How Can Cannabis Be a Path from Pain toward Restored Function?

When it comes to pain, everyone is different. How you experience pain, as well as your pain tolerance level, is shaped by many different factors. In the same way, people respond to medicines differently.

Cannabis is emerging as a different option, proving to be a powerful new tool for managing pain. The cannabinoids in the cannabis plant, especially cannabidiol (CBD) and tetrahydrocannabinol (THC), have been shown to reduce inflammation and pain. Other cannabinoids, such as cannabidiolic acid (CBDA), tetrahydrocannabinolic acid (THCA) and cannabigerol (CBG), plus plant compounds like terpenes may also play a role in reducing pain.

Federal restrictions in the United States continue to limit research on how cannabis impacts pain. However, other countries such as Israel have completed considerable research on cannabis’s therapeutic benefits.

The Different Types of Pain

Understanding the different types of pain and their sources can help you find the best cannabis options.

Acute pain usually comes about as the result of an injury, overuse, or medical procedure. While the initial pain can be mild or severe, it gets better over time as your body heals. Slamming your finger in a door will result in acute pain. Post-workout soreness, broken bones, and surgery recovery also fit into this category.

With chronic pain, “the pain itself becomes the disease,” explains Dr. Eduardo Fraifeld, MD. Doctors typically categorize pain lasting over 3-6 months as chronic pain. Chronic pain can be associated with arthritis, migraines, diabetes, or multiple sclerosis (MS), among other conditions. It can also be a side effect of chemotherapy or other long-term medical treatments. In addition, when an injury heals yet the pain remains, that fits the description for chronic pain.

Pain can also be broken down into the following categories:

• Nociceptive pain: Pain in soft tissues, tendons, or joints caused by injury, overuse, stress, or illness. Arthritis and other types of inflammatory pain also fit in this category. Nociceptive pain tends to get better over time, except for arthritis. With this type of pain, inflammation triggers nearby nerves, resulting in aching or throbbing pain.
• Neuropathic pain: Neuropathic pain, or nerve pain, originates in the nervous system. This type of pain is chronic in nature. It often feels like pins and needles, an electric shock, or a burning sensation. Some common causes of neuropathic pain are carpal tunnel syndrome, sciatica, diabetes, and chemotherapy.
• Nociplastic pain: Is a relatively new category for pain that doesn’t fit well into the other two categories. Fibromyalgia, non-specific low back pain, and irritable bowel syndrome are a few examples. Also, pain associated with and exacerbated by centralized and peripheral sensitization is an example of nociplastic pain.

THC or CBD? It Depends on the Person and the Type of Pain

Cannabis plant compounds (cannabinoids) work on the CB1 and CB2 receptors in the human body’s Endocannabinoid System.

Everyone’s endocannabinoid system is different, just like everyone has their own pain tolerance levels. Keep this in mind if a cannabis product ends up not working for you, there may be a better product, dose, or route for you. However, there are specific differences you should know that exist between the two most prominent cannabinoids, CBD and THC.

CBD

Many people successfully use CBD products to reduce inflammation-based pain. Full spectrum products containing all the plant compounds, including some amount of THC (including CBD hemp that has a small amount of THC), tend to be the most effective. Primarily because minor cannabinoids, terpenes, flavonoids and essential fatty acids work together to create the “entourage effect.”

By helping to reduce inflammation, CBD may indirectly help reduce pain. However, it doesn’t bind directly to the receptors that control pain like an opioid does. For that, you need a different cannabinoid, THC.

THC

A lot of people immediately rule out products with THC because of concerns they will become impaired or “high.” It’s important to know that small amounts of THC may have little to no impairing effects. At the same time, THC even in small amounts can be a gamechanger when it comes to pain.

THC can act on the same receptors in your body that opioids do. However, you don’t get some of the problematic side effects that opioids can bring—nausea, constipation, and risk of physical addiction.

Cannabis Compared to Opiates

Ironically, long-term use of opioids for chronic pain can make you more sensitive to pain—an effect called opioid-induced hyperalgesia. What’s the recommended protocol in response to opioid-induced hyperalgesia? To wean off opioids (with help from your prescribing physician) and find a safer alternative for managing pain. Interestingly, cannabis has shown promise on this front, based on emerging research.

Cannabis does not cause pain sensitization but in fact can help treat it. As stated earlier, THC and other cannabinoids work through the same receptors that opioids do. However, the way that they reduce pain (their chemical process) is different.

Neuropathic pain is difficult to treat even with conventional pharmaceuticals. Generally, opioid use for chronic neuropathic pain is ineffective. One study considered the risk and benefits of opioids for the treatment of neuropathies. It stated that “long-term opioid therapy didn’t improve the functional status but rather was associated with a higher risk of subsequent opioid dependency and overdose.”

The Goal: To Restore Function

We wish that we could state definitively that CBD or THC products will completely eliminate all pain. However, that is not the case. If there were a magic one-size-fits-all cure for pain, the pharmaceutical companies would have discovered and patented it!

Instead, the goal is to reduce pain to a manageable level and restore function. When you restore function, you open the possibility of adding on additional supportive activities such as exercise and relaxation that further promote healing.

About the Author

Katherine Golden is a registered nurse and CEO, executive director, and founder of Leaf411, a 501(c)(3) nonprofit organization founded in 2019 with a mission to provide education and directional support to the general public about the safe and effective use of cannabis (marijuana and hemp). For more information or to schedule a consultation with a cannabis-certified nurse, call 844-LEAF411 (844-532-3411) or visit leaf411.org.

Can’t wait to get started with cannabis? Our Leaf411 quick question hotline and one-on-one scheduled nurse guidance calls are available now to answer your questions about using cannabis to manage pain. Call us at 844-LEAF411 (844-532-3411).