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Cannabis clinic teams up with UK charity to tackle nation’s back pain

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BackCare has been helping those in the UK manage back pain since 1968

Integro Medical Clinics has announced its new collaboration with the UK’s national back pain charity, BackCare.

The two organisations, which share a goal to provide support and relief to the millions of people living with back pain in the UK, have joined forces to collaborate on a number of projects around education and research. 

The first event, a webinar, looking at the use of cannabis medicines to help chronic back pain with a panel of medical specialists will take place in late May. 

Established in 1968, BackCare – the National Back Pain Association – has been educating the public on ways to alleviate and help prevent back pain for over 50 years. 

The organisation, whose patron is HRH Prince of Wales, provides practical and emotional support to people living with back pain through education, information, advice and a network of UK-based branches. 

BackCare helps a whole range of people living with back pain, whether the cause is through injury, musculoskeletal disorders such as Scoliosis, Axial Spa, or Spina Bifida or as a consequence of another underlying health condition including Multiple Sclerosis (MS) Parkinson’s disease or cancer. 

Integro Medical Clinic helps patients through prescription cannabis medicines, when conventional approaches to pain have failed. In the case of back pain, cannabis is widely acknowledged to be extremely helpful in providing relief and allowing patients to better maintain their normal lives and activities.

With the shared goals and natural synergy between the two organisations, a collaboration and association on projects such as webinars, education and research was a natural fit. 

Denice Logan Rose, executive director, BackCare, said: “It is good to be collaborating with Integro Clinics, a like-minded organisation and one that is interested in investigating new approaches to back pain management.

What is back pain?

Back and neck pain are extremely common complaints of the spine and can affect both men and women at any age. 

Thankfully most back pain is not caused by anything serious and will usually get better over time. However, sometimes the pain can become long-term or severe, and interfere with every-day activities and sleep, and effect your mood, making you feel low or anxious.

Lower back pain or lumbosacral spine pain can be broadly divided into two categories – mechanical pain and nerve compressive pain. 

Mechanical back pain can be caused by an acute strain of the spine’s mechanics, in other words the spines muscle discs, facet joints and ligaments, leading to inflammation and painful muscle spasm. 

It is called mechanical because it refers to the mechanics of the spine and often occurs after unusual exertion, especially when the back has not been kept fully fit by regular movement or exercise. 

Nerve compression pain results from pressure or irritation on the spinal nerve roots that leave the spine. This causes nerve pain often down the leg, ’sciatica,’ and numbness and even muscle weakness in the leg or foot. 

Sometimes, it can be difficult to identify what exactly is causing back-pain and this is called non-specific back pain.

Very rarely, if your leg becomes very weak or your foot becomes floppy, ‘foot drop’ or your bladder or bowel and surrounding areas become numb, then urgent medical attention is needed.

In many ways, the causes of neck pain can, surprisingly,  result from similar causes to lower back pain. These can also include ageing in the cervical spine and receiving repeated injuries, that may not have actually caused pain at the time of impact. ‘Wear and tear’ over time can weaken the connective tissue that makes up the disc and once the connective tissue is weak sudden stress or whiplash may injure the disc more easily.  Neck pain can result from many causes including bones spurs, herniated disc, muscle strain, stenosis, myelopathy and arthritis. 

“A doctor or physiotherapist can generally listen to your symptoms and examine you, to help you decide what sort of back pain you have and advise you accordingly, explained Dr Anthony Ordman, senior clinical adviser and hon. clinical director at Integro Medical Clinics.

“You can be assured that all of the pain specialists at Integro Clinics Ltd are highly experienced consultants in pain medicine. 

“In their training, these clinicians will have learned all about the many medical conditions that can lead to back pain; a slipped or prolapsed disc causing back pain and sciatica, arthritis and facet joint syndrome, pinched nerves, spinal stenosis , degenerative disc disease and bulging or herniated discs and segmental instability. 

“All of these conditions can lead to the debilitating symptoms mentioned above, muscle spasms and cramping, stiffness, leg pain, numbness and weakness. These can all be painful and debilitating conditions to live with and can have a significant impact on a person’s quality of life.”

Conventional treatment for back and neck pain ranges from pain medication, anti-inflammatories, physical therapy and manipulation, cognitive behavioural therapy to surgery in the most extreme cases. 

Cannabis medicines can help manage the mechanical and nerve pain associated with back and neck pain by rebalancing the body’s natural endocannabinoid pain-processing system and having an anti-inflammatory effect on inflamed body tissues. 

When used carefully, cannabis medicines can also help improve your sleep to allow better healing and also lift your mood and treat anxiety. In many cases, cannabis medicines can do this more gently than conventional medicines and sometimes with less risk of dependency.

Sophie Hayes specialist cannabis nurse at Integro Medical  Clinics added: “Back and neck pain are really common symptoms amongst our patients. Cannabis medicines can be a very effective pain management tool in these cases. However, the clinical team at Integro always advise and support our patients to continue to explore the underlying injury or cause of the chronic pain alongside their cannabis medicine prescriptions.”

The patient’s story

Jessica is a 51-year-old mum with a large family and a very physically active lifestyle that became affected by chronic pain in her neck, resulting from a skiing accident several years before. 

Five or six years ago I had a nasty fall skiing and remember at the time my neck flipping backwards and really smacking my head on the ice,” she recalled.

“I was not immediately in pain and it took about a year for a creeping pain in my neck and down my shoulder to develop. The pain would come and go but I found that it was really limiting the amount of exercise I was able to do. It also made me extremely grumpy and generally out of sorts.”

“My sleep at night was very disturbed as I had pain down my left side and could not get comfortable. 

“I had repeated MRI scans over 2 years to monitor the situation. I was told that I was suffering from degenerative C4/5 discs. This was causing nerve pain from pressure on my spinal cord. I had several steroid injections and tried physical manipulation, but this only made the pain worse. 

Jessica continued: “Eventually my specialist recommended I have an operation called anterior cervical discectomy. This involves opening the front of the neck, removing the degenerated discs and replacing them with  artificial discs in a titanium cage. 

“I was very nervous about this type of intervention and I had read about the effect cannabis medicines can have upon the type of chronic pain I was suffering. Within two weeks of starting the cannabis oil (a careful mix of THC and CBD) my sleep massively improved and the pain lessened.

“I was still aware of slight twinges if I worked out too vigorously  but if I took things at a sensible pace the pain was really improved and much more tolerable. All in all a great result andI would recommend trying this approach to anyone suffering a similar condition to my own.”

Dr Ordman added: “Integro Clinics always recommends 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.”

 

For further information, or to make an appointment for a medical consultation, contact www.integroclinics.com,

Email: Contact@integroclinics.com and follow @clinicsintegro on Twitter

BackCare

+44 (0) 208 977 5474

Email: Info@backcare.org.uk

 www.backcare.org.uk 

Industry

Provacan brings high-strength, 72% CBD to UK

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Kanabo's VapePod will be compatible for Provocan's new CBD range

The science-led brand is bringing the latest cannabis technology to the UK with two high potency CBD formulas.

Provacan, the CBD brand from cannabis research company CiiTECH, has introduced the two 72 percent products as part of its popular VapePod range developed in partnership with Kanabo. 

The Provacan range of VapePod compatible pre-filled pods have grown to become one of the company’s most popular vape products.

The VapePod device was developed by Israel-based Kanabo Group and provides users with a certified, safe and effective vaporisation system with innovative metered dosing with high bioavailability. 

Vaporisation of CBD improves the rate of absorption when compared to other means such as ingestion.

The device optimises efficiency while delivering CBD formulas more safely and simply. It can only be used with compatible pre-filled cartridges, such as Provacan’s Day and Night pre-filled pods.

Kanabo recently became the second cannabis company to list on the London stock exchange. 

This is a revolutionary step for the VapePod entering the medical cannabis scene in the UK and is vital for patients for whom this delivery method will replace the smoking of cannabis flowers.

Avihu Tamir, CEO at Kanabo, said: “We are pleased to have CiiTECH as a partner in the UK for developing pure innovative hemp formulas. The unique formulas are coupled with the VapePod platform which give consumers great satisfaction in knowing that they’re getting the most out of their CBD.”

Building on the popularity of the 55 percent CBD VapePod­­ range, Provacan has worked with Kanabo Research to launch two new higher strength vape formulas for its customers. 

The all-new Night Terpene and Day Terpene CBD VapePod formulations contain 72 percent CBD together with other minor cannabinoids and a potent mix of terpenes.

Terpenes are widely used and can be found in essential oils and aromatherapy. 

Additionally, the all natural pods are free from traces of pesticides, heavy metals and solvents and don’t containing PG, VC, MCT, nicotine or vitamin E. 

Provacan is part of the growing portfolio of brands by leading British cannabis company CiiTECH Ltd, with R&D management based in Israel.

Founded by Clifton Flack in 2017, Provacan is the flagship brand within the portfolio and focuses on bringing the latest cannabis technology to its loyal consumers in the UK and across the world.

Partnerships with international medical cannabis research companies fuel CiiTECH’s product development and provide brands like Provacan with forward thinking industry knowledge and the ability to create highly respected science-backed CBD products for sale in the UK today.

Eli Whiteman, CiiTECH’s VP business development, said: “Our partnership with Kanabo goes back a long way and beyond technological innovation. Our main priority is to strive to ensure our customers have access to a superior combination of bioavailability, unique delivery systems and consistent CBD products that they can rely on.

“We achieve this by channelling consumer demands into product development and by partnering with like minded medical cannabis companies that do the same.”

The new Night Terpene CBD and Day Terpene CBD VapePods are available from Provacan now, retailing at £49.99 each. To find out more information about the products, visit https://provacan.co.uk/vapes/.

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Integro Medical Clinics: How cannabis can help manage migraine pain

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Sponsored feature

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:

Website: www.integroclinics.com
Email: Contact@integroclinics.com
Twitter: @clinicsintegro

Further help and support can be found at the following patient charities:

https://www.migrainetrust.org/ @MigraineTrust

https://www.nationalmigrainecentre.org.uk/ @NatMigraineCtr

https://headachemigraine.org/connect-with-others/ @CoalitionCHAMP

https://painuk.org/members/charities/migraine-trust/ @Pain_UK

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Study: Is CBD the future of chronic bladder pain treatment?

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"Cannabinoids prevent the activation of your pain-sensing neurons"

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

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.”

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