There seem to be many anecdotal stories of marijuana being used as a medication to treat seizures, chronic pain, and much more. Whether you are an adult, child, smoking cannabis, or using oil or edible baked goods the success stories exist with sometimes life changing results.
The risk factors have often been reported to be minimal and there has never been a death recorded as a result of overdosing on cannabis.
Over time more research has come out and shown that the medical evidence exists to be an effective treatment which verifies many of these stories. With this drug being around and engrained in our lives for so long, how can cannabis help with chronic back pain?
According to National Geographic charred seeds from marijuana were found in Siberia and can be dated back to 3000 B.C. The Chinese used this plant as medicine in the past and in America George Washington grew hemp on one of his properties. Cannabis has clearly been a part of many cultures for a very long time and been tested in recreational and medicinal capacities. This long standing history of cannabis shows that it has always been a part of society in some way or another as a medical and recreational tool.
“Millions of people are using different types of cannabis products for supposedly therapeutic purposes…”
– Ryan Vandrey – Associate professor of psychiatry and researcher of marijuana at Johns Hopkins Medicine.
Pain: An Epidemic
Approximately 20% of the world’s adult population, or 1.5 billion people, suffers from chronic pain; it is one of the top reasons people seek medical treatment and it accounts for the number one cause of disability in America. The number site for chronic pain is the back, neck and shoulders.
To put these numbers in some perspective though let’s compare afflictions in just the U.S. alone:
- Approximate number of people in the United States that suffer from chronic pain: 50 million
- Approximate number of people in the United States that suffer from diabetes: 21 million
- Approximate number of people in the United States that suffer from some form of cancer: 14 million
Causes of back pain are varied and can range from trauma and injury to natural aging or psychologically induced, while some causes of back pain, such as fibromyalgia, have an unknown etiology.
Trauma and injury related pain is straightforward, identifying the cause and the location of the pain is easy to pinpoint. Natural aging changes, such as arthritis, are easily diagnosed and have a range of treatment options, including over the counter pain relievers.
Back pain can commonly be brought about by tension, stress, anxiety, depression or any number of other mental ailments can be more difficult in terms of identifying the cause. Not only does the cause of the pain itself need to be identified, take anxiety for example, but then the root cause of the anxiety must be identified and worked to overcome, ideally with the help of a qualified therapist of some kind.
There are numerous ways that back pain can affect one’s life; no one wants to live in constant pain. It is rather difficult to heal as the back is in constant motion, all parts of the body move through the back making walking difficult, sitting or standing uncomfortable and even cause sleep to be illusive.
There are also numerous options for the treatment of pain; but, how does one decide when to seek medical advice? What kind of treatment depends on the site and origin of the pain; so then, how does one decide what treatment is the best for them?
Opioids – does it provide the most relief?
Recent years have seen a sharp increase in opioid use and abuse. Opioids are an oft-prescribed form of treatment for severe or chronic pain as they are thought to provide the most relief to a large number of patients with various types and degrees of chronic pain.
They are, however, highly addictive due to easily acquired tolerance and, following cessation, come with a difficult road to recovery. It is hard to know if opioids are being prescribed for chronic pain when a patient fills the prescription and they are also widely ILLEGALLY used. Taking both of these facts into account, one can not specifically say that chronic pain is driving the “opioid epidemic”.
Interestingly, however, only 23% of those with chronic pain in the United States found opioids to be effective in relieving pain per thegoodbody.com. More research must be done on the best methods of treatment, integration of other forms of treatment in combination with opioids, cooperation of all healthcare fields etc.
Enter Cannabis, the controversial cure for what ails you
The Research Behind Cannabis
Results of an ABC News poll in the USA show that of the 50 million people that suffer, chronic pain only about 12 million have utilized cannabis in attempts to treat it (ABC News et al 2005).
In the US alone 29 states have legalized the medical use of cannabis and around the world at least 27 countries have done the same. Some countries and states have also decriminalized the possession of marijuana for self-use.
Marijuana contains of over 100 different chemicals but the two used for medicinal purposes are the Tetrahydrocannabinol, or THC, and Cannabidiol, or CBD.
THC is the component of recreational marijuana that causes one to get high, however both of these have been shown to have analgesic – pain relieving – properties. Many patients with some form of neuropathic pain such as: multiple sclerosis, rheumatoid arthritis, pain caused by cancer, menstrual pain or headaches, to name a few, have found some relief.
Patients with degenerative disc disease of the spine find a decrease in back pain because of the anti inflammatory effects of cannabis.
According to WebMD, and several other sites, side effects of THC and CBD could include dizziness, drowsiness, confusion, the possibility of worsening some mental illnesses such as depression and can, like cigarettes, cause some lung damage.
Cognitive effects of cannabis, however, have been reviewed (Russo et al 2002; Fride and Russo 2006), but less study has occurred in therapeutic contexts. Effects of chronic heavy recreational cannabis usage on memory abate without sequelae after a few weeks of abstinence (Pope et al 2001)
Several clinical trials have been performed, and can be searched on the internet if one wishes to read more, but some of the findings include these two drugs: Sativex and Marinol.
In an article entitled: Cannabinoids in the Management of Difficult to Treat Pain via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503660/
“The vast majority of subjects in Sativex clinical trials do not experience psychotropic effects outside of initial dose titration intervals and most often report subjective intoxication levels on visual analogue scales that are indistinguishable from placebo, in the single digits out of 100 (Wade et al 2006). Thus, it is no longer tenable to claim that psychoactive effects are a necessary prerequisite to symptom relief in the therapeutic setting with a standardized intermediate onset cannabis-based preparation. Intoxication has remained a persistent issue in Marinol usage (Calhoun et al 1998), in contrast.”
“In the United Kingdom, Sativex, overall, appears to pose less risk of dependency than smoked cannabis based on its slower onset, lower dosage utilized in therapy, almost total absence of intoxication in regular usage, and minimal withdrawal symptomatology even after chronic administration. No known abuse or diversion incidents have been reported with Sativex to date (as of November 2007) and it is expected to be placed in Schedule IV of the Misuse of Drugs Act in the United Kingdom once approved.”
Research is, however, rather new in this field and as such has kept the Food and Drug Administration, or FDA, from approving the medicinal use of cannabis and as of now the Drug Enforcement Agency, or DEA, still considers Marijuana as a class I drug, in the same category as heroin or PCP!
One of the largest issues surrounding medical marijuana is the lack of “information about which types of products to choose, what doses to use, and how cannabis compares to other medications,” according to Ryan Vandrey, associate professor of psychiatry and researcher of marijuana at Johns Hopkins Medicine.
A product purchased in a dispensary in California is going to be very different from a product purchased in a different dispensary in a different state; and neither will be the same as the Cannabinoid form of the drug designed to alleviate back pain. “All of these substances fall under the cannabis umbrella, but depending on their specific cannabinoid content and the means through which they are ingested, they’re going to have different effects” says Vandrey
Other reasons behind the controversy of legalizing marijuana for any type of use, are:
- It would lead to increased accidents, injuries or fatalities if driving while high,
- Teens would be able to get it easily and that it may be a gateway drug – paving the way to more dangerous drugs.
The bottom line is that more research on all fronts must be done.
Forms Of Medical Cannabis
- Inhale – There are a number of ways Cannabis can be inhaled, some of which are stated below, but of course the most well known is to smoke it.
- Edibles – Most people are familiar with the idea of “special brownies” but using Cannabis in many different food types, even spaghetti sauce, has been proven effective as well.
- Herbal Tea – Cannabis infused tea has a longer lasting effect than inhalation. One might maintain relief of back pain for several hours before it wears off. This will of course depend on body mass and metabolism but presents a more gentle approach and can be used by a wide array of patients.
- Liquid sublingual – The benefits of this method are that it filters straight to the bloodstream making it fast acting. Many pain sufferers rely on quick pain relief methods to maintain a quality of life that is manageable.
- Oils – Oils are extremely versatile; they may be inhaled via a pipe or put in a vaporizer, added to foods or even put directly on the skin. Choosing a method would depend on how quickly one needs relief.
- Gum – This product is very new and is still in trial stages but it is said to deliver pain relief much more rapidly than smoking “as it bypasses the liver” and goes directly to the bloodstream. It is also more socially acceptable. See healthy-life-box.com and search for Marijuana chewing gum.
- Butter/Cooking Oils – Parts of the cannabis plant may be simmered with either butter or cooking oil making allowing the THC to saturate them. They may then be used in whatever form of baking one desires. This is great for patients that can not or choose not to inhale it or use a vaporizer.
- Vaporizer – Heating the Cannabis until it creates a fine mist to be inhaled. Many prefer this to inhalation via smoking.
The Future of Cannabis
As time ticks by and as researchers begin to roll out their test results and clinical findings regarding medical marijuana, more forms or methods of use will be found. For now these seem to be the most common, or at least the up-and-comers.
All of them have been shown to provide some degree of chronic pain relief from head to toe, back pain most definitely included.
Whether one agrees with legalization or not what would this world be without research outside the box or outside the comfort zone? THAT is how innovations are made, discoveries happen and who knows, it might possibly be the step we need to decrease or eradicate the pain epidemic around the world!
Is cannabis the answer to your back pain? Most likely not, but it can help and the evidence behind cannabis as a treatment option is growing. A combination of treatments such as stretching and strengthening, movement, drug therapy, and daily activities all influence your back pain and should all influence your back staying healthy. It is impossible to rely on one solution for a problem that has multiple causes. Knowing this, when healthcare is sought out in regards to a back pain patients should discuss all options with their doctor and see what fits within their care plan.
With that in mind, relying solely on traditional methods of treatment may not be the only way to manage your back pain. As more people experience back pain there will be the need for new interventions to help them, including cannabis.
The many effects of cannabis and the relatively low side effects make it a great option for some individuals. However, it should be discussed with your primary care provider to make sure that the treatments you are receiving to do interfere with each other and make your situation worse.
Above all, if you are considering using cannabis to help your back pain know that it is treating the symptoms and not actually fixing your back pain. Most back pain is resolved in six weeks or less because those patients see providers who work with your pain and your body to enhance its capacity to endure load. The reason why injury occurs is that the load is greater than the body’s capacity and the muscle, joint, ligament, tendon cannot respond accordingly. In order to restore full function and prevent further or future injury the capacity to respond to load must be enhanced through strengthening and stretching muscle, ligaments, tendons and joints.