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Overview of Muscular Dystrophy

Muscular dystrophy encompasses an entire group of more than 30 inherited disorders, all of which cause the loss of skeletal muscle tissue and accompanying muscle weakness. Unfortunately, all of the disorders that make up the muscular dystrophy, or MD, group are known to degenerate, or get worse over time. As a result, keeping the patient comfortable and as pain-free as possible is often one of the most prominent treatment goals.

There are nine different types of MD that vary in their onset and severity. They are all caused by a genetic defect and are all degenerative:

1. Myotonic

Most common form of MD for adults that is caused by a repeat in their genetic code.

  • Common Symptoms: Weight loss, frontal baldness, drowsiness, infertility, difficulty swallowing, vision problems, long thin face and neck, coronary issues that could become fatal before age 50

  • Progression: Develops in men and women from 20 to 30 years of age.

2. Duchenne

Accounting for more than 50% of cases, Duchenne is the most severe form of MD affecting children.

  • Common Symptoms: Weakness in the pelvis and upper legs, difficulty running and jumping, waddle gait, fat accumulation in calf muscles, fall down a lot

  • Progression: A fast progression in boys from age three and is usually non-ambulatory by age 12. The life expectancy is approximately 20 years.

3. Becker

Similar in nature to Duchenne, Becker MD can move quickly or slowly.

  • Common Symptoms: Difficulty getting up from the floor, frequent muscle cramps, walking on tiptoes, falling down a lot

  • Progression: Boys between 11 and 25 can begin to show symptoms, and it is often non-ambulatory by the mid-thirties or later.

4. Limb-Girdle

Both boys and girls can inherit the defective gene from either parent or, in more severe cases, the same genetic defect from both parents.

  • Common Symptoms: Fall down a lot, develop hip weakness that spreads to shoulders, legs and neck, waddle gait, rigid spine, difficulty climbing stairs

  • Progression: Usually presents in young adults and progresses to severe symptoms within the next 20 years.

5. Facioscapulohumeral

This form of MD affects the face, shoulders and upper arms, although the exact gene that causes it is not known.

  • Common Symptoms: Difficulty closing and opening eyes, trouble smiling or puckering, bicep and tricep reflex impairment, hearing problems, lordosis curve of the spine, muscle wasting around shoulders

  • Progression: Both boys and girls are affected in their teens. The life span is normal, but symptoms can be debilitating.

6. Congenital

Most often caused by a genetic defect in muscle fiber proteins but can sometimes affect the central nervous system.

  • Common Symptoms: Scoliosis (curvature of the spine), muscle shortening that stiffens joints, difficulty with muscle control from birth, feet deformities, intellectual disabilities, trouble breathing and swallowing

  • Progression: Evident by age two in boys and girls. Ambulation may never occur, but death is possible in infancy.

7. Oculopharyngeal

This form of MD is common in specific ethnic groups including French-Canadian, Jewish Ashkenazi and Hispanics from the southwestern United States.

  • Common Symptoms: Heart problems, drooping eyelids, muscle wasting in shoulders and neck, trouble swallowing

  • Progression: Symptoms usually reveal before age 60 and progress slowly. Some become non-ambulatory.

8. Distal

Distal MD can present in men and women, and it affects the forearms, lower legs, hands and feet.

  • Common Symptoms: Trouble extending fingers, difficulty hopping or standing on heels, inability to climb stairs without difficulty, trouble forming hand gestures

  • Progression: Usually presents between ages 40 to 60. Progression is slow but could eventually result in the need for a ventilator.

9. Emery-Dreifuss

This MD variation is caused by a defect in the proteins surrounding cell nucleus, and it affects boys primarily. 

  • Common Symptoms: Elbows may lock in a flexed position, shoulder deteriorates, walk on tiptoes, rigid spine, facial muscle weakness, chronic muscle shortening in back of neck, ankles, knees, elbows or spine

  • Progression: Symptoms often present by age ten. Heart problems occur in late 20s, and death from pulmonary or cardiac failure is likely in middle age.

The progressive muscle weakness creates poor posture and spinal deformities. These symptoms lead to poor balance as well as the tightening and shortening of leg muscles, foot muscles and soft tissue. This eventually results in an inability to walk. Once confined to a wheelchair, a person with MD deteriorates faster.

Findings: Effects of Cannabis on Muscular Dystrophy

All the MD disorders are inherited, meaning the genes causing the disorder are passed down through families. The age of onset, degree of muscle loss and weakness, rate at which the disorder progresses through the body, and the pattern of inheritance within the family can vary significantly among the MD disorders. Duchenne MD, the most common of all the MD disorders, for example, affects males at an early age, commonly between the ages of three and five years old. Duchenne MD also progresses rapidly, often leaving the sufferer unable to walk as early as age 12. Females in a Duchenne MD family have a 50 percent chance of passing the Duchenne MD gene down to their children. Myontic MD, on the other hand, typically waits until the adult years to show symptoms and progresses slower but can be marked by prolonged muscle spasms among other symptoms.

Medical marijuana effectively relieves extreme pain, including the nerve pain that opioids are used for. In most cases, marijuana is a better solution for pain relief than opioids because it can be used long-term for chronic pain. The brain does adapt to cannabis, but at a much slower rate than opioids. This means the dose does not have to rapidly increase to get the same results.

Medical cannabis products do not carry the same side effects as opioids, either. Opioids block pain signals and reduce respiration at the same time. Opioid overdoses often result in death because respiration becomes so slow that it stops entirely. Marijuana has no such side effects. If you get too much cannabis in your system, you might experience a period of anxiety or paranoia, but it is not fatal.

Medical marijuana may help MD sufferers who live with chronic pain avoid building up a never-ending tolerance to opiate based pain medication. A recent study looked at the effect of adding medical marijuana to the daily regime of patients who consume opiate based pain medication for chronic pain. The study found that the participants experienced an average drop in pain level of 27 percent while not significantly affecting the blood-levels of the prescription drugs. For MD patients, in particular, excessive levels of opiates in the blood can be extremely dangerous given the respiratory problems common to MD sufferers. The fact that medical marijuana was able to reduce pain levels without increasing opiate blood levels is important.

Smoking marijuana has been found to be the most effective and rapid mechanism for relaying the active compounds to the brain, thereby allowing the sufferer to feel immediate relief from pain as well as offering better control over medication levels. Smoking anything, however, is clearly not good for your lungs or respiratory system. An MD sufferer may have a particularly compromised respiratory system. Luckily, there is another, equally effective, yet healthier mechanism for using medical marijuana - vaporization. Because the active compounds in marijuana, known as cannabinoids, are volatile, they can be vaporized at a temperature level significantly lower than that needed to reach combustion, or smoke. As a result, hot air can simply be drawn through the marijuana, which in turn vaporizes the cannabinoids and frees them for inhalation.

Medical cannabis is also effective at reducing the length and severity of muscle spasms and cramps. Patients with MD can get very painful muscle cramps. A regular regime of cannabis treatment could reduce or possibly eliminate these incidents.

Can Medical Marijuana Cure Muscular Dystrophy?

Unfortunately, there is no known cure for any of the MD disorders. Conventional treatment attempts to control seizures and muscle spasms as well as provide physical, respiratory and speech therapy in order to give the patient the best quality of life possible.  Medical marijuana and Muscular Dystrophy has been known to help treat some of the side-effects associated with Muscular Dystrophy. 

Unfortunately, all of the disorders that make up the muscular dystrophy, or MD, group are known to degenerate, or get worse over time. As a result, keeping the patient comfortable and as pain-free as possible is often one of the most prominent treatment goals. Among the common members of the group of MD disorders are Becker muscular dystrophy, Duchenne muscular dystrophy, Emery-Dreifuss muscular dystrophy, Facioscapulohumerol muscular dystrophy, Limb-girdle muscular dystrophy, Myotonia congenita, and Myotonic muscular dystrophy.

There are not many medical studies done on the use of cannabis to treat MD, although the medical community is continuing to make progress on proving the beneficial properties of medical marijuana. The results of some studies performed on the uses of medical cannabis for ALS can be applied to MD, as well, since ALS also involves muscle atrophy and weakness. Some studies have seen the following results of medical cannabis on ALS:

  • Pain relief

  • Muscle relaxation

  • Saliva reduction

  • Appetite induction

  • Sleep improvement

  • Bronchodilation

Several of these same treatment mechanisms could be useful in treating MD and eventually offer the basis for a cure to the disease. In the meantime, more studies and more testing are needed to clearly define the effects of marijuana on MD.

Anecdotal reports of MD patients finding relief through medical marijuana are encouraging. The effects on their quality of life can be so profound as to prompt them to move across the country to a state when medical cannabis is easily accessible. MD patients are finding relief from pain and improved sleep habits from medical marijuana use.

The mental health benefits of reducing chronic pain are measurable. Chronic pain can develop into a serious problem of its own, leading to mental health issues such as depression and anxiety. Living with a chronic disease like MD also contributes to mental health issues like depression and anxiety. Reducing the pain without causing dangerous side-effects improves mental outlook.

Medical marijuana is proven to reduce anxiety and promote relaxation in a number of different conditions. Relieving stress can give the brain a chance to rest and work on improved healing. MD is a chronic condition with no real cure, but in some cases, the symptoms can be managed for a normal life expectancy. The use of medical cannabis improves the chances of slowing the progression of the disease and the onset of symptoms.

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