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Medicinal cannabis and neuropathic pain: What does the research say?

by | Oct 15, 2020

Neuropathic pain reduces quality of life and is difficult to treat, but studies are finding that medicinal cannabis may help to provide relief.

Patients with neuropathic pain often experience burning, shooting, stabbing or electric sensations that can be constant, in response to triggers, or completely random.

Untreated or under-treated it can lead to psychological issues, sleep problems, difficulty with participating in everyday life, and often a deep sense of frustration and helplessness.

If you’re living with chronic nerve pain (or know someone who is), you’ll be familiar with the challenges of managing the condition.

Treatments are relatively ineffective. You may experience adverse effects from commonly prescribed drugs. And most medicines reduce, rather than eliminate, pain.

If you’re struggling to find effective treatment for neuropathic pain, you may want to ask your doctor about medicinal cannabis.

Recent clinical trials have found that both THC and CBD — the main therapeutic compounds in cannabis — help to reduce neuropathic pain in patients with a wide range of conditions, including peripheral neuropathy, fibromialgia, multiple sclerosis, spinal cord injury, and post-surgical nerve pain.

In New Zealand and Australia, chronic pain is the main condition for which patients are getting medicinal cannabis prescriptions.

The data suggests that patients are actively seeking medical cannabis for pain management and doctors are open to prescribing it.


What is neuropathic pain?

Neuropathic pain, also known as neuropathy, is a catch-all term for pain caused by damage to the nervous system.

It occurs when damaged or dysfunctional nerves send false signals to pain centres in the brain.

Neuropathic pain may result from disorders of the peripheral nervous system or the central nervous system (brain and spinal cord).

There are more than 100 types of peripheral neuropathy, each with its own set of symptoms, including:

  • numbness and tingling in the feet or hands
  • burning, stabbing or shooting pain in affected areas
  • loss of balance and coordination
  • muscle weakness, especially in the feet

There are a range of causes of neuropathic pain including alcoholism, diabetes, surgery, multiple sclerosis, stroke, cancer and chemotherapy.

But the root cause can be difficult to determine and, therefore, difficult to manage.

It’s estimated that 7% of people are affected by neuropathic pain.

This number is expected to rise with the ageing population, increased cancer survival rates and chemotherapy-induced neuropathy, and an increased prevalence of diabetic neuropathy.


Treatments for neuropathic pain

Because of the complexity of the nervous system, neuropathy can be hard to treat.

The first-line treatments for neuropathic pain include antidepressants, anticonvulsants, opioids, and anti-seizure drugs.

However, these treatments are relatively ineffective and come with significant side effects.

While some patients can be easily treated and, in rare cases, cured, others can only hope to manage the symptoms and prevent further nerve damage.


Medicinal cannabis for neuropathic pain

Cannabis and neuropathic pain: What does the research say?

Cannabis is emerging as a potentially effective treatment for neuropathic pain.

Recent clinical trials have looked at the efficacy of cannabis in neuropathic pain-related conditions.

In all of the published clinical trials, subjects reported reduced pain after consuming cannabis, sometimes lasting for several hours.

In some cases, subjects also reported improved sleep quality and ability.

The trials experimented with various amounts of CBD and THC, as well as different consumption methods, including vaporising, oil and mouth spray.

A 2009 review concluded that “cannabinoids show promise for treatment of neuropathic pain in humans either alone or as an add-on to other therapeutic agents”.

A more recent review in 2018 said: “There is a lack of good evidence that any cannabis-derived product works for any chronic neuropathic pain.”

Ora Pharm Medical and Research Officer, Dr Roger Negrete, says the results in support of the therapeutic value of medicinal cannabis for neuropathic pain management are “promising”, but further research is needed to draw definitive conclusions.

“Together, as scientific evidence increases, societal perceptions change, and legislation relaxes, the use of medical cannabis for neuropathic pain must be taken into consideration.”

While the results of early clinical trials are promising, the science is far from conclusive and more research is needed.

However, this hasn’t stopped patients from seeking medical cannabis for neuropathic pain nor doctors from prescribing it.

There’s plenty of anecdotal evidence that suggests that medicinal cannabis can be life-changing for some people with neuropathic pain.

If you think medicinal cannabis could be helpful for you, or you’re interested in trying it, you can ask your doctor about getting a prescription.

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