Medical marijuana is being used by many people across the United States for a variety of reasons, with chronic pain being one of the most common. Patients diagnosed with a diverse range of illnesses and conditions use medical marijuana to combat the chronic pain that accompanies the malady, and many report successes. In this post, we will cover what chronic pain is, how medical marijuana can help relieve it, and some strains that may be especially useful to combat it.

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What is Chronic Pain?

Simply put, chronic pain is pain that persists. Chronic pain can last days, months, or even years in some people. This pain can be due to visible damage or injury, or, in some cases, seemingly without physical cause. Chronic pain may also be triggered by an initial event, such as an accident or illness, that initially causes pain, but this is not always the case.

The classification of chronic pain has also proved complicated, with physicians and researchers calling for tighter accounts in both the DSM and ICD (both of which provide classification symptoms to health professionals, though in slightly different ways and capacities). While many classification methods have been proposed, the most accepted method seems to divide chronic pain into seven categories [1]:

  1. Chronic primary pain: Chronic primary pain is pain in 1 or more anatomic regions that persists or recurs for longer than 3 months and is associated with significant emotional distress or significant functional disability (interference with activities of daily life and participation in social roles) and that cannot be better explained by another chronic pain condition.
  2. Chronic cancer pain:  pain caused by the cancer itself (the primary tumor or metastases) and pain that is caused by the cancer treatment (surgical, chemotherapy, radiotherapy, and others).
  3. Chronic postsurgical and posttraumatic pain: pain that develops after a surgical procedure or a tissue injury (involving any trauma, including burns) and persists for at least 3 months after surgery or tissue trauma.
  4. Chronic neuropathic pain:  pain caused by a lesion or disease of the somatosensory nervous system.
  5. Chronic headache or orofacial pain:  headaches or orofacial pains that occur on at least 50% of the days during at least 3 months.
  6. Chronic visceral pain: pain that originates from the internal organs of the head and neck region and the thoracic, abdominal, and pelvic cavities.
  7. Chronic musculoskeletal pain: persistent or recurrent pain that arises as part of a disease process directly affecting bone(s), joint(s), muscle(s), or related soft tissue(s).

Chronic pain may also be divided into nociceptive, neuropathic, and possibly psychosomatic (or “other”) pain. Nociceptive pain, named for the nociceptors in the skin, is pain triggered by a harmful or potentially harmful stimulus. This could mean burning, cutting, crushing, etc. Neuropathic pain is pain caused by damage to the sensory system. Neuropathic pain often is less responsive to medications than nociceptive pain. Psychosomatic pain usually means pain that may be caused or worsened by psychological processes.

Can Medical Marijuana Help Those with Chronic Pain?

The CDC estimates the rate of adults in the US with chronic pain to be about twenty percent, with eight percent of adults suffering from high-impact chronic pain [2]. This makes it one of the most common reasons for doctor visits and a huge target for pharmaceutical and biotech companies. As such, research on the impact of marijuana on pain has become very common.

This rise in research rates is not endemic to the US either. Pain specialists in Israel have begun to prescribe cannabis. Of these specialists, sixty-three percent find it to be moderately to highly effective, and fifty six percent have found either mild or no side-effects [3]. The most common symptoms it is prescribed for are neuropathic pain, oncological pain, and any other intractable pain.

Neuropathic pain has been brought up many times in cannabis research, and CBD is often shown to help users reduce neuropathic pain. CBD/THC sprays have been shown to help neuropathic pain not originating in the spine or brain [4], low THC/CBD doses lower chronic pain in cancer patients [5], and CBD along with other cannabinoids reduce inflammation and neuropathic pain by targeting glycine receptors [6].

Other studies have suggested adding medical marijuana to an already established analgesic drug routine. It is suggested that addition, rather than outright substitution may lead to the strongest results in some people. It has been further hypothesized that by adding marijuana to the patient’s opioid intake, the rates of tolerance and withdrawal may decrease, and once-ineffective dosages may once again become useful [7].

While this research is very exciting, it is important to remember that marijuana has side-effects, just like any other drug. Many of these are well known, and in the case of chronic pain, studies show that sleep problems may occur in those who use medical marijuana [8]. Other problems may include memory and mood changes, behavioral changes, and possible drug interactions, so it is always recommended to speak with a certified physician.

Which Strains of Marijuana are Best for Pain?

Based on research regarding chronic neuropathic pain, high CBD strains may be best in those cases. Such strains include ACDC and Harlequin, and they may help combat the inflammation that accompanies such conditions as well. Some research shows that patients with migraines and headaches prefer hybrid and high-THC strains, in particular OG Shark [9]. Other examples include Redwood Kush and Dynamite. Of course, any strain high in THC will cause psychoactive effects, so it is best to exercise caution no matter the amount.

Resources

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450869/

[2] https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074811/

[4] https://www.ncbi.nlm.nih.gov/pubmed/24420962

[5] https://www.ncbi.nlm.nih.gov/pubmed/28866904

[6] https://www.ncbi.nlm.nih.gov/pubmed/22585736

[7] https://www.tandfonline.com/doi/abs/10.1080/02791072.2012.684624

[8] https://www.ncbi.nlm.nih.gov/pubmed/28926791

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968020/