One of the most frequently asked questions linked to the use of CBD and medical cannabis is, ‘will it ease my pain?’
While there’s no definitive answer yet, research into the subject so far is indicating a positive response, much to the relief of chronic pain sufferers across the world.
Here, Cannabis Health explores the most common chronic pain conditions cannabis may help with.
Thought to affect around one in 20 people, fibromyalgia is a long-term condition that causes pain all over the body, as well as other symptoms including headaches and muscle stiffening. There is currently no cure for the condition and those affected continue to look for new and alternative ways to manage their pain – with a recent US study finding that one third of fibromyalgia patients use medicinal cannabis for symptom relief.
A 2019 study of 367 patients supported this usage, finding that the remedy can reduce pain intensity. The team leading the research stated that “cannabis therapy should be considered to ease the symptom burden among those fibromyalgia patients who are not responding to standard care”.
Despite affecting at least one in ten women in the UK, endometriosis is a regularly misunderstood and misdiagnosed condition. Again, there is no cure for the condition, which is caused by tissue similar to the lining of the womb growing in other places and reacting to the menstrual cycle. Treatment is limited to painkillers and hormonal contraception, however in severe cases this can provide little relief – which is why more and more women are turning to CBD.
Results from women using the remedy are encouraging, with research supporting this and finding that cannabinoids such as CBD can stop endometrial cells from multiplying, reduce inflammation and desensitise nerves that transmit pain.
Multiple Sclerosis (MS)
A 2017 review from the MS Society found that 66% of people with MS surveyed had used cannabis to help with their symptoms, which can include muscle spasms, stiffness and chronic pain. As much-needed research and evidence to support these claims continues to grow, the number of MS patients turning to CBD is likely to have grown even further.
While still ongoing, research certainly seems to back up usage, with Rudroff and Sosnoff stating in a 2018 study: “It is our opinion that CBD supplementation may be advisable for PwMS (patients with MS) to reduce fatigue, pain, spasticity, and ultimately improve mobility.”
Arthritis is the most common cause of disability in the UK, with around 10 million people of all ages thought to be affected. However, despite a growing number of cases, most sufferers are left to self-manage pain and find their own methods of relief – such as CBD.
While no rigorous clinical studies in humans have been conducted to confirm the science behind the impact of CBD on arthritic pain so far, extensive positive reviews by users and results from animal studies are encouraging. For example, a 2017 study found that CBD might be a safe and useful treatment option for joint pain associated with osteoarthritis, while a 2016 review found that topical application of CBD had the potential to relieve pain and inflammation associated with the condition.
For sufferers of these conditions – as well as other illnesses causing chronic pain – CBD has been a welcome natural alternative for easing symptoms and reducing intensity, with ever-growing research only set to increase its popularity.
Integro Medical Clinics: How cannabis can help manage migraine pain
The experts at Integro Medical Clinics explain how cannabis medicines can help manage and alleviate the excruciating pain of migraine.
Migraine can be a devastating and utterly miserable condition that can have a profound effect upon the patient’s quality of life.
But medical cannabis can offer a really effective, side-effect free treatment option, as we see in our patients’ story with Mike.
A migraine is categorised as a moderate or severe headache felt as a throbbing pain on one side of the head. It is generally accompanied with symptoms such as feeling sick, vomiting and increased sensitivity to light or sound.
It’s a common health condition, affecting around one in every five women and around one in every 15 men and they usually begin in early adulthood.
No one knows exactly what causes migraines, although they are thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain.
Many patients find they have a specific trigger such as certain food or drink, stress, tiredness or hormonal changes such as starting your period. Around half of all people who experience migraines also have a close relative with the condition.
There are several types of migraine, including:
migraine with aura – where there are specific warning signs just before the migraine begins, such as seeing flashing lights
migraine without aura – the most common type, where the migraine happens without the specific warning signs
migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop
The frequency of the occurrence of migraines really depends upon the individual. It can be several times a week to every few years.
There’s no one specific cure for migraines. Patients try pain medicines such as paracetamol and ibuprofen and triptans to help with the pain but these medicines are often ineffective.
If you suspect a specific trigger is causing your migraines, such as stress or a certain type of food, avoiding this trigger may help reduce your risk of experiencing migraines.
It may also help to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, as well as ensuring you stay well hydrated and limiting your intake of caffeine and alcohol.
Cannabis medicines have been found by certain patients to be incredibly helpful in the management of pain.
Dr Anthony Ordman, senior clinical adviser and hon. clinical director of Integro Clinics explains why: “Recent medical scientific research is showing that cannabis medicines can have several useful roles in the prevention of migraine, and also reducing pain if a migraine attack does occur.
“It is likely that substances in cannabis medicines (plant-derived CBD, THC and terpenes) all have roles to play and that they supplement the activity of the brain’s naturally occurring endocannabinoid system. This system may be under-active in people prone to migraine.
“There are three likely mechanisms by which cannabis medicines may be effective. Firstly, the natural stabilising or anticonvulsant effect of the cannabinoids suppresses the spreading abnormal wave of voltage depression in the brain’s cortical neurones. This wave precedes all migraine attacks and causes the aura familiar to migraine sufferers.
“Secondly, cannabis substances are thought to stabilise the mast cells of the immune system. In migraine, mast cells are involved in dilatation, or opening up of the blood vessels of the brain’s lining (dura), causing that familiar pulsating headache. Cannabis medicines may prevent this process from occurring.
He adds: “And finally, as in other painful conditions, if a migraine does occur, cannabis medicines are likely to block the transmission of pain messages in nerves running from the brain stem to the pain centres of the brain, to reduce pain itself.
A recent study showed that cannabinoids may reduce migraine severity by 49.6 percent without causing the ‘overuse headache,’ that other pain medicines such as paracetamol may cause.”
The patient’s story
Mike is a physically fit 37-year-old South African, who first experienced migraines as a teenager.
The pain he suffered was agonising and totally debilitating. It disturbed his vision, caused nausea and deep pain. Prior to the onset he experienced the aura of lights and would go blind in one eye.
An attack could wipe out days of his life whilst he recovered. For several days after the attack, he would feel befuddled and that his brain was not working properly.
Initially he looked into what could be causing the migraines worrying that he might have a brain tumour, but MRI scans thankfully showed that this was not the case. It was through luck and circumstance he stumbled upon cannabis as a medicine for his condition.
Mike was out playing golf in the hot sun and he became dehydrated. He felt the first symptoms of the headache begin so he paused for a rest under a tree and smoked some cannabis.
Instantly, he felt the pain begin to recede and he knew he had found a solution to his condition. He also wanted to point out that he was able to finish his round of golf and win. He came to the realisation that dehydration and hot sun were his major triggers.
Using cannabis would also mean that when a migraine did come it would last for a much shorter period of time and there was none of the post attack brain fog.
“I cannot recommend medical cannabis highly enough as treatment for migraine,” says Mike.
“It addresses all of the symptoms of the loss of vision, nausea and deep pain by addressing the inflammation in the blood vessels of the brain.”
Dr Ordman adds: “Integro Medical Clinics always recommend remaining under the care and treatment of your GP and specialist for your condition, while using cannabis-based medicines, and the Integro clinical team would always prefer to work in collaboration with them.”
If you would like further information, or to make an appointment for a medical consultation, please contact us at Integro Clinics:
Further help and support can be found at the following patient charities:
Study: Is CBD the future of chronic bladder pain treatment?
A first-of-its-kind study using human donors is examining the potential of CBD for treating chronic bladder pain. Cannabis Health speaks to the scientist leading the research.
Chronic pain is an oppressive human health problem that affects millions worldwide. In 2011 alone, the direct and indirect costs of chronic pain were at $600 billion dollars in the USA. This outweighs the costs related to heart disease, cancer, and diabetes combined.
Among these patients are the nearly eight million women and four million men suffering from interstitial cystitis (IC), commonly referred to as chronic bladder pain.
The symptoms of this chronic disease include pelvic pain and urinary storage dysfunctions, which can severely impact quality of life.
There are currently no adequate treatments for people with chronic bladder pain and scientists say new therapeutic approaches are desperately needed to not only prevent pain but also address co-morbidities such as social isolation, depression and anxiety.
A growing body of evidence suggests that cannabinoids could be the answer for treating chronic pain and inflammation. And as the research effort increases, the formulation of novel cannabinoid formulations progresses alongside it.
One of these formulations, developed by Desert Harvest Inc., packages cannabidiol with aloe vera to increase the bioavailability of CBD by 25 per cent.
As with most areas of CBD research, evidence regarding its efficacy is limited, however, a new collaborative study between Desert Harvest and the McGill University Research Centre for Cannabis in Montreal hopes to change this.
The two-phase study aims to validate whether the CBD and aloe vera formulation could alleviate the pain symptoms in a preclinical model of IC.
Dr. Reza Sharif-Naeini who leads the study said: “For the past 20 years or so, there hasn’t really been any development of new therapeutic drugs for patients with chronic pain.
“By partnering with industry colleagues, we’re trying to accelerate the speed to market for these analgesics so that the patients can benefit from them.
The first phase of the study involved a rodent model in which mice were administered a compound that metabolises acrolein in the liver.
The compound then accumulated in the bladder causing tissue damage. The symptoms are similar to human IC, including bladder inflammation, pain and bladder overactivity.
Initial data from the study are encouraging. The researchers demonstrated treatment with the cannabidiol-aloe vera formulation significantly reduced pain symptoms.
“Although we only tested it for seven days, it was enough for us to see a significant reduction in bladder pain experienced by these animals,” Dr Sharif Naeini said.
“It is a very important and exciting discovery.
“The next step for us is to start testing these compounds on human pain neurons to determine whether the effects can be translated to humans.”
The second phase of the study, expected to begin within the next month, will involve testing the effect of cannabidiol on neurons obtained from deceased human donors.
Dr Sharif-Naemi explained: “We’ve partnered with surgeons in local hospitals, so as soon as a donor dies the nervous tissue, including the pain-sensing neurons, can be harvested and kept alive in a small dish for about two weeks.
“[We] can assess the function of these pain neurons and see what happens when we apply these cannabinoid drugs to them.
“This way, we’ll be able to tell directly whether these compounds would have a beneficial effect on humans.”
The pain transmission pathway can be broken down into three steps. First are pain-sensing cells in the ‘periphery’, such as the skin or, in this case, the bladder. These nerve fibres detect the pain stimulus and transfer the information to the spinal cord.
At the spinal cord, pain transmitting neurons take information up the spine and into the brain where the third step takes place. This final step is referred to as pain interpretation.
“Cannabinoids can affect either one of these steps or all three of them together,” Dr Sharif-Naeini added.
“We think that in the periphery, cannabinoids prevent the activation of your pain-sensing neurons. This means that your nervous system doesn’t even detect the pain inflammation; it is not allowed to enter into your central nervous system.
“This is what we’re going to test in the second phase of these studies.”
Sadly, current pharmacological treatments for chronic pain, mainly opioids, are burdened with severe side effects. A rise in opioid prescription over the past decade has led to what is referred to as the opioid epidemic.
Although not a primary factor, the treatment of chronic pain is thought to be linked to this crisis.
“The absence of proper pain management is one of the contributing factors that led us to the opioid epidemic in America, so there’s really a push to develop new treatments,” Dr Sharif Naeini said.
“There are people doing opioid research to come up with better ways of eliminating the side effects of opioids, but eventually we’re going to come to a place where maybe we have gotten all that we can out of drugs, and we need new alternatives.
Dr Sharif-Naeini believes that cannabinoids could be a future alternative.
“Cannabinoids are an alternative with high potential. The more studies that are done, the more people can make informed decisions about what [medication] they take for their pain.
“Every time more research comes out it’s great because it allows us to better understand how the cannabinoid system functions.
“The hope is that we can develop better tools that will allow us to reduce pain in some of these intractable chronic pain syndromes, without necessarily affecting the patient’s functioning and cognitive capacity.”
How can CBD help arthritis?
In the UK, more than 10 million people have arthritis or other, similar conditions that affect the joints – and many are turning to CBD products to ease their pain and discomfort.
With an ever-expanding range of drinks, gummies and edibles on thee market CBD could be seen as something aimed at the younger generation.
However, there is a growing body of research that suggests CBD can also be of great use for the older members of the population – and one condition in particular.
Arthritis is a common condition that causes pain and inflammation in a joint, and while it can affect people of all ages, it is more likely to begin when people are in their 40s and 50s, worsening with age.
A Canadian study from 2020 found that up to one in five patients who consulted an orthopedic surgeon for chronic musculoskeletal pain were using a cannabis product to treat them, with the express aim of reducing pain.
The researchers also found that interest in the compound was high, with two thirds of non-users curious to try a cannabis product to treat their muscle and joint pain.
Furthermore, those patients already using CBD had generally positive experiences using the products. Nine out of 10 said it was effective in managing their pain, and four in 10 said it decreased their reliance on other pain medications. Nearly 6 in 10 said cannabis products were more effective than other drugs.
Such findings corroborate what we already know about CBD; thanks to its anti-inflammatory and analgesic properties, early research into its use as a treatment for acute and chronic pain is promising.
A 2016 study found that transdermal cannabidiol has potential for reducing pain and inflammation associated with arthritis without any noticeable side effects.
Cannabis-based medicines can help manage the pain of arthritis by rebalancing the body’s natural endocannabinoid pain-processing system and soothing inflamed body tissues.
There are two primary ways of taking a CBD supplement; topically or orally.
In the case of arthritis, a cream or ointment containing CBD would be rubbed into the affected area. Topical products may also include common over-the-counter ingredients such as menthol, capsaicin or camphor, which could make it difficult to determine if any positive effect is due to the CBD or another ingredient.
There are a number of ways to take CBD orally, from gummies, snacks and drinks to tinctures and capsules – although gummies are discouraged in households with children, due to their similarity with sweets.
However, all work in largely the same way, being absorbed through the digestive tract. However, it is worth noting that absorption can be slow and dosing is tricky due to the delayed onset of effect (one to two hours), unknown effects of stomach acids, recent meals and other factors.
Whichever method you choose, it is always a good idea to check with your medical practitioner first, as CBD, although it is natural, may interact with other treatments, such as prescription medications.
However, for those looking for an alternative to prescribed drugs, with fewer side effects, CBD could well prove to be the answer.
- Provacan brings high-strength, 72% CBD to UK
- Integro Medical Clinics: How cannabis can help manage migraine pain
- Study: Is CBD the future of chronic bladder pain treatment?
- What are CBD patches and do they work?
- Is it safe to take CBD with other medication?
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