 146°、屈曲166、後方内旋T9

２回目(2ヶ月後)治療後：右肩関節　外転180°、屈曲180°、後方内旋T9

治療経過：

注射・ストレッチなどは全て医師(院長)による手技です。

初診：適切な部位のステロイド注射、筋膜リリース注射、適切なストレッチ　(total １時間)

２回目受診(2ヶ月後)：筋膜リリース注射と適切なストレッチ。投球動作（外転、外旋）にてインピンジメント症状消失。投球練習開始。

考察：本当はもう少し早めの再診予定でしたが、仕事忙しくなかなか受診できず。ただストレッチや投球動作はしないなど家での過ごし方をしっかり守っていただいたせいか、特に増悪なく、２回目の診察でインピンジメント症状の明らかな改善が認められた。２回目治療後は軽いものでオーバースローを試すと痛みなく可能となった。いまままでの治療で改善しなかったポイントとしてはまずステロイド注射打つべきところが間違っている、適切なリハビリができていない。肩まわりしか調節していない、リハでのストレッチ技術が未熟(難治性の場合は教科書通りのストレッチはあまり意味のないことが多い、ちゃんと筋肉が伸長しているかどうか確認しないといけない、目的の筋肉を動かすために関節に強烈な負荷を加えながらストレッチをしていた可能性、見当違いの筋肉に対してリハビリしていた可能性)。このケースにおけるインピンジメントの発生する３次元的解釈ができていなかった可能性が考えられる（個別によってインピンジメントを引き起こしている原因が違うため）。

症例：女性

現病歴：1年前(R6年7月ごろ)に転んでしまった。右手をついて右肩関節が痛くなった。2~3週間整形外科に行ったが改善なかった。11月の終わり頃から鍼灸の治療を受けるようになり少しずつよくなってきた。治療が滞っているためR7年7月当院受診。

罹患期間：約1年

直近治療期間：8ヶ月

肩関節可動域：

初日治療前：屈曲133°、外転 135°、後方内旋 T9

初日治療後：屈曲157°、外転 158°、後方内旋 T9

3回目(2ヶ月後)治療前：屈曲160、外転170、後方内旋 T4

3回目(2ヶ月後)治療後：屈曲161、外転170、後方内旋T4

4回目(3ヶ月後)治療前：屈曲170 　外転 175° 後方内旋　T4

4回目(3ヶ月後)治療後：曲170°　外転 176°. 後方内旋 T4

治療経過：

注射・ストレッチなどは全て医師(院長)による手技です。

初診：適切な部位のステロイド注射、筋膜リリース注射、適切なストレッチ　(total １時間)

１週間後(2回目)：経過観察　ストレッチのみ。睡眠時の痛みは減った。

2ヶ月後：睡眠時の痛みはほぼなし。ROMは改善傾向。筋膜リリース注射とストレッチ併用。

3ヶ月後：睡眠時の痛みはほぼなし。ROMは改善傾向。筋膜リリース注射とストレッチ併用。

ほぼ日常生活に問題なし。

現在　各関節、肩こり、腰痛予防目的で定期的なバランス調節受診。

Gender: Female, Age: 40s

Medical History: One year ago, I lost the ability to raise my shoulder. I visited an orthopedic clinic where I received oral medication and stretching guidance, but after about five months with no improvement, I consulted another orthopedic clinic. I underwent rehabilitation for two months with no improvement. I then received myofascial release injections at another clinic, but still saw no improvement and was told I had no choice but to take Loxonin. After that, I tried acupuncture treatment, but it also did not help. Currently, pain occurs with every movement of the shoulder and arm. Numbness during computer work is particularly distressing.

Progress:

Initial Visit: Pain improved to 39% (VAS). Joint range of motion improved.

7 Days Later: Pain decreased. Pain during sleep significantly improved. Feels stiffer than immediately after treatment.

1 Month Later: Hardly any pain felt during daily activities, no numbness. Joint range of motion still restricted.

Current Status: Discomfort in daily life has almost completely disappeared. As the patient has entered the recovery phase, we are providing stretching guidance to prevent deterioration and conducting monthly follow-ups.

Case: Female Present Illness: Fell approximately one year ago (around July 2024). Supported herself with her right hand, causing pain in her right shoulder joint. Visited an orthopedic clinic for 2-3 weeks with no improvement. Began acupuncture treatment around late November and gradually improved. Due to interrupted treatment, visited our clinic in July 2025.

Duration of illness: Approximately 1 year Most recent treatment period: 8 months

Shoulder Joint Range of Motion: Day 1 Pre-Treatment: Flexion 133°, Abduction 135°, Posterior Internal Rotation T9 Day 1 Post-Treatment: Flexion 157°, Abduction 158°, Posterior Internal Rotation T9 3rd Session (2 months later) Pre-Treatment: Flexion 160°, Abduction 170°, Posterior Internal Rotation T4 After 3rd session (2 months later): Flexion 161°, Abduction 170°, Posterior Internal Rotation T4 Before 4th session (3 months later): Flexion 170°, Abduction 175°, Posterior Internal Rotation T4 After 4th session (3 months later): Flexion 170°, Abduction 176°, Posterior Internal Rotation T4 Translated with DeepL.com (free version)

Treatment Progress: All injections and stretches are performed manually by the physician (Director). Initial Visit: Steroid injection at appropriate site, fascia release injection, appropriate stretching (total 1 hour) 1 week later (2nd visit): Follow-up observation. Stretching only. Pain during sleep reduced. 2 months later: Pain during sleep nearly absent. Range of motion (ROM) showing improvement. Fascia release injection combined with stretching. 3 months later: Sleep pain nearly gone. Range of motion (ROM) showing improvement. Combination of fascia release injections and stretching. Nearly no issues with daily life. Currently receiving regular balance adjustments for each joint, shoulder stiffness, and lower back pain prevention.

Case: Male in his 40s

Medical History: Experienced pain in the right shoulder joint since age 18. The shoulder has been painful ever since. At age 40, his child started playing baseball. When he played catch with his child, the shoulder pain worsened. He visited a local orthopedic clinic and underwent an MRI. He was told it was impingement. Over the next 2-3 years, he visited the local orthopedic clinic again and also saw a renowned orthopedic surgeon in the city center, but there was no improvement. He could only play catch with his child using an underhand throw. He visited our clinic because he desperately wanted to play catch with his child.

Duration of illness: Approximately 30 years

Most recent treatment period: 2-3 years

Shoulder Joint Range of Motion:

Day 1 Pre-Treatment: Right Shoulder Joint - Abduction 130°, Flexion 145°, Posterior Internal Rotation T12

Day 1 Post-Treatment: Right Shoulder Joint - Abduction 155°, Flexion 164°, Posterior Internal Rotation T12

Second session (2 months later) before treatment: Right shoulder joint abduction 146°, flexion 166°, posterior internal rotation T9

Second session (2 months later) after treatment: Right shoulder joint abduction 180°, flexion 180°, posterior internal rotation T9

Treatment Course:

All injections and stretches are performed manually by the physician (Director).

Initial Visit: Steroid injection at the appropriate site, fascia release injection, and appropriate stretching (total 1 hour).

Second Visit (2 months later): Fascia release injection and appropriate stretching. Impingement symptoms resolved during throwing motion (abduction, external rotation). Throwing practice commenced.

Consideration: The follow-up appointment was actually scheduled a bit earlier, but due to a busy work schedule, it was difficult to attend. However, likely because the patient diligently followed home care instructions—such as avoiding stretching and throwing motions—there was no significant worsening. At the second examination, a clear improvement in impingement symptoms was observed. After the second treatment, attempting an overhand throw with light force became possible without pain. Key points where previous treatments failed to improve included: the steroid injection was administered in the wrong location, and appropriate rehabilitation was not performed. They only adjusted the shoulder area, and the stretching techniques used in rehab were inadequate (for stubborn cases, textbook stretches often aren't very effective; you need to confirm the muscles are actually being stretched. There's a possibility they were stretching by applying intense stress to the joint to move the target muscle, or they might have been rehabilitating the wrong muscles). It's possible they didn't fully grasp the three-dimensional interpretation of how impingement occurs in this specific case (because the cause triggering impingement differs for each individual).

乃木坂YMクリニック

性別：女性　、年齢40代

症例：40代男性

症例：女性

Gender: Female, Age: 40s

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​性別：女性 、年齢40代

Gender: Female, Age: 40s

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Fee

Access Map

chatt

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性別：女性　、年齢40代