Many different medications are available to treat chronic pain. One natural alternative treatment option is marijuana, or cannabis, which has a. If you are struggling with chronic pain, one of the safest and most effective options could be marijuana. Medical marijuana is becoming one of. If you suffer from chronic pain, you're likely aware of the fact that patients claim medical cannabis is an effective treatment for this condition.
pain: Marijuana chronic relief for best The pain strains for
Interestingly, our first knowledge of each pain system has derived from investigation of natural origin analgesic plants, respectively: Notably, no endocannabinoid has ever been administered to humans, possibly due to issues of patentability and lack of commercial feasibility Raphael Mechoulam, pers comm For an excellent comprehensive review of the endocannabinoid system, see Pacher et al , while Walker and Huang have provided a key review of antinociceptive effects of cannabinoids in models of acute and persistent pain Walker and Huang A clinical endocannabinoid deficiency has been postulated to be operative in certain treatment-resistant conditions Russo , and has received recent support in findings that anandamide levels are reduced over controls in migraineurs Sarchielli et al , that a subset of fibromyalgia patients reported significant decreased pain after THC treatment Schley et al , and the active role of the ECS in intestinal pain and motility in irritable bowel syndrome Massa and Monory wherein anecdotal efficacy of cannabinoid treatments have also been claimed.
The endocannabinoid system is tonically active in control of pain, as demonstrated by the ability of SRA rimonabant , a CB 1 antagonist, to produce hyperalgesia upon administration to mice Richardson et al As mentioned above, the ECS is active throughout the neuraxis, including integrative functions in the periacqueductal gray Walker et al a ; Walker et al b , and in the ventroposterolateral nucleus of the thalamus, in which cannabinoids proved to be fold more potent than morphine in wide dynamic range neurons mediating pain Martin et al The ECS also mediates central stress-induced analgesia Hohmann et al , and is active in nociceptive spinal areas Hohmann et al ; Richardson et al a including mechanisms of wind-up Strangman and Walker and N-methyl-D-aspartate NMDA receptors Richardson et al b.
It was recently demonstrated that cannabinoid agonists suppress the maintenance of vincristine-induced allodynia through activation of CB 1 and CB 2 receptors in the spinal cord Rahn et al The ECS is also active peripherally Richardson et al c where CB 1 stimulation reduces pain, inflammation and hyperalgesia.
These mechanisms were also proven to include mediation of contact dermatitis via CB 1 and CB 2 with benefits of THC noted systemically and locally on inflammation and itch Karsak et al Recent experiments in mice have even suggested the paramount importance of peripheral over central CB 1 receptors in nociception of pain Agarwal et al Cannabinoid agonists produce many effects beyond those mediated directly on receptors, including anti-inflammatory effects and interactions with various other neurotransmitter systems previously reviewed Russo a.
Briefly stated, THC effects in serotonergic systems are widespread, including its ability to decrease 5-hydroxytryptamine 5-HT release from platelets Volfe et al , increase its cerebral production and decrease synaptosomal uptake Spadone THC may affect many mechanisms of the trigeminovascular system in migraine Akerman et al ; Akerman et al ; Akerman et al ; Russo ; Russo The glutamatergic system is integral to development and maintenance of neuropathic pain, and is responsible for generating secondary and tertiary hyperalgesia in migraine and fibromyalgia via NMDA mechanisms Nicolodi et al Additionally, cannabinoids reduce hyperalgesia via inhibition of calcitonin gene-related peptide Richardson et al a.
As for Substance P mechanisms, cannabinoids block capsaicin-induced hyperalgesia Li et al , and THC will do so at sub-psychoactive doses in experimental animals Ko and Woods These are all promising attributes for an adjunctive agent in treatment of clinical chronic pain states. The anti-inflammatory contributions of THC are also extensive, including inhibition of PGE-2 synthesis Burstein et al , decreased platelet aggregation Schaefer et al , and stimulation of lipooxygenase Fimiani et al THC has twenty times the anti-inflammatory potency of aspirin and twice that of hydrocortisone Evans , but in contrast to all nonsteroidal anti-inflammatory drugs NSAIDs , demonstrates no cyclo-oxygenase COX inhibition at physiological concentrations Stott et al a.
Cannabidiol, a non-euphoriant phytocannabinoid common in certain strains, shares neuroprotective effects with THC, inhibits glutamate neurotoxicity, and displays antioxidant activity greater than ascorbic acid vitamin C or tocopherol vitamin E Hampson et al These activities reinforce the conception of CBD as an endocannabinoid modulator, the first clinically available Russo and Guy CBD additionally affects THC function by inhibiting first pass hepatic metabolism to the possibly more psychoactive hydroxy-THC, prolonging its half-life, and reducing associated intoxication, panic, anxiety and tachycardia Russo and Guy A new explanation of inflammatory and analgesic effects of CBD has recently come to light with the discovery that it is able to promote signaling of the adenosine receptor A2A by inhibiting the adenosine transporter Carrier et al Cannabichromene CBC is the third most prevalent cannabinoid in cannabis, and is also anti-inflammatory Wirth et al , and analgesic, if weaker than THC Davis and Hatoum Furthermore, CBG has more potent analgesic, anti-erythema and lipooxygenase blocking activity than THC Evans , mechanisms that merit further investigation.
It requires emphasis that drug stains of North American ElSohly et al ; Mehmedic et al , and European King et al cannabis display relatively high concentrations of THC, but are virtually lacking in CBD or other phytocannabinoid content.
Cannabis terpenoids also display numerous attributes that may be germane to pain treatment McPartland and Russo Myrcene is analgesic, and such activity, in contrast to cannabinoids, is blocked by naloxone Rao et al , suggesting an opioid-like mechanism.
It also blocks inflammation via PGE-2 Lorenzetti et al It is anti-inflammatory comparable to phenylbutazone via PGE-1 Basile et al , but simultaneously acts as a gastric cytoprotective Tambe et al Cannabis flavonoids in whole cannabis extracts may also contribute useful activity McPartland and Russo Cannflavin A, a flavone unique to cannabis, inhibits PGE-2 thirty times more potently than aspirin Barrett et al , but has not been subsequently investigated.
Very few randomized controlled trials RCTs have been conducted using smoked cannabis Campbell et al despite many anecdotal claims Grinspoon and Bakalar A recent brief trial of smoked cannabis 3. This short clinical trial also demonstrated prominent adverse events associated with intoxication. In Canada, 21 subjects with chronic pain sequentially smoked single inhalations of 25 mg of cannabis 0, 2. Even after political and legal considerations, it remains extremely unlikely that crude cannabis could ever be approved by the FDA as a prescription medicine as outlined in the FDA Botanical Guidance document Food and Drug Administration ; Russo b , due to a lack of rigorous standardization of the drug, an absence of Phase III clinical trials, and pulmonary sequelae bronchial irritation and cough associated with smoking Tashkin Although cannabis vaporizers reduce potentially carcinogenic polyaromatic hydrocarbons, they have not been totally eliminated by this technology Gieringer et al ; Hazekamp et al Two open label studies in France of oral dronabinol for chronic neuropathic pain in 7 subjects Clermont-Gnamien et al and 8 subjects Attal et al , respectively, failed to show significant benefit on pain or other parameters, and showed adverse event frequently requiring discontinuation with doses averaging 15— Dronabinol did demonstrate positive results in a clinical trial of multiple sclerosis pain in two measures Svendsen et al , but negative results in post-operative pain Buggy et al Table 1.
Another uncontrolled case report in three subjects noted relief of intractable pruritus associated with cholestatic jaundice employing oral dronabinol Neff et al Some authors have noted patient preference for whole cannabis preparations over oral THC Joy et al , and the contribution of other components beyond THC to therapeutic benefits McPartland and Russo THC absorption orally is slow and erratic with peak serum levels in 45— minutes or longer.
Systemic bioavailability is also quite low due to rapid hepatic metabolism on first pass to hydroxy-THC. A rectal suppository of THC-hemisuccinate is under investigation Broom et al , as are transdermal delivery techniques Challapalli and Stinchcomb The terminal half-life of THC is quite prolonged due to storage in body lipids Grotenhermen Nabilone Cesamet Figure 1 , is a synthetic dimethylheptyl analogue of THC British Medical Association that displays greater potency and prolonged half-life.
Serum levels peak in 1—4 hours Lemberger et al It was also primarily developed as an anti-emetic in chemotherapy, and was recently re-approved for this indication in the USA. Prior case reports have noted analgesic effects in case reports in neuropathic pain Notcutt et al and other pain disorders Berlach et al Sedation and dysphoria were prominent sequelae. An RCT of nabilone in 41 post-operative subjects actually documented exacerbation of pain scores after thrice daily dosing Beaulieu Table 1.
An abstract of a study of 82 cancer patients on nabilone claimed improvement in pain levels after varying periods of follow-up compared to patients treated without this agent Maida However, 17 subjects dropped out, and the study was neither randomized nor controlled, and therefore is not included in Table 1.
Part of its analgesic activity may relate to binding to intracellular peroxisome proliferator-activator receptor gamma Liu et al Peak plasma concentrations have generally been attained in 1—2 hours, but with delays up to 4—5 hours is some subjects Karst et al Debate surrounds the degree of psychoactivity associated with the drug Dyson et al Current research is confined to the indication of interstitial cystitis. CBD ratios reviewed in Russo and Guy , generally approximately 2: Two pharmacokinetic studies on possibly related material have been reported Nadulski et al a ; Nadulski et al b.
Both Marinol and Cannador produced reductions in pain scores in long-term follow-up Zajicek et al Cannador was assayed in postherpetic neuralgia in 65 subjects with no observed benefit Ernst et al Table 1 , and in 30 post-operative pain subjects CANPOP without opiates, with slight benefits, but prominent psychoactive sequelae Holdcroft et al Table 1.
It was approved by Health Canada in June for prescription for central neuropathic pain in multiple sclerosis, and in August , it was additionally approved for treatment of cancer pain unresponsive to optimized opioid therapy. Sativex effects commence in 15—40 minutes, an interval that permits symptomatic dose titration. A very favorable adverse event profile has been observed in over patient years of exposure in over experimental subjects.
Patients most often ascertain an individual stable dosage within 7—10 days that provides therapeutic relief without unwanted psychotropic effects often in the range of 8—10 sprays per day. In a Phase II double-blind crossover study of intractable chronic pain Notcutt et al in 24 subjects, visual analogue scales VAS were 5. During that time, there was no escalation of dose indicating an absence of tolerance to the preparation.
Similarly, no withdrawal effects were noted in a subset of patients who voluntarily stopped the medicine abruptly. Upon resumption, benefits resumed at the prior established dosages. In a Phase II double-blind, randomized, placebo-controlled, 5-week study of 56 rheumatoid arthritis patients with Sativex Blake et al , employed nocturnal treatment only to a maximum of 6 sprays per evening In a study of spinal injury pain, NRS of pain were not statistically different from placebo, probably due to the short duration of the trial, but secondary endpoints were clearly positive Table 1.
Finally, in an RCT of intractable lower urinary tract symptoms in MS, accompanying pain in affected patients was prominently alleviated Table 1. Common adverse events AE of Sativex acutely in RCTs have included complaints of bad taste, oral stinging, dry mouth, dizziness, nausea or fatigue, but do not generally necessitate discontinuation, and prove less common over time.
While there have been no head-to-head comparative RCTs of Sativex with other cannabinoid agents, certain contrasts can be drawn. Sativex Rog et al and Marinol Svendsen et al have both been examined in treatment of central neuropathic pain in MS, with comparable results Table 1. However, adverse events were comparable or greater with Marinol than with Sativex employing THC dosages some 2. Similarly, while Sativex and smoked cannabis have not been employed in the same clinical trial, comparisons of side effect profiles can be made on the basis of SAFEX studies of Sativex for over a year and up to several years in MS and other types of neuropathic pain Russo b ; Wade et al , and government-approved research programs employing standardized herbal cannabis from Canada for chronic pain Lynch et al and the Netherlands for general conditions Janse et al ; Gorter et al over a period of several months or more.
As is evident in Figure 2 Figure 2 , all adverse events are more frequently reported with herbal cannabis, except for nausea and dizziness, both early and usually transiently reported with Sativex see Russo b for additional discussion. Comparison of adverse events AE encountered with long term therapeutic use of herbal cannabis in the Netherlands Janse et al ; Gorter et al and Canada Lynch et al , vs that observed in safety-extension SAFEX studies of Sativex oromucosal spray Russo ; Wade et al Phytocannabinoids are lipid soluble with slow and erratic oral absorption.
While cannabis users claim that the smoking of cannabis allows easy dose titration as a function of rapid onset, high serum levels in a short interval inevitably result. This quick onset is desirable for recreational purposes, wherein intoxication is the ultimate goal, but aside from paroxysmal disorders eg, episodic trigeminal neuralgia or cluster headache attack , such rapid onset of activity is not usually necessary for therapeutic purposes in chronic pain states.
The vast majority of subjects in Sativex clinical trials do not experience psychotropic effects outside of initial dose titration intervals Figure 2 and most often report subjective intoxication levels on visual analogue scales that are indistinguishable from placebo, in the single digits out of Wade et al Thus, it is now longer tenable to claim that psychoactive effects are a necessary prerequisite to symptom relief in the therapeutic setting with a standardized intermediate onset cannabis-based preparation.
Intoxication has remained a persistent issue in Marinol usage Calhoun et al , in contrast. Recent controversies have arisen in relation to non-steroidal anti-inflammatory drugs NSAID , with concerns that COX-1 agents may provoke gastrointestinal ulceration and bleeding, and COX-2 drugs may increase incidents of myocardial infarction and cerebrovascular accidents Fitzgerald ; Topol Frequent questions have been raised as to whether psychoactive drugs may be adequately blinded masked in randomized clinical trials.
Internal review and outside analysis have confirmed that blinding in Sativex spasticity studies has been effective Clark and Altman ; Wright Sativex and its placebo are prepared to appear identical in taste and color. Great public concern attends recreational cannabis usage and risks of dependency.
The addictive potential of a drug is assessed on the basis of five elements: Drug abuse liability DAL is also assessed by examining a drug's rates of abuse and diversion. US Congress placed cannabis in Schedule I of the Controlled Substances Act in , with drugs categorized as addictive, dangerous, possessing severe abuse potential and no recognized medical value. Marinol was placed in Schedule II, the category for drugs with high abuse potential and liability to produce dependency, but certain recognized medical uses, after its FDA approval in Marinol was reassigned to Schedule III in , a category denoting a lesser potential for abuse or lower dependency risk after documentation that little abuse or diversion Calhoun et al had occurred.
Nabilone was placed and has remained in Schedule II since The degree to which a drug is reinforcing is determined partly by the by the rate of its delivery to the brain Samaha and Robinson Sativex has effect onset in 15—40 minutes, peaking in a few hours, quite a bit slower than drugs of high abuse potential. It has been claimed that inclusion of CBD diminishes psychoactive effects of THC, and may lower potential drug abuse liability of the preparation see Russo b for discussion. Prior studies from Sativex clinical trials do not support the presence reinforcement or euphoria as problems in administration Wade et al Certain facets of acute cannabinoid exposure, including tachycardia, hypothermia, orthostatic hypotension, dry mouth, ocular injection, intraocular pressure decreases, etc.
No dose tolerance to the therapeutic effects of Sativex has been observed in clinical trials in over patient-years of administration. Additionally, therapeutic efficacy has been sustained for several years in a wide variety of symptoms; SAFEX studies in MS and peripheral neuropathic pain, confirm that Sativex doses remain stable or even decreased after prolonged usage Wade et al , with maintenance of therapeutic benefit and even continued improvement.
Debate continues as to the existence of a clinically significant cannabis withdrawal syndrome with proponents Budney et al , and questioners Smith While symptoms recurred after 7—10 days of abstinence from Sativex, prior levels of symptom control were readily re-established upon re-titration of the agent Wade et al Overall, Sativex appears to pose less risk of dependency than smoked cannabis based on its slower onset, lower dosage utilized in therapy, almost total absence of intoxication in regular usage, and minimal withdrawal symptomatology even after chronic administration.
No known abuse or diversion incidents have been reported with Sativex to date as of November Cognitive effects of cannabis have been reviewed Russo et al ; Fride and Russo , but less study has occurred in therapeutic contexts. Effects of chronic heavy recreational cannabis usage on memory abate without sequelae after a few weeks of abstinence Pope et al Studies of components of the Halstead-Reitan battery with Sativex in neuropathic pain with allodynia have revealed no changes vs placebo Nurmikko et al , and in central neuropathic pain in MS Rog et al , 4 of 5 tests showed no significant differences.
While the Selective Reminding Test did not change significantly on Sativex, placebo patients displayed unexpected improvement. Slight improvements were observed in Hospital Anxiety and Depression Scales depression and anxiety scores were noted with Sativex in MS patients with central neuropathic pain Rog et al , although not quite statistically significant. No long-term mood disorders have been associated with Sativex administration. Debate continues with regard to the relationship between cannabis usage and schizophrenia reviewed Fride and Russo An etiological relationship is not supported by epidemiological data Degenhardt et al , but if present, should bear relation to dose and length of high exposure.
It is likely that lower serum levels of Sativex in therapeutic usage, in conjunction with anti-psychotic properties of CBD Zuardi and Guimaraes , would minimize risks. Children and adolescents have been excluded from Sativex RCTs to date.
SAFEX studies of Sativex have yielded few incidents of thought disorder, paranoia or related complaints.
Spinal injury, badly messed up left knee, fibromyalgia, all over pain. Would love to know where to turn. Okay, maybe someone out there in cannabis land can help me. I am an alcoholic, and pot has always made me very thirsty, so to speak. But, as I get older 60 , pain management has become a real issue neuropathy, migraines, arthritis, degenerative disc disease. I heard that you can take cannabis in non-vapor form that is not mind-altering and relieves pain.
If so, what strain, and where can I get it? I live in Montana. I think most of this info might be available on Leafy, as well, but there is a lot of info out there. Many online stores make and sell them in various forms. Now, the big problem, for me at least, was fining a strain that worked for me. You might need to try a few strains but you should be able to find one or two that actually help. I hope this helps. I had a prescription for medical marijuana last year I live in Ontario and tried several strains, and even some from the black market.
None of them helped. I am desperate for someone knowledgeable and willing to help me ASAP. I have lost hope. I live in west Los Angeles. I am all alone. Doctors are unspeakably inadequate, at least the ones I have been exposed to. Will be ordering again anytime soon. My sister has cancer with a tumor in her lungs that is causing a constant nerve pain in her back at the bottom of her ribs. We are very new to the topic. Any info or suggestions are appreciated.
They have potent products at good prices too. I always find cannabis as my best buddy in health. I have fibromyalgia and severe arthritis. It was all good for about 2 months, now my pain is coming back. Please tell me I just have to try another strain. The best decision that everyone could make is to legalize cannabis. Recommend this dispensary to anyone looking at Cannabis for help!! I have several blown discs in my lower back and one in my neck.
The ones in my back are putting pressure on my spinal cord causing nerve pain. Any suggestions on a good strain to try for pain relief.
Cannabis is definitely what everyone needs right now! Cannabis makes life so much easier. It allows you to be comfortable. I have cronic neuropathic pain in my hip and leg. It bothers me most when I lie down, I find it very difficult to sleep. Could you recommend a product for me to try and give a dosage I should take. Who made the hybrid plants? Where did they come from on the market for plants? Growers get their starter plants from somewhere and to have all the different strains, that is my question.
Give me the history of the hybrids. Who, where and when? I never liked the smell or the coughing that went with the smoking. I have only tried it three different times in my life. The first was the best. I have had some people tell me my experience was not for plain mmj and it must have had something else in it. I laughed so much with 3 other friends who also smoked it I never thought I would stop!
I definitely had the perception of time passing very fast and I kept checking the clock. I would be shocked to find that only 3 minutes had past when it seemed like This caused more intense laughing as the night went on.
I was impressed that I was aware of everything till it wore off and not like alcohol where you forget what happened after a certain level of intoxication. So, when will be able to take a capsule or pill with the THC or without? I am looking for straight pain relief with no high.
That is where the hybrid can be a friend or foe. I have 2 bulging disc and unstable SI joint that causes me tremendous pain.
At the very least you could have a good time, get hungry and fall asleep. Try that with big pharma. Content failed to load. Country United States Canada. Sorry, you're not old enough to visit Leafly. Sorry, Leafly isn't available in your location yet.
Bailey Rahn Bailey is an editor at Leafly, specializing in strains and health. Is There Any Truth to It? Gumbi, and Sweetooth a 1: And sorry for the slow reply ok.. And with pneumonia, you could die. Vape juices are, typically, suspended in propylene glycol. That is ethylene glycol, not propylene glycol. Its Scarry to think about all the misinformation out there.
First off vaping is not inhaling smoke, second it does not have proplylene Glycol, that is what is in ecigarette cartridges: I like blueberry kush myself and I use it for pain from neuropathy and post chemo probs. Any suggestions for fasomyalgia, very painful. CBD has no psychoactive effects at all. You can also get CBD oil and tinctures from hemp, now legal in all 50 states. Try Afghan Kush, which is one of the greatest pain slayer strains known to me.
Soon to be ex rbc client. You can buy seeds. I also have PSTD. Look online they sell seeds. It is difficult to purchase it in small amounts. Only indica purple tag. I have Lymes disease,severe pain in my shoulder,neck and back of my head what can I take. Have you ordered from there? Seems a little sketchy. Have you ever ordered from there? And many thanks to thier staff for their stealth packaging.
Thank you so much for the quick response. Has anyone tried this for trigeminal neuralgia? How much are CBD patches? They deliver as far as the UK and Australia. Sure they can in Sweden. I agree that ACDC is a good one to try for chronic pain. Some lack of sleep and not hungry. Second order from them with success!! Simple and straightforward website, with lots of information..
Thank you Angela Grundy. Who all will have access to recreational pot in a few months??????????? I must have been high or something. Take a road trip! Wait, they ship to all states? Suggestions for multiple sclerosis? Leg and back pain. What is the best recommended strain to combat Peripheral Neourapathy?
Is this something I put under my tongue? You can as well as it topically to treat pain and as a massage oil. What would you recommend for occipital neuralgia? Although pain works the same way throughout the body, different areas react to pain differently.
As pain encompasses a broad and diverse spectrum of areas, types and reactions, you should be treating it as such. Choosing the right strain of medical marijuana to treat a specific pain is an important decision to make for any MMJ card holder. Sure, some strains can be amazing at eliminating your post-surgery pain, but if they knock you out in the process, you need to opt for something else.
To help guide you in the right direction, here are some of the best pain-busting MMJ strains available to California medical marijuana holders right now. Probably one of the most famous medical marijuana strains worldwide, White Widow is a mixed sativa-indica strain first cultivated in the MMJ haven of the Netherlands. A soothing mix of Brazilian sativa and Indian indica, White Widow is a majorly potent strain that will effectively soothe your mild aches and pains while also providing you with a euphoric buzz.
Not only does White Widow act as an ultra-effective pain reliever, but also it is a favorite of creatives the world over due to its unrivaled ability to stimulate their creative side.
What Medical Marijuana Strains Are Best for Treating My Specific Pain?
A variety of different medical cannabis strains for pain relief are available, each can help patients discover a custom-tailored pain solution that's the perfect fit. A sought-after choice for chronic pain sufferers for its smooth. Cannabis Strains That Help With Generalized Pain Purple Arrow hits the target somewhere between heavy pain relief and uplifting euphoria. Chronic pain is one of the most uncomfortable and difficult ailments to manage. We've done the research for you. Here are the best 5 marijuana strains for.