Is medical cannabis effective in managing pain?

In addition to chronic pain, episodes of acute pain are an inevitable part of life. Whether resulting from injury, surgery, or medical procedures, everyone will encounter these temporary discomforts at some stage. These short-term pain issues can disrupt daily life, so effectively managing and alleviating the discomfort remains a priority for people suffering from acute pain.

And then we have neuropathic pain, also known as nerve pain. This type of pain can be experienced in regions that are typically unrelated to the underlying issue, posing challenges for accurate diagnosis and effective treatment.

Thankfully, medical cannabis is proving an effective option to help manage most types of pain. While medical cannabis research is still in the preliminary stage, there is a growing body of evidence to suggest that cannabinoid-based treatments can be an effective addition to traditional pain management solutions. Studies have also shown that it can improve quality of life, reduce opioid dependence, and improve sleep – all issues that can be caused or aggravated by pain.

In this guide, we will break down the mechanisms behind exactly how medical cannabis works to alleviate pain, provide an overview of the types of cannabis-infused treatment options available, and explain the restrictions surrounding cannabis products in the UK.

How does medical cannabis help with pain relief?

Medical cannabis works by interacting with the endocannabinoid system (ECS). The ECS is the largest receptor system in the human body. It is suspected to be the 'master regulator' of the body's homeostatic balance and controls not only pain sensations, but also mood, sleep, appetite, immunity, and sexual function, alongside a vast range of other functions.

It is made up of three main components:

• Endocannabinoids are the molecules that activate our cannabinoid receptors. They are created naturally in our bodies.
• Cannabinoid receptors are found all over the body, particularly in areas associated with pain sensations. There are two types of cannabinoid receptors – CB1 and CB2. CB1 receptors are found in the central nervous system, while CB2 receptors are located in the immune system.
• Metabolic enzymes play a crucial role in the synthesis, regulation, and breakdown of endocannabinoids. They carefully balance the levels of these compounds and efficiently break them down once their purpose is fulfilled.

The Cannabis sativa L. genus of plants also produces cannabinoids, or phytocannabinoids to be more precise. These compounds are remarkably similar in structure to our endocannabinoids, which allows them to interact with the ECS receptors and modulate the body's functions. Researchers have, so far, isolated more than 110 cannabinoids, but two take centre stage.

• THC (tetrahydrocannabinol) is the cannabinoid found in the highest concentration in most cannabis cultivars. It is the intoxicating compound in cannabis (the cannabinoid that offers the 'high' linked to recreational cannabis consumption), but it has also been shown to hold therapeutic value, including powerful analgesic properties. It interacts with CB1 receptors, which are found in high concentrations in the rostral ventromedial medulla, a pain-modulating centre of the brain. This is thought to decrease sensitivity to pain.
• CBD (cannabidiol) is the second most abundant cannabinoid found in cannabis, but it is totally non-intoxicating. It interacts with the body's CB2 receptors (along with other systems) to reduce inflammation and block pain signals from reaching the brain. In addition, it has been proven to boost levels of naturally occurring endocannabinoids in the body, reducing the breakdown of these molecules.

Medical cannabis for acute pain

When it comes to acute pain, medical cannabis can offer both short-term and long-term relief. Cannabis has been found to stop the transmission of pain signals from reaching the brain, meaning that the physical sensation is dulled. In terms of treatments, vaporised dried cannabis flower is proving to be effective for acute pain management due to the rapid onset of effects.

With that said, not all patients like the idea of inhaling their medicine. In that case, sublingual administration of cannabis tinctures and oil can be considered. Sublingual drops and sprays are taken under the tongue, an area with a large number of capillaries that absorb the cannabis molecules and transport them to the bloodstream, bypassing the liver. This gives a fast onset of effects (typically within five minutes) and has been found to reduce inflammation and pain in patients with inflammatory diseases.

Both CBD and THC have been found to be effective for pain relief in acute scenarios, but there are other factors to consider. For instance, if you're looking for something more calming or sedative, treatment options that contain a high concentration of CBD could be the best option – whereas a higher THC content could be more beneficial for those needing heavy pain relief.

Medical cannabis for chronic pain

When it comes to chronic pain, there are a variety of medical cannabis treatment options available. The most common method is through oral ingestion, typically in the form of capsules containing cannabis extracts or edibles with activated cannabinoids.

These products offer longer-lasting effects and can be dosed easily and accurately. If you’re looking to reduce inflammation and reduce the experience of pain, CBD-dominant products could be beneficial. However, if you’re looking for something that helps with muscular spasms, a THC-dominant product may be more beneficial.

Topical cannabis products are also proving to be effective for treating chronic pain when applied directly to the skin. CBD-based salves and lotions have been found to reduce pain and inflammation in localized areas, while THC-dominant creams may help relax tense muscles.

In one large scale study, two-thirds of chronic pain patients reported pain relief as the main benefit of medical cannabis application.

Medical cannabis for neuropathic pain

Neuropathic pain occurs when a health condition affects the nerves that carry sensations to your brain. Nerve pain can feel different from other kinds of pain and can be extremely challenging to treat. Medical cannabis is gaining attention for its ability to help manage this type of pain due to the interaction between cannabinoids and nerve cells in the body.

Cannabinoids have been found to reduce inflammation, block cell-signalling pathways, and dampen down activity in the brain’s pain processing centres. CBD-dominant products have been found to be particularly effective for managing neuropathic pain. Whether used alone or in combination with THC, it can alleviate chronic neuropathic pain and may provide a protective effect following nerve injury.

Is medical cannabis legal in the UK?

Yes indeed. Long overdue changes to legislation on the 1st of November 2018 allowed specialist doctors to prescribe medical cannabis products in the UK. This means that patients who qualify for medical cannabis treatment can now access legal cannabis-based treatments with a prescription from their doctor.

CBD products are available for unrestricted sale as long as they contain less than 0.2% THC, or 1 mg per container.

How to find the most effective treatment option

When starting medicinal cannabis treatment for pain management (or any serious health concern), it’s important to consult with a medical professional who has experience in prescribing medical cannabis.

With the help of a doctor, you can find out which cannabis product is right for your particular medical condition, as well as what dose and route of administration will be most effective in managing your symptoms.

Here in the UK, only specialist accredited doctors are able to prescribe medical cannabis for certain conditions, including chronic pain. If you think that medical cannabis could be beneficial for you, make sure to discuss it with your GP, and see if they are able to provide a referral to an appropriate specialist.

If you would prefer to talk to a specialist from the comfort of your own home, you can also look into medical cannabis consultation services. These services allow for specialist consultations via video call, with a registered doctor who will evaluate your case and provide a medical cannabis prescription if appropriate.

The wrap-up

As medical cannabis continues to rise in popularity, so do the rates of uptake here in the UK (and globally). Once demonised and misunderstood, cannabis is now being widely explored for its potential to treat a range of medical conditions, including pain.

Whether you’re looking to add medical cannabis to your own pain treatment regime, or know someone who could benefit from it, it’s important to consult with your doctor first and get the necessary referral for prescribed products.

Releaf is committed to helping you access the benefits of a medical cannabis service. Our monthly packages are tailored to your cannabis prescription, and we offer specialist consultations for medical cannabis and a unique medical cannabis card for protection.