Medicinal cannabis for nerve pain

Up to 18.1% of patients with chronic pain in the UK suffer from nerve pain, also referred to as neuropathic pain.   It is a condition characterized by intense discomfort that many describe as sharp, throbbing, or piercing. Damage or dysfunction to nerves, or even the brain itself, results in a chronic condition in which the patient experiences pain symptoms that can range from mild to excruciating. Conventional medications and treatment work for some patients, but not all. 

Thanks to the sweeping changes made to the legality of medical cannabis on the 1st of November 2018 here in the UK, sufferers of nerve pain can now supplement conventional therapies with medicinal cannabis use. Some patients are reporting that medical cannabis offers a pain management solution after years of trial and error with traditional medical approaches.

How severe is nerve pain, and what causes it?

Nerve pain can range from mild to severe, and various external and internal stimuli can aggravate pain. There is no “one-size-fits-all” description for the pain felt by people suffering from nerve pain, and the causes are also wide-ranging and somewhat poorly understood in many cases.

It can present in many forms and can be caused by a huge range of not only injuries, but also lifestyle choices, diseases, and also certain pharmaceutical medications or treatments. For some, it may be caused by issues related to the brain and spinal cord (the central nervous system), while for others it can be the result of damage or injury to the nerves themselves. An unhealthy diet, toxin exposure, and alcohol or substance abuse are also suspected factors in certain types of neuropathy.

Common nerve pain symptoms include:

• sharp, stinging or stabbing pain
• tingling in hands and feet
• muscle weakness (usually in the feet)
• loss of coordination

The efficacy of medicinal cannabis for nerve pain management

A growing body of research studies and clinical trials are highlighting the potential effectiveness of medicinal cannabis in managing symptoms for a range of disorders, nerve pain included. While the research into medicinal cannabis is still in its early stages, in large part due to the legal standing of the plant over the past century or so, many countries are now accepting the fact that cannabis is a viable treatment option for a range of health issues.

And although the need for more research is obvious, there are a few clinical studies that show just how promising medicinal cannabis is proving in the battle against neuropathic pain. 

This study, published all the way back in 2008, is one of the first to look into the topic.  While not huge in scale, with only 38 patients with central and peripheral neuropathic pain, the results were constantly positive, with most participants reporting a marked drop in pain after receiving the medicinal cannabis treatment. 

Another paper, titled “Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial” found similar results. A little larger in scope, with 50 participants, the paper concludes medicinal cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy. There was a greater than 30% pain reduction reported by 52% of the group. 

Then we have this paper, which looked into low-dose vaporised cannabis for the reduction of nerve pain. Through a double-blind, placebo-controlled, crossover study with most participants who were experiencing neuropathic pain with traditional treatment not proving effective. The paper concludes

“Vaporised cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain.”

The last study we will highlight in this article is “The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities”. The previous studies all looked at inhalable or ingestible medicinal cannabis products, but this piece of research looked at how topical application of CBD oil could offer potential relief. It showed that there was “a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group” with no adverse events reported.

So, as we can see, medical cannabis has been effective for many in managing nerve pain. While it is too early to say that it will be effective for all patients with all types of nerve pain, the potential it is showing is certainly promising. 

It may also be helpful with treating, or at least reducing, some of the secondary issues that go hand-in-hand with nerve pain for many sufferers. It may help reduce anxiety while also aiding sleep, lower chronic inflammation, and even control brain excitation. 

How does medicinal cannabis interact with the human system?

If you haven't heard of the endocannabinoid system (ECS), you are not alone. Only discovered in the late 80s, the ECS is actually the largest regulatory system in humans and plays a substantial role in maintaining homeostasis, or balance. It is a complex system of endogenous (produced by your body) cannabinoids and cannabinoid receptors (CB1 and CB2) which are found throughout both the central and peripheral nervous system.

Cannabinoids, both the ones our bodies produce, and the types sourced from cannabis (phytocannabinoids - THC and CBD among others) have the ability to interact with the ECS receptors, essentially turning on and off certain physiological functions. Think of these receptors' interactions like a set of traffic lights, as each receptor can be activated by the cannabinoids to allow certain signals through.

When it comes to nerve pain management, it’s believed that CBD and THC interact with the receptors to temporarily reduce pain signals, providing an analgesic effect. By stimulating CB1 and CB2 receptors found in the peripheral nervous system, these cannabinoids may also reduce the inflammation caused by nerve pain. In addition to this analgesic effect, the phytocannabinoids may also stimulate the release of endorphins, which are natural opioid-like compounds produced by your body. This may explain the intoxicating effects offered by THC.

Methods of medicinal cannabis administration for nerve pain

There are multiple avenues available for medicinal cannabis delivery now available to neuropathy sufferers in the UK. Each comes with its own list of pros and cons.

Inhalation

Inhalation is an often preferred method for patients seeking fast relief, as its effects are felt rapidly. The vaporization of dried cannabis flower or extracted cannabis oil is the commonly prescribed inhalation technique, offering a reduced risk of health issues compared to smoking cannabis. This approach ensures quick relief while maintaining a higher level of safety.

Edibles

Edibles are discreet, and delicious, and provide an uncomplicated way to measure doses. Many patients prefer edibles to inhalation, as they don’t have to worry about the associated smell of vaporised cannabis, or the perceived stigma attached to cannabis inhalation.

Edibles are available in a wide variety of forms and dosage sizes. One thing to keep in mind with edibles is that they can take an extended period before the effects are felt, anywhere from 30 to 120 minutes.

Tinctures and oils

Tinctures and oils are typically grouped in with edibles, but they are actually very different. Tinctures are applied sublingually, meaning you drop the measured dose under your tongue and hold it there, allowing for the cannabinoids to be absorbed into your bloodstream through the capillaries in your mouth. This method of delivery is proving to be popular with neuropathy sufferers, as the effects may be felt within minutes, when compared to the up to 90-minute wait with edibles.

Cannabis oils can also be applied sublingually, but they can also be vaped or added to food. Cannabis oils are made by extracting cannabinoids from the cannabis flower, most often through the process of CO2 supercritical extraction in medical products.

Topicals

Topicals are a relatively new application method in the medical field. They are available in various forms and can be directly applied to the affected area, providing discreet relief without the potentially intoxicating effects of alternative delivery methods.

These products offer different percentages of cannabinoids. Some are THC-dominant, others have high concentrations of CBD, and there are also balanced options available.

Are there any risks or side effects of medicinal cannabis administration for nerve pain?

Of course, as with any therapeutic option, there are potential risks and side effects. The most common side effects of medicinal cannabis use include dry mouth, dizziness, low blood pressure, and altered mood. 

It is also worth noting that medicinal cannabis has the ability to negatively interact with certain pharmaceutical medications. These include anticonvulsants, some sedative drugs, some opioids, and certain blood thinners. It is always advised to seek medical advice before you embark on any sort of therapeutic journey with medicinal cannabis, and to seek the advice of a doctor that has experience prescribing it. 

Most medicinal cannabis research is showing that, for the vast majority of patients and health conditions, medicinal cannabis offers a very high safety profile with few negative side effects. 

Medical cannabis is legal in the UK and has been since the 1st of November 2018. To access this therapeutic option legally, you must be prescribed it by a specialist doctor that has been registered to do so. 

Recreation cannabis usage is still illegal. It is a controlled substance and classified as a Class B drug.

Conclusion

Medicinal cannabis offers a gentle, safe, and effective method for managing nerve pain and the symptoms that sometimes accompany it. Although medical inquiry surrounding tthis subject is still in its infancy, medical researchers around the world are now beginning to see the potential offered by this powerful plant-based medicine, and patients are finally being offered the opportunity to try a safe, natural option when it comes to managing their chronic neuropathic pain.  

With improved access and further research, the potential benefits of medical cannabis are sure to be further realised in the near future. For now, if you suffer from nerve pain and believe medicinal cannabis could offer relief, it is important that you discuss your options with a doctor who is experienced in prescribing medicinal cannabis.  They will be able to make an informed decision on whether this treatment option is right for you, and offer the best advice on how to administer it in a safe and effective manner. 

It is essential to remember that medicinal cannabis may offer relief, but it is in no way a cure for nerve pain. As with any condition, continued treatment and maintenance of the symptoms are needed to ensure quality of life.  It is always recommended to adhere to the advice of your healthcare professional in order for you to make the most out of any therapeutic journey.

Releaf understands the importance of medical cannabis in treating various medical conditions. With our tailored monthly packages, specialist consultations for medical cannabis, and a unique medical cannabis card for protection, you can access the treatment you require without worrying about the stigma.