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Medical Marijuana for Back Pain

Elizabeth I. Molina Ortiz, MD, is board-certified in family medicine. She is a primary care provider with Atrius Health in Boston and was the medical director of Charles River Community Health.

Our understanding of the risks and benefits of medical marijuana use has been increasing in recent years. Although as of 2016, not all the questions have been answered, a handful of states have set up dispensaries and passed laws protecting patients who use this drug from prosecution. These programs are far from complete. But the good news is some spine conditions and types of chronic neck or back pain are included by a few of the more forward-leaning states as conditions for which medical marijuana can be prescribed.

Find out where your state stands in the medical marijuana for back and neck pain issue.

About Medical Marijuana

Marijuana is the leading cash crop in the US and a Schedule I drug under the Controlled Substances Act of 1970. This designation means it has a lot of potential for abuse (i.e. addiction), and no medicinal value.

Yet, Marinol, a synthetic marijuana-based medication approved by the FDA, is classified as a Schedule III drug.   Marinol contains a synthetic version of THC, which is the active ingredient in marijuana. As a Schedule III drug, Marinol is regarded as medicinal, with less potential for abuse. The FDA approved Marinol to help stimulate the appetite in people with AIDS and to treat nausea and vomiting due to chemotherapy.

Cannabinoids and Pain

According to the Americans for Safe Access Foundation (ASAF), a pro-medical marijuana advocacy group in Oakland, California, the natural form of marijuana contains many more cannabinoids (in addition to the THC) than does the synthetic Marinol, and consequently delivers more therapeutic benefits.   Cannabinoids are naturally occurring chemicals in the cannabis plant. The University of Washington says over 480 cannabinoids exist, and these can be further sub-divided.   Some of the sub-divided compounds are more psychologically active than others. THC, which is perhaps the best known of the cannabinoid sub-classes is very psychologically active. Others are not as active as THC but are nonetheless valuable for treating certain medical conditions, for example, seizures in children.

As far as pain is concerned, ASAF reports that taking a combination of cannabinoids yields more pain control than taking THC alone. Americans for Safe Access says that cannabis has at least two roles to play in the management of chronic pain,   including neck and back pain.

First, it can relieve the pain itself—either alone or in combination with other pain-relieving drugs. And second, it can control nausea associated with long-term pain and also with taking opioids, a narcotic pain reliever.

ASAF also says that because inhaling leads to better absorption and fewer complications, it is the most common and preferable way to take cannabis.

Medical marijuana for back pain relief may show some promise. Find out what's going on in this industry for people who live with pain.

Can Cannabis Be Used To Treat Back Pain?

Back pain is a common ailment, and usually, the problem is resolved within weeks. However, many people are not so lucky. Medical treatment may be required. Let’s take a closer look at cannabis as an alternative to opioids and surgery when treating back pain.

GOT A BAD BACK?

If you’ve got a bad back, you’re certainly not alone. According to a recent WebMD analysis [1] , “540 million people worldwide” are affected by lower back pain. But back pain is not limited to lumbago or lower back problems. Plenty of people also suffer from upper back pain and/or experience side back pain.

Back pain is arguably the leading cause of disability in the world, and studies evidence a rising trend since the 1990s. For most people, it is a sudden and temporary health problem that works itself out. Unfortunately, others experience episodic occurrences and some even suffer from chronic, persistent back pain.

The good news is cannabis is becoming increasingly recognised and recommended as an effective treatment by medical professionals. Well, in the US and Canada at least. New York has allowed back pain patients access to the state’s medical marijuana program since 2016.

Furthermore, the latest WHO data [2] indicates some 2.5% or 147 million people on the planet use cannabis. This number could swell significantly with new medical cannabis users seeking relief from back pain.

COMMON CAUSES AND TYPES OF BACK PAIN

The Mayo Clinic [3] defines back pain of fewer than 6 weeks as “acute”, while back pain that lasts 3 months or more is categorised as “chronic”. Simple back pain or “mechanical” back pain is believed to be the most common type. “This means that the pain is not related to any serious underlying condition and there are no trapped or compressed nerves” so says the British Chiropractic Association [4] .

Ageing, everyday wear and tear, poor posture, and stress can cause simple back pain. More serious back pain usually stems from trapped nerves and slipped discs. Sports-related injuries, slips, trips, and falls are the usual suspects as the cause. Shooting pains running down into the legs are indicative of sciatica. However, back pain can also be associated with other serious underlying conditions like arthritis and osteoporosis. Surgery is always a last resort, but sometimes inevitable whether you use cannabis or not to treat pain.

HOW CANNABIS CAN HELP

Cannabis has been used as a kind of cure-all for centuries. The anecdotal evidence of millions of cannabis users can attest to the pain-relieving and anti-inflammatory properties of the sacred herb. With the rising tide of cannabis legalization these days, we can be more specific. Today, we have solid medical evidence that proves cannabis to be an effective treatment. Patients are already on legally prescribed medical cannabis to treat back pain in the US. We can go further still and say cannabis is the preferential natural medicine in comparison with Big Pharma pain pills.

Cannabinoids, as usual, are the key to the effectiveness of the treatment. We already know that THC and CBD have critical roles to play. THC is best known for its blissful qualities, and if your back pain is linked to depression, a high-THC sativa could be enough to boost your mood and re-energise you.

Similarly, CBD-rich herbal cannabis or CBD oil, while not psychoactive, is renowned for relieving physical pain and discomfort. In combination, both cannabinoids can even achieve synergy through a theory known as the “entourage effect”. Some patients will benefit more or less from different combinations, as everyone’s ECS or endocannabinoid system is unique. The bottom line is, weed works as an effective treatment. But don’t just take our word for it. The 2017 National Academies of Sciences, Engineering, and Medicine (NASEM) [5] report confirms it.

Inhaled cannabis via a joint or vaporizer will deliver almost immediate relief. Eating edibles may be more appropriate for ongoing pain where a longer-lasting effect is required.

CANNABIS AS AN ALTERNATIVE TO OPIOIDS

Post-surgery pain management can be a slippery slope into an opioid addiction. Just one day on a prescription for opioid-based painkillers gives you a 6% chance of finding yourself still popping pills a year later according to an in-depth CDC study [6] from 2006–2015.

Cannabis is not an addictive substance, certainly not in the way that opioids are. Patients from all walks of life are choosing to manage their back pain with cannabis instead. Professional athletes in arguably the most physically damaging contact sports MMA and American football are the most well-known advocates.

THE LAST WORD ON CANNABIS AND BACK PAIN

We’ve all seen Nate Diaz puff on his CBD pen and live to take another beating from Conor McGregor. Even NFL players are thinking twice about lining up for another shot of Toradol [7] in the behind. Players like Eben Britton [8] are speaking out. Celebrities are spreading the word far and wide. As a result, cannabis has become accepted and popularised as a treatment for pain in North America.

Hopefully, legislators across European countries will come to the same conclusion sooner rather than later. Outside of the Netherlands, Germany, Italy, and Spain, all European back pain sufferers can do its experiment with CBD products to seek relief. Access to the complete spectrum of cannabinoids in cannabis is what they really need.

Back pain is one of the most common health problems. In this blog, we explore if cannabis could be the best natural treatment for back pain. ]]>