Sciatica and medical cannabis: A promising path for pain relief?

What is sciatica?

Sciatica is a condition which is characterised by pain experienced along the path of the sciatic nerve. The sciatic nerve is a nerve that runs from the lower back through the hips and buttocks and down each leg to the feet. The pain is usually caused by the nerve becoming compressed or irritated, such as something rubbing on it. 

What causes sciatica?

The most common cause of sciatica is a slipped disk, when a soft cushion of tissue between the bones in the spine pushes out. Other causes might include: spinal stenosis, a narrowing of the part of the spine where nerves pass through; spondylolisthesis – when one of the bones in the spine slips out of position; a back injury of some other form. All of these cause pain and inflammation in the affected area. 

How common is it?

According to the National Institute of Health and Care Excellence (NICE), between 13-40% of the UK population will experience sciatica at some point in their lifetime. However, statistics around its prevalence also vary significantly due to differences in the definitions of sciatica, data collection methods, and the populations studied.

What are the symptoms of sciatica?

Sciatica usually occurs on one side of the body, with common symptoms including:

• Pain (stabbing, burning or shooting)
• Tingling (pins and needles)
• Numbness 
• Muscle weakness

These symptoms usually occur in the bottom, back of the legs, feet, or toes and get worse with movement or coughing and sneezing. 

Some people with sciatica may also experience back pain, but this is not typically as severe as in the other areas. The NHS advises that back pain in isolation is unlikely to be caused by sciatica. 

While symptoms usually improve within 4 to 6 weeks, they can last longer and may be debilitating.

How is sciatica normally treated?

Sciatica can often be managed at home with relatively conservative treatments, but severe cases may require more advanced medical intervention.

Initially, a doctor may suggest things like:

• Medications such as painkillers, anti-inflammatories, muscle relaxants
• Using heat packs on the affected areas 
• Exercises to try at home
• Physiotherapy, including exercise advice and techniques like massage (manual therapy)
• Psychological support such as counselling to help you cope with the pain

In some cases more invasive interventions may be required, such as:

• Steroid injections to reduce inflammation around the irritated nerve
• Surgery - an operation called decompression surgery can sometimes help relieve pressure on the nerve 
• Procedures to seal off some of the back nerves so they stop sending pain signals

How to prevent sciatica?

There are also preventative measures that can be taken to reduce the likelihood of developing sciatica or it recurring in the future. 

This includes:

• Staying active and exercising regularly 
• use a safe technique when lifting heavy objects
• Maintaining a good posture when sitting and standing
• Sitting correctly when using a computer and ensuring you have an ergonomic work environment to reduce strain on the back

Medical cannabis and sciatica

In the UK medical cannabis can be legally prescribed to manage sciatica if the patient hasn’t responded to these conventional medications and treatment options.

Chronic pain is actually the most common indication for which medical cannabis is prescribed in the UK, and it can be beneficial for managing symptoms and improving quality of life for those experiencing an episode. 

What does the research say about medical cannabis and sciatica?

There are relatively few studies which have looked specifically at the effects of cannabis in sciatica. However, one paper from 2018 looked specifically at radicular pain, a type of nerve pain that radiates from the spine into the legs, of which sciatica is a common form. The authors found that medical cannabis may provide pain relief in chronic nerve pain by reducing connections between the areas of the brain that process emotions and sensory signals.

Meanwhile, a larger number of studies have been conducted on cannabis and neuropathic pain more broadly. In fact, clinical trials have demonstrated that cannabinoid-based medicine holds potential for alleviating pain, particularly chronic and neuropathic pain.

In a randomised control trial from 2010, patients with chronic neuropathic pain experienced pain relief, improved mood and better quality sleep after consuming cannabis.

More recently, a retrospective study from 2023, found that cannabis was not only ‘effective’ and ‘fast-acting’ in the treatment of neuropathic pain, but also had fewer side-effects than conventional medicines. 

The same year, a different group of researchers concluded that while medical cannabis and opioids were perceived to be ‘equally efficacious in reducing pain intensity’, cannabis had beneficial effects on ‘broader pain-related factors such as emotion, functionality, and overall sense of wellbeing’. 

What do patients say about medical cannabis and sciatica?

Ryan, 31, is prescribed medical cannabis for chronic pain related to sciatica. Before becoming a patient with Releaf, he had been struggling to manage the condition for over a decade and had even had to give up walking and hiking—his favourite pastime.

“The sciatica mainly affects my back, and the medication that I was prescribed was so strong it just made me sleep all the time, and, if I wasn’t asleep, I’d feel really drowsy - which of course wasn’t nice. I even tried having an injection in my back to neuter the nerve, but that didn’t work,” says Ryan.

“Before I started using medical cannabis, it was at the point where I could barely walk, and I certainly couldn’t walk for extended periods of time. 

[Now] “In terms of everyday life, I’m also sleeping much better, and I’ve got a much better appetite than I used to when I was using my other medications, so that's a massive positive. It really has had a knock on effect.”

Read more about Ryan’s journey here 

What do experts say about medical cannabis and sciatica?

Dr. Alexander Van Heerden is a prescribing clinician at Releaf and has seen first-hand the benefits that medical cannabis can have on chronic pain and sciatica in particular.

“As well as being extremely unpleasant and uncomfortable, sciatica symptoms can also have a major impact on a person’s mobility, their mood, and their overall quality of life,” he explains.

“While there are a number of conventional pharmaceutical treatments available for patients experiencing chronic sciatica pain, unfortunately there are also a number of patients who have not responded to these options.

Dr Van Heerden adds: “Now, we have real-life evidence that shows how medical cannabis can make a positive difference when it’s incorporated into pain management treatment plans. 

“Research shows it not only targets pain at the source, but also has an ability to decrease the brain’s perception of pain, and this can have a remarkable difference for patients with sciatica - especially for those who have been left without an effective treatment for years.”

How can I access medical cannabis for sciatica?

If you have a diagnosis of sciatica and feel medical cannabis could be beneficial for your symptoms, you can use the Releaf eligibility checker to determine if it's right for you. 

A team of expert clinicians will review your application and if appropriate you will be invited to schedule an appointment with a specialist consultant.

During the initial consultation you will have the opportunity to discuss your symptoms and needs with the consultant and if they feel it’s appropriate they will issue your prescription and guide you through the next steps. 

You can find out more about medical cannabis via the FAQs page or by contacting a member of the team. As always, never make any changes to your treatment plan without consulting a doctor first.