Medical Cannabis for Back Pain: 5 Things You Should Know

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March 19, 2020

 

If you are struggling with back pain, you are not alone. In fact, according to the World Health Organization up to 70 percent of people worldwide have experienced back pain. For many people, pain in the back is temporary and will go away on its own but for others, unfortunately, back pain can become chronic and even lead to permanent disability. The symptoms of back problems can range from significant pain and discomfort and spasms of the muscles to nausea and other side effects from the medications taken to treat it. Fortunately, medical cannabis (also known as medical marijuana) is steadily becoming more accepted and acknowledged as an efficient treatment option for back pain by scientific and medical professionals. Here, we will take a look at five things that you should know about treating back pain with medical cannabis.

 

1. Types of Back Pain

It can be helpful to understand how to differentiate between the various major types of back pain when considering the best treatment plan. The most common types of back pain are mechanical pain, radicular pain, nociceptive pain, and neuropathic pain. Mechanical back pain, which is sometimes referred to as axial pain, is the most typical cause of lower back pain. This is generally felt in the muscles, ligaments, spine, and the joints surrounding the area- such as the facet joints and sacroiliac joints. It can also be centralized in the buttock area and radiate upward into the lower back and down into the top of the legs. Mechanical pain can be influenced by various movements such as resting in one spot too long, twisting, sitting, and standing. Radicular pain is caused by the nerve root of the spinal cord becoming inflamed. This inflammation can also cause the pain to radiate downward into the buttocks or the upper legs and is experienced by a type of sharp pain often described as burning or electric and can also at times include feelings of numbness or weakness. Radicular pain is generally felt on one side of the body only.

Nociceptive pain is a term which refers to the activation of sensors known as nociceptors which respond to potentially harmful stimuli. These receptors send alerts in when the body has received injuries to muscles, joints, ligaments, skin, and bones. As a result, the brain and central nervous system receives these alerts which then lead to the feeling of pain in these injured or inflamed areas. Nociceptive pain can be described as gnawing or aching. Some examples of the types of nociceptive pain that can be experienced are arthritis pain and pain after surgery. This type of pain generally goes away as the injury heals.

Neuropathy, or neuropathic pain, is caused by damaging nerve tissues either through infection or injury. When nerve damage occurs, the nerves still continue to send pain signals long after the initial injury has fully healed. When the neuropathic pain is in the back it can cause a symptom which is known as sciatica. Sciatica happens when the root nerve of the lower back gets compressed which can then lead to numbness and in some cases extreme pain along the length of the sciatic nerve. In addition, patients with neuropathic pain can feel pain travelling up their arm to the spine when they have any type of back surgery.

 

2. Back Pain Causes and Statistics

Back pain that is sudden or acute (not lasting longer than 6 weeks) can be caused by a variety of incidents such as lifting something which is heavy or falling. When back pain lingers for three months or longer, it then falls under the category of chronic back pain. Though it can seem as though back pain can develop for no reason, medical professionals can run tests in an attempt to identify its source. Some of the most common causes of back pain are overuse of muscles or straining the ligaments, ruptured discs, bulging discs, irregularities of the skeleton, osteoporosis, and arthritis. According to the experts at The American Chiropractic Association, approximately 31 million people in the United States are dealing with pain in their back at any given time. In a calendar year, up to half of all working Americans will experience some type of back pain symptom and up to 80 percent of the adult population in the United States will experience back pain at some point in their lives!

 

3. Problems Caused by Back Pain

Back pain can create a wide variety of symptoms ranging from a mild inconvenience to a permanent and debilitating permanent disability. The pain can seem to suddenly and randomly present itself or slowly accumulate as time goes on. Back pain can also feel as though it is present in one moment and disappears the next. For this reason, the effects of having back pain can be both physical and/or mental. While each patient will experience back pain differently depending on the root cause of their pain, there are some physical effects that are often experienced across the board. These physical experiences are burning or stinging pain that may or may not radiate downward through the thighs and into the feet, tightness or even muscular spasms in the hips and pelvis, difficulty walking, pain after prolonged periods of sitting, and difficulting moving between sitting and standing positions. 

When back pain begins to turn from acute to chronic, it can begin to negatively affect a person’s mental health. Having chronic pain can get in the way of daily activities and negatively impact someone’s quality of life. Chronic pain affects sleep patterns, eating habits, and can also affect a person’s memory and ability to concentrate. When someone is always feeling chronic pain, they may not be able to perform the daily tasks needed to function at work or school. These difficulties can lead to stress, anxiety, and depression

 

4. Available Treatments and their side effects

Once a patient has been thoroughly examined by their doctor and the cause of back pain has been identified, a treatment plan can be formulated. Some of the most common treatments for back pain are chiropractic treatment, steroid injections, opioid pain medication, and back surgery. Unfortunately these treatments are not always successful and can often be the cause of many unwanted side effects, making what is an already bad situation possibly worse. 

With chiropractic treatment, a chiropractor can perform an adjustment to the painful area by using their hands or instruments to apply a quick and controlled force of pressure to the joints of the spine. This is done with the goal or improving overall physical functioning by aligning the spine. Although they are rare, there can be serious complications from chiropractic adjustments including nerve compression, herniated discs, and even strokes. Another treatment option is epidural steroid injections. Rare but serious side effects of these injections include allergic reactions, bleeding, infection, nerve damage, and even paralysis. When these more conservative treatments aren’t working, back surgery can be offered as a potential solution. There are four main types of surgery available for issues causing back pain and these are: laminectomy, discectomy, artificial disc implantation, and spinal fusion. Each of these surgeries carries a great number of risks and potential side effects and it is strongly encouraged that patients seek a second or third opinion before undergoing back surgery. 

 

5. How Cannabis Helps

Though the above mentioned conventional treatments can be effective in treating some types of back pain, as mentioned they are not without their own risks and unwanted side effects. For these and other reasons, many patients are turning to medical cannabis as their preferred treatment. Medical cannabis does not have many of the side effects associated with chronic pain medications such as nausea, ulcers, gastric bleeding, or addiction. Further, patients who use cannabis to treat their back pain note that they have been able to eliminate their dependence on pharmaceutical medications entirely and in a manner that is safe and natural.  

Though back pain can present itself with a wide range of symptoms, medical cannabis contains a variety of therapeutic qualities that work with the body’s own endocannabinoid system to alleviate these symptoms. Medical cannabis is well known for its ability to treat even the most severe forms of chronic pain and this is because the cannabinoids found in cannabis, such as THC and CBD, act as potent anti-inflammatories. This is especially useful  for those patients suffering from pain caused by degenerative disc diseases and neuropathic pain. In addition, for those who have been prescribed opioids or other pharmaceutical medications, cannabis treats their nausea and vomiting due to its natural antiemetic properties. On top of this, when cannabis is used in a safe and controlled manner, it has wonderful mood-boosting properties that can help with depression, anxiety, and even with sleep regulation. 

One thing that sets medical cannabis apart from traditional treatment methods such as pharmaceutical medications is that it has multiple methods of ingestion. The variety of methods of use and available strains make medical cannabis an attractive treatment due to its versatility and practicality. Though perhaps smoking cannabis is the most well-known way of ingestion, it is not advised. Instead, there are a variety of options available to patients that are very effective without negatively impacting someone’s health. Tinctures and oil extracts are a popular way to use medical cannabis and allow for reliable dosing. Edibles are another safe and inconspicuous way to take the medicine. For immediate pain relief, vaping is a wonderful alternative to smoking. In addition to the various methods of ingestion, there are multiple strains of medical cannabis available and using the correct strain and dosage are both important for obtaining the best results. It is therefore advised that each patient speak with a reputable medical cannabis practitioner before taking any form of medical cannabis for treating their back pain.

 

Further Reading:

https://www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf

https://www.medpagetoday.com/MeetingCoverage/AdditionalMeetings/42228?xid=nl_mpt_DHE_2013-10-12

https://medschool.cuanschutz.edu/physical-medicine-and-rehabilitation

https://www.mayoclinic.org/diseases-conditions/back-pain/symptoms-causes/syc-20369906

https://www.acatoday.org/Patients/What-is-Chiropractic/Back-Pain-Facts-and-Statistics