PDF(Pubmed)
Abstract：
BACKGROUND: Playing-related musculoskeletal disorders (PRMDs) are musculoskeletal symptoms that interfere with the ability to play at the level a musician is accustomed to. Musicians have an 84% lifetime prevalence of PRMD. Many types of analgesia are inappropriate for this population due to their risks, but cannabidiol (CBD) has been shown to have anti-inflammatory properties and can reduce the perception of pain. Medical cannabis has also been shown to be safer than other analgesia in terms of serious adverse events. This study explores the impact of medical cannabis for PRMD on perceptions of pain and mental health outcomes.
METHODS: Participants (n = 204) completed questionnaires at baseline and six months: the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) and Depression, Anxiety and Stress Scale (DASS-21). Participants self-selected their group: non-cannabis users (n = 42), new medical cannabis users (n = 61), and long-term medical cannabis users (n = 101). Data were analyzed using paired t-tests for within-group and ANOVA for between-group differences.
RESULTS: At six months, there was no difference (p = 0.579) in cannabidiol dose between new (24.87 ± 12.86 mg) and long-term users (21.48 ± 12.50 mg). There was a difference in tetrahydrocannabinol (THC) dose (p = 0.003) between new (3.74 ± 4.22 mg) and long-term users (4.41 ± 5.18 mg). At six months, new cannabis users had a significant reduction in pain intensity as measured by The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM40) (p = 0.002). Non-users (p = 0.035), new users (p = 0.002), and long-term cannabis users (p = 0.009) all had significant reductions in pain interference (MPIIQM50) at six months. At six months, non-cannabis (p = 0.022) and long-term cannabis users (p = 0.001) had an improvement in DASS-21. The change in pain intensity was the only difference between groups, F(2, 201) = 3.845, p = 0.023. This difference was between long-term (0.83 ± 0.79) and new users (-2.61 ± 7.15). No serious adverse events occurred, and a minority experienced tiredness, cough, and dry mouth.
CONCLUSIONS: This practice-based evidence demonstrated that the multidimensional approach to care provided by the Musicians\' Clinics of Canada benefited all groups at six months. Medical cannabis significantly reduced pain intensity in new users of medical cannabis with PRMD, and all groups saw improvements in pain interference. In keeping with prior studies, medical cannabis seems to be effective at reducing perceptions of pain, including for PRMD. CBD/THC dosing was within guideline recommendations, and no patients experienced any serious adverse events. Limitations include multiple factors impacting patients\' decisions to opt in or out of medical cannabis. These include cost, comorbidities, and disease chronicity. In conclusion, medical cannabis reduces pain intensity in new users, and when combined with a multidimensional approach to care, patients with PRMD can see improvements in pain as well as mental wellbeing.
METHODS: Participants (n = 204) completed questionnaires at baseline and six months: the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) and Depression, Anxiety and Stress Scale (DASS-21). Participants self-selected their group: non-cannabis users (n = 42), new medical cannabis users (n = 61), and long-term medical cannabis users (n = 101). Data were analyzed using paired t-tests for within-group and ANOVA for between-group differences.
RESULTS: At six months, there was no difference (p = 0.579) in cannabidiol dose between new (24.87 ± 12.86 mg) and long-term users (21.48 ± 12.50 mg). There was a difference in tetrahydrocannabinol (THC) dose (p = 0.003) between new (3.74 ± 4.22 mg) and long-term users (4.41 ± 5.18 mg). At six months, new cannabis users had a significant reduction in pain intensity as measured by The Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM40) (p = 0.002). Non-users (p = 0.035), new users (p = 0.002), and long-term cannabis users (p = 0.009) all had significant reductions in pain interference (MPIIQM50) at six months. At six months, non-cannabis (p = 0.022) and long-term cannabis users (p = 0.001) had an improvement in DASS-21. The change in pain intensity was the only difference between groups, F(2, 201) = 3.845, p = 0.023. This difference was between long-term (0.83 ± 0.79) and new users (-2.61 ± 7.15). No serious adverse events occurred, and a minority experienced tiredness, cough, and dry mouth.
CONCLUSIONS: This practice-based evidence demonstrated that the multidimensional approach to care provided by the Musicians\' Clinics of Canada benefited all groups at six months. Medical cannabis significantly reduced pain intensity in new users of medical cannabis with PRMD, and all groups saw improvements in pain interference. In keeping with prior studies, medical cannabis seems to be effective at reducing perceptions of pain, including for PRMD. CBD/THC dosing was within guideline recommendations, and no patients experienced any serious adverse events. Limitations include multiple factors impacting patients\' decisions to opt in or out of medical cannabis. These include cost, comorbidities, and disease chronicity. In conclusion, medical cannabis reduces pain intensity in new users, and when combined with a multidimensional approach to care, patients with PRMD can see improvements in pain as well as mental wellbeing.
摘要：
背景：与演奏相关的肌肉骨骼疾病（PRMD）是肌肉骨骼症状，干扰音乐家习惯水平的演奏能力。音乐家的PRMD终生患病率为84％。许多类型的镇痛由于其风险而不适用于该人群，但大麻二酚（CBD）已被证明具有抗炎特性，可以减少疼痛的感觉。在严重不良事件方面，医用大麻也被证明比其他镇痛更安全。这项研究探讨了用于PRMD的医用大麻对疼痛和心理健康结果的影响。
方法：参与者（n=204）在基线和六个月完成问卷：音乐家肌肉骨骼疼痛强度和干扰问卷（MPIIQM）和抑郁症，焦虑和压力量表（DASS-21）。参与者自我选择他们的组：非大麻使用者（n=42），新的医用大麻使用者(n=61)，和长期医用大麻使用者（n=101）。使用配对t检验分析组内数据，使用ANOVA分析组间差异。
结果：六个月时，新用户(24.87±12.86mg)和长期用户(21.48±12.50mg)之间的大麻二酚剂量没有差异(p=0.579).新用户（3.74±4.22mg）和长期用户（4.41±5.18mg）之间的四氢大麻酚（THC）剂量（p=0.003）存在差异。六个月的时候，根据音乐家肌肉骨骼疼痛强度和干扰问卷（MPIIQM40）的测量，新大麻使用者的疼痛强度显着降低（p=0.002）。非用户（p=0.035），新用户(p=0.002)，和长期吸食大麻者(p=0.009)在6个月时疼痛干扰(MPIIQM50)均显著减少.六个月的时候，非大麻（p=0.022）和长期大麻使用者（p=0.001）的DASS-21有所改善。疼痛强度的变化是组间唯一的差异，F(2,201)=3.845,p=0.023。长期用户（0.83±0.79）和新用户（-2.61±7.15）之间存在差异。无严重不良事件发生,少数人经历了疲劳，咳嗽,口干。
结论：这一基于实践的证据表明，加拿大音乐家诊所提供的多维护理方法在6个月时使所有群体受益。医用大麻显着降低了PRMD医用大麻新使用者的疼痛强度，所有组的疼痛干扰都有所改善。与之前的研究一致,医用大麻似乎可以有效减少疼痛的感觉，包括PRMD。CBD/THC剂量在指南建议范围内，并且没有患者经历任何严重不良事件。限制包括影响患者选择加入或退出医用大麻的多种因素。这些包括成本，合并症,和疾病慢性。总之,医用大麻降低了新用户的疼痛强度，当与多维护理方法相结合时，PRMD患者可以看到疼痛和精神健康的改善.
方法：参与者（n=204）在基线和六个月完成问卷：音乐家肌肉骨骼疼痛强度和干扰问卷（MPIIQM）和抑郁症，焦虑和压力量表（DASS-21）。参与者自我选择他们的组：非大麻使用者（n=42），新的医用大麻使用者(n=61)，和长期医用大麻使用者（n=101）。使用配对t检验分析组内数据，使用ANOVA分析组间差异。
结果：六个月时，新用户(24.87±12.86mg)和长期用户(21.48±12.50mg)之间的大麻二酚剂量没有差异(p=0.579).新用户（3.74±4.22mg）和长期用户（4.41±5.18mg）之间的四氢大麻酚（THC）剂量（p=0.003）存在差异。六个月的时候，根据音乐家肌肉骨骼疼痛强度和干扰问卷（MPIIQM40）的测量，新大麻使用者的疼痛强度显着降低（p=0.002）。非用户（p=0.035），新用户(p=0.002)，和长期吸食大麻者(p=0.009)在6个月时疼痛干扰(MPIIQM50)均显著减少.六个月的时候，非大麻（p=0.022）和长期大麻使用者（p=0.001）的DASS-21有所改善。疼痛强度的变化是组间唯一的差异，F(2,201)=3.845,p=0.023。长期用户（0.83±0.79）和新用户（-2.61±7.15）之间存在差异。无严重不良事件发生,少数人经历了疲劳，咳嗽,口干。
结论：这一基于实践的证据表明，加拿大音乐家诊所提供的多维护理方法在6个月时使所有群体受益。医用大麻显着降低了PRMD医用大麻新使用者的疼痛强度，所有组的疼痛干扰都有所改善。与之前的研究一致,医用大麻似乎可以有效减少疼痛的感觉，包括PRMD。CBD/THC剂量在指南建议范围内，并且没有患者经历任何严重不良事件。限制包括影响患者选择加入或退出医用大麻的多种因素。这些包括成本，合并症,和疾病慢性。总之,医用大麻降低了新用户的疼痛强度，当与多维护理方法相结合时，PRMD患者可以看到疼痛和精神健康的改善.
