back pain
Can Cannabis Provide Some Relief From Chronic Pain
Chronic pain can be life changing – from the pain to zapped energy. But can cannabis make a difference?
An estimated 20% of adults in the US and roughly 8 million Canadians experience chronic pain. This condition is defined as pain that lasts for more than three months. It can lead to insomnia and fatigue. If can impact many other parts of life, including mood and the ability to move and body functions. It can also lead to changes in the brain and nervous system, which can make the pain worse and harder to manage. But can cannabis provide some relief from chronic pain?
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Medical cannabis (MC) and cannabidiol (CBD) have show promise in managing chronic pain, though efficacy varies by condition and formulation. Research indicates cannabinoids may reduce pain severity by 30–50% compared to placebo, particularly in neuropathic and inflammatory conditions. A 2023 systematic review of 15 studies found CBD alone or combined with tetrahydrocannabinol (THC) reduced pain by 42–66%.
Cannabinoids interact with the body’s endocannabinoid system, modulating pain signaling and inflammation:
- THC binds to CB1 receptors in the central nervous system, altering pain perception.
- CBD enhances anandamide (a natural pain-regulating compound) and activates glycine receptors, potentially reducing localized inflammation.
- Combined THC:CBD formulations (e.g., nabiximols) often show superior pain relief compared to single cannabinoids, with CBD mitigating THC’s psychoactive effects.
Clinical Evidence by Condition
- Neuropathic pain: THC:CBD sprays reduced pain scores in multiple sclerosis and spinal injury patients.
- Arthritis/fibromyalgia: Topical CBD improved peripheral neuropathy, while oral formulations alleviated fibromyalgia pain in 30% of patients.
- Chronic back/neck pain: Preliminary trials suggest vaporized cannabis may rival oxycodone’s efficacy.
The good news is studies report 18–29% of patients achieve ≥30% pain reduction with cannabinoids vs. 14–26% on placebo. Effective CBD doses range widely (2.5–1,500 mg/day), and prolonged use may alter drug metabolism. So trend carefully with both CBD and THC. Remember, only THC:CBD combos like nabiximols are FDA-approved for specific conditions; most CBD products remain unregulated.
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CBD alone shows fewer side effects (fatigue, diarrhea) than THC-containing products. Notably, real-world data associate medical cannabis with 60% reduced opioid use in chronic pain patients, though long-term safety data remain limited.
While cannabinoids offer a potential alternative for refractory chronic pain, optimal use requires personalized dosing and further high-quality trials targeting specific pain subtypes. Current evidence supports cautious integration into multimodal pain regimens, particularly when conventional therapies fail. Always talk with your health professional when adding something new to your pain management regime.