5 minute read
NEUROPATHIC PAIN
BY BEN OWENS
Pain is a familiar sensation to most of us that involves some sort of outside stimuli and a sharp, burning, or throbbing sensation. For those living with neuropathic pain, this experience can happen at any time, regardless of stimuli, or may not happen at all, even when stimulated. Neuropathic pain is the result of damage to the body’s nerves that inhibits or aggravates our pain experiences. Typical neuropathy treatments involve a variety of drug classes which cannabis may have the ability to minimize and replace. Science is beginning to validate patient anecdotes about efficacy and add substance to the idea that cannabis and cannabinoids can be an alternative to conventional medical treatments for neuropathic pain.
Neuropathic pain is pain specific to the nervous system that may be triggered by a variety or lack of stimuli. Most commonly, neuropathic pain is the sensation of pain without a physical trigger, such as feeling a burning sensation but not being subjected to an external heat source. Usually chronic in nature, neuropathic pain does not have a rapid onset or predictable cadence, waxing and waning throughout the day. This form of nerve-based pain is often the result of nerve damage or a malfunctioning nervous system that impairs the body’s ability to transmit sensory information, resulting in numbness when there should be sensation and sensation when there isn’t anything to sense. 1,2
As mentioned, neuropathic pain is caused by damaged or malfunctioning nerves. This damage can create the sensation of pain at the site of the damage or can result in sensations felt elsewhere on the body whose nerve signals may be impeded or blocked. This is often described as a shooting, burning pain or tingling numbness. Our nervous system is made up of our spine, brain, and a variety of nerve receptors found throughout the body. Damage to this system caused by accidents, strokes, or physical trauma can result in neuropathic pain. Additionally, diabetes, alcoholism, cancer, infections and nerve-related diseases may lead to neuropathic pain. 1,2
For those suffering from chronic episodes of neuropathic pain, one of the most common treatments is the use of an anticonvulsant or an antidepressant. Additionally, pain killers such as non-steroidal anti-inflammatory drugs (NSAIDs) may also be suggested. 1 If the pain is a result of a disease such as alcoholism, cancer, or diabetes, attempts may be made to better manage the underlying cause of the pain before treating for additional symptoms. In extreme cases, surgery involving implants and electric stimulation may be used. 1,2
Due to the variety of causes of neuropathic pain, it can be hard to treat all of the symptoms and sensations with one cure-all treatment. While conventional treatments may work for others, some require extreme measures to relieve their pain. Cannabis has been shown to have anticonvulsant, antidepressant, and anti-inflammatory properties, which suggests that it could be an effective supplemental or replacement treatment option for those living with chronic neuropathic pain. Studies are beginning to show cannabinoids such as THC present unique opportunities for alternative treatment minimizing the need for pharmaceuticals and surgery.
Thanks to the FDA’s approval of a specific CBD option for epilepsy, we have seen an upswing in studies focused on conclusive evidence that CBD, and potentially other cannabinoids, possess anticonvulsant properties. 3 Studies have gone so far as to examine CBD’s role in neurotherapeutics for epilepsy and other conditions, finding CBD to be an effective anticonvulsant. 4 In addition to being an anticonvulsant, cannabis has also been shown to possess antidepressant properties, and literature suggests that if observations are true and replicable, that cannabis is already being used widely "to “self treat” depressive symptoms.” 5 Cannabinoids such as ∆9-THC, ∆8-THC, CBG and CBD have been confirmed to "exhibit antidepressant-like actions [on the brain].” 6 To top it off, cannabinoids and terpenes found in cannabis have anti-inflammatory properties that make the effective at treating inflammatory disorders and symptoms. 7,8
Based on these studies alone, cannabis presents itself as a natural alternative to all three categories of prescribed pharmaceuticals upon which conventional treatment lies.
Studies are backing up this deduction. Results from randomized controlled trials (RCTs) evaluating medical cannabis for the treatment of neuropathic pain indicate that is “as tolerable and effective as current neuropathic agents.” 9 The majority of studies on cannabis as an effective treatment option demonstrate "improved pain from inhaled cannabis”, particularly with peripheral neuropathy resulting from damage to the body’s ability to send and receive nerve signals. 10 Multiple meta-analyses of currently available research have concluded that cannabis can be an effective treatment option for neuropathic pain in a variety of cases. Almost all studies urge caution regarding proper dosage and the lack of knowledge surrounding long-term use of cannabis. 9,10,11,12,14 Additionally, due to concerns over the safety of inhaling combusted, smoked cannabis, studies have also looked into the efficacy of vaporized cannabis and found vaporized cannabis in low doses minimized psychoactive effects while offering “an effective option for patients with treatment-resistant neuropathic pain.” 13
While cannabis has shown promising results as an option for the treatment of neuropathic pain, it is important to speak with someone that is knowledgeable about your specific case. If you’re considering cannabis as an alternative or supplement to your existing treatment routine, talk to your doctor about this decision and ask for recommendations. Your doctor may feel CBD or THC specifically may be best and offer recommendations of products that can be trusted. If you live in a state with medical or adult-use cannabis, consider visiting one of your local shops and talking with staff who can advise you on what other patients with similar needs found helpful. As many studies mentioned, serving sizes are incredibly important; start low and go slow; you can always consume more as needed.
