Ankle pain from an ageing patient with the hand of a doctor assessing the affected part

Key points

  • Studies show promising results that cannabis may treat several types of nerve or neuropathic pain. A treatment that combines both THC and CBD could work to alleviate pain symptoms.
  • The primary cannabinoids,THC and CBD, interact with the endocannabinoid system (ECS). Once activated, the ECS affects pain perception and regulation.
  • Medical cannabis for neuropathic pain is an alternative to commonly prescribed analgesics like ketamine and opioids. Unlike most medications, the side effects of THC and CBD are less severe and common.
  • Not all types of nerve pain can be treatable with cannabis. Furthermore, medical cannabis for nerve pain may not be as effective as other treatments.
  • People considering using cannabis for nerve pain should consult a doctor first. A specialist with experience administering doses of medical cannabis can give you a personalised recommendation.

Nerve pain is a common condition many people face. In fact, a 2016 BMJ Review showed that 8% of UK adults experience chronic neuropathic pain, and 5.5% live with fibromyalgia.

Despite its ubiquity, treating nerve pain is not often straightforward. The most common approach to treating nerve pain is a prescription medication that can lead to side effects.

Both clinical studies and anecdotal evidence report another challenge: the persistence of pain despite using pain medication or analgesics. There are various reasons why analgesics may fail.

But the concern remains – what other options do pain practitioners, physicians, and patients have? Recent scientific discovery is bringing into the light an alternative option to address neuropathic pain: cannabis.

The cannabis plant has been used for centuries to relieve pain. Today, researchers are exploring the potential of medical cannabis for nerve pain.

This article will discuss the current research and what it means for pain patients.

Nerve pain – a significant challenge for many

Close up hands of senior elderly woman patient suffering from nerve pain

Nerve pain, also known as neuropathic pain, is an uncomfortable and sometimes debilitating condition that can make it difficult to do simple tasks like walking or gripping objects.

The condition is usually chronic. It is usually caused by a nerve disease or an injury or inflammation.

Symptoms of nerve pain

Neuropathic pain falls under a broader classification of nerve dysfunction known as neuropathy. It’s a common symptom of chronic conditions such as:

  • diabetes
  • multiple sclerosis
  • shingles
  • ALS (amyotrophic lateral sclerosis)
  • HIV/AIDS
  • chemotherapy nerve injuries
  • spinal cord injuries
  • fibromyalgia

There are many types of nerve damage, and not all patients experience the same symptoms. For example, some people report feeling pins and needles in their hands while others feel numbness in one or more limbs.

Other common symptoms include:

  • Pain in the hands and feet (a common symptom of peripheral neuropathy)
  • Numbness or tingling in one or more limbs
  • Loss of muscle strength, which can lead to balance problems and difficulty walking
  • Temperature sensitivity (some people with diabetes experience cold extremities)
  • Drop in blood pressure

Causes and treatment of nerve pain

Nerves carry information to and from the brain. They can become damaged by inflammation or injury, disease, diabetes or old age. Nerve tissue can also degrade naturally due to ageing.

Damage to nerves can cause pain, numbness and weakness in the affected areas. Nerve damage can occur without you even knowing it.

For people with nerve pain caused by a medical condition such as diabetes, nerve damage is usually short-term and reversible once the underlying health problem is treated. The pain can be managed with medication to control inflammation and reduce swelling around affected nerves.

In other cases of nerve damage due to injury or trauma, it may take longer to get better because scar tissue has formed around injured nerves that have not appropriately healed since being injured (or not being repaired at all).

Few medications are effective against neuropathic pain. Ketamine and opioids are the most widely used pain medications. Though potent, these medications can cause side effects and even severe addiction or dependence.

Cannabis and its cannabinoids

Cannabis has long been used as an analgesic by many cultures around the world. Modern research suggests that cannabis may be particularly effective against neuropathic pain caused by damage to or diseases of nerves.

The plant contains nearly 500 different compounds, but two main cannabinoids stand out:

  • Tetrahydrocannabinol (THC) – THC is the primary psychoactive component of the plant. It’s responsible for the “high” people feel when they use cannabis.
  • Cannabidiol (CBD) – CBD is considered an essential compound because it doesn’t cause any psychoactive effects. Research suggests that CBD may help reduce anxiety and inflammation, which can both contribute to pain.

Aside from CBD and THC, cannabis consists of potentially therapeutic compounds like terpenes, flavonoids, and other phytocannabinoids. Combined, these substances produce what is known as the entourage effect.

The entourage effect is the idea that when cannabinoids and other compounds are combined in the proper ratios, they’re more effective than any one of them would be on their own. Some users who use cannabis for pain report that taking a full-spectrum product (one that contains all of the cannabinoids and terpenes that make up cannabis) makes their pain more tolerable.

How do cannabinoids affect pain perception?

Human CBD receptor chart horizontal textbook infographic

The endocannabinoid system plays many roles in the regulation of bodily functions.

One of the most prominent of these functions is pain perception. THC and CBD target particular cannabinoid receptors CB1 and CB2.

  • CB1 receptors are found primarily in the central nervous system. They are involved in movement, memory, and modulating pain signals.
  • CB2 receptors can be found in abundance along peripheral tissues and organs. They are involved in regulating inflammation, allodynia (extreme pain sensitivity to touch), and hyperalgesia (extreme responses to pain).

After nerve injury, our neurons become more sensitive. This process involves a cascade of cellular events that lead to an increase in pain perception.

Studies suggest that cannabinoids can alter how these events occur. Once activated, CB1 receptors slow down how the body perceives pain. Meanwhile, activated CB2 receptors aid in reducing overall pain perception.

What do studies say about medical cannabis for nerve pain?

It’s no surprise that a large body of research supports using cannabis to treat nerve pain. Traditionally, cannabis has been used for its pain-relieving (analgesic) properties. THC and CBD interact with the ECS, which is heavily involved in pain perception.

What once was traditional medicine is now being explored for widespread use in both medical and therapeutic settings. Researchers today are investigating its potential for clinical applications against particular forms of neuropathic pain.

Neuropathic pain reduction

In a study published in the Journal of Pain, researchers discovered that smoking cannabis reduced neuropathic pain in patients. The researchers assessed the efficacy of cannabis in treating pain and concluded that “the results of this study provide evidence that cannabis can reduce chronic neuropathic pain in some patients.

HIV neuropathy

Human immunodeficiency virus (HIV) is a virus that damages your immune system and makes it hard for your body to fight off infections. About 25% of people infected with HIV experience some form of neuropathy in their lifetime, making it one of the most common neurological conditions associated with the infection.

A 2009 study published in Neuropsychopharmacology found that smoking cannabis reduced nerve pain in patients who did not respond to regular treatment. Of the 28 patients, 46% experienced a significant pain reduction.

Nerve pain in the legs

Radicular pain is a type of nerve pain that occurs when one or more nerves in your spine are compressed or irritated. It radiates from the spine and into the legs. One of the most common forms of radicular pain is sciatica.

Sciatica is a form of radicular pain that occurs when the sciatic nerve is compressed or irritated. It most often affects people with spinal stenosis and can cause tingling, numbness or weakness in one or both legs.

Medical cannabis for sciatic nerve pain could help reduce symptoms, a 2018 study published in the medical journal of the American Academy of Neurology suggests.

People who took THC experienced less pain than those given a placebo. In particular, the use of THC oil for at least a week caused significant pain reduction.

The mechanism behind the relief is complex. However, the substance THC may help reduce the number of connections between areas in our brains that process pain.

Post-traumatic or post-surgical nerve pain

Nerve pain can also occur after a traumatic event or surgery since the nerve may be damaged. When it happens, the pain is often described as shooting and burning. Nerve pain treatment for post-traumatic or post-surgical pain can be challenging, but a 2010 study suggests that THC may be an effective option.

Researchers found that those who inhaled a 25mg dose of THC daily reported less pain and better sleep. Though the relief was modest, patients reported better outcomes as opposed to standard treatment. Moreover, a high dose (9.4%%) fared better than lower doses of the cannabinoid.

Treatment-resistant neuropathy

In rarer cases, neuropathic pain in patients does not respond to standard treatment. In these cases, researchers are investigating the use of THC as an alternative option for pain relief.

A 2012 study found that those who ingested moderate doses of THC experienced a 30% reduction in pain. Researchers also noted that patients were able to sleep better and had less anxiety.

Diabetic peripheral neuropathy

One of the more common causes of nerve pain is diabetic neuropathy. According to the Mayo Clinic, diabetic neuropathy is a condition that occurs when high blood sugar levels damage the nerves. It is estimated that as many as 60% of people with diabetes will develop neuropathy at some point in their lives.

A 2015 study in the Journal of Pain showed that high doses of cannabis produced a significant analgesic effect in patients. The pain-relieving effects were reported to be quick and long-lasting. However, as with other studies, the researchers noted a decline in cognitive performance afterwards.

Cannabis can help with other symptoms associated with nerve pain

Nerve pain, on its own, can already be debilitating for many individuals. Those who suffer from it also experience other symptoms that can make their lives more difficult.

Things like depression, anxiety, insomnia and restless leg syndrome can all be exacerbated by neuropathy. Cannabis has several properties that can alleviate these comorbidities.

Here are a number of ways cannabis can help patients with other symptoms:

  • Improved sleep: THC is known for its ability to make people feel sleepy or relaxed after use; this may be helpful for those with nerve-related insomnia.
  • Reduced inflammation: Cannabinoids such as CBD are anti-inflammatory agents as well as antioxidants, which may account for their usefulness in treating neuropathy symptoms like tingling or numbness caused by damaged nerves.
  • Improved mood: Studies show that certain cannabinoids can improve mood disorders like depression or anxiety disorders that occur alongside chronic pain conditions.

What type of medical cannabis is used for nerve pain?

Doctor writes a prescription for a patient for marijuana

When it comes to medical cannabis for nerve pain, there are a few different ways that are recommended to consume it:

  • Vaporised – Vaporised cannabis can offer pain relief. Vaporised cannabis is a healthier alternative to smoked cannabis since no smoke is involved.
  • Cannabis oil – Consuming cannabis oil for nerve pain is an option for those who do not enjoy smoking or cannot tolerate the flavour of cannabis. Patients may take the dose orally (i.e., ingested) or sublingually (i.e., drops under the tongue).
  • Edibles – For patients who find it difficult altogether to consume cannabis, edibles like cookies or brownies are an option. Do note that users report feeling the onset of pain relief is slower as opposed to other delivery methods.

Conclusion – Medical THC and CBD for Nerve Pain

As shown, cannabis shows promise in managing the symptoms of neuropathic pain. THC and CBD in cannabis can relieve inflammation, spasms, and other symptoms that arise from the damage or injury of nerves.

Smoking cannabis is a common way researchers administer doses to patients in clinical trials. However, other methods are used as well. Nevertheless, these studies highlight the general safety of cannabis use as opposed to other treatment methods for nerve pain.

Still, there’s a need for more research to include cannabis as a standard treatment for this neuropathy. The best way to take medical cannabis for nerve pain will depend on your individual needs and preferences.

Speak with your doctor or specialist before starting any treatment for nerve pain. Here at The Medical Cannabis Clinics, we’re happy to help you find the proper treatment for your condition. Book your online consultation now. 

Frequently Asked Questions (FAQs)

What are the best strains for nerve pain?

There isn’t a “best strain” for nerve pain, but your doctor will be able to help you decide on the strain that best suits you and your condition.

Should I use sativa or indica for nerve pain?

For pain management, a 2015 study published in the Journal of Alternative and Complementary Medicine reported better outcomes with an indica strain or product. Do note that indicas also tend to sedate the user and leave them couch-locked.

Can edibles help with nerve pain?

Yes, an edible with enough THC and CBD can help with nerve pain. Discuss your options with your doctor before taking the medication.

Which is better: CBD oil vs gabapentin for nerve pain?

Gabapentin is a medication that is commonly used in the treatment of nerve pain. If this standard medication does not work for your condition, you should consult your doctor and ask if CBD oil might be a good alternative.

Does CBD oil help with pinched nerve pain?

There is increasing evidence that CBD oil can help with pinched nerve pain. Do not use CBD oil for any other purpose without first consulting your doctor.

References

https://www.sciencedirect.com/science/article/abs/pii/S0965229919308040
https://www.ccjm.org/content/85/12/943#
https://www.aan.com/PressRoom/Home/PressRelease/1669
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2950178/
https://link.springer.com/article/10.1007/s11916-018-0658-8
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8540828/
https://www.sciencedaily.com/releases/2016/06/160620221800.htm
https://www.liebertpub.com/doi/abs/10.1089/acm.2013.0190