Using Medical Cannabis for Different Types of Pain

Original Author: Josh Kaplan

Date: March 4, 2019

Both medical professionals and the general public have long known that medical cannabis can be effective in managing pain, including chronic pain. However, few realize that not every type of cannabis or cannabis product is equally effective for all types of pain. In fact, certain cannabinoids and terpenes may be more effective for specific pain sources, while in other cases, they may have little effect or even worsen the situation.

Types of Pain

• Nociceptive or Inflammatory Pain
• Neuropathic Pain
• Central Nervous System (CNS) Pain (including symptoms not fitting the other categories, such as pain from arthritis or fibromyalgia)

Each category includes conditions with a specific source of pain, which can often be managed using similar therapeutic approaches. Pain itself is a result of a chain reaction in the nervous system, designed to draw attention to a potentially dangerous stimulus. Because of this, one type of pain can sometimes transition into another.

Generally, each pain type is associated with certain triggers. For example, inflammatory pain usually results from physical injury, while CNS and neuropathic pain are often linked to internal dysfunctions. Many biological factors, from body chemistry at the time of injury to psychological resilience, can influence the intensity and duration of pain.

Medical Cannabis for Inflammatory Pain

Nociceptive (inflammatory) pain is the body’s response to tissue damage. This type of pain is often accompanied by swelling and a sharp, sometimes throbbing sensation, caused by immune cells releasing enzymes and toxins to fight off foreign invaders. These substances activate nerve endings, which then send pain signals to the brain and spinal cord.

This type of pain is often the easiest to manage with cannabinoids. Cannabis’s main cannabinoids—CBD and THC—can reduce inflammatory pain by both decreasing nerve sensitivity and blocking the release of inflammatory substances. THC, even at low doses, can significantly reduce pain at the injury site by blocking CB2 receptors, slowing the transmission of pain signals. CBD, on the other hand, influences immune cells to switch from releasing toxins to repairing tissue. In other words, using cannabis with balanced THC and CBD not only reduces pain but also addresses the inflammation itself.

Research has shown that cannabinoids are effective anti-inflammatory and pain-relieving agents in both animals and humans. THC also activates CB1 receptors in the brain, which are linked to the release of the body’s own opioids, further reducing pain. CBD increases the production of anandamide, an endocannabinoid that also activates CB1, modulating pain perception. Additionally, CBD directly activates GABA receptors in the brain, which slows down the transmission of pain signals.

Some experts believe that the overall sedative effect of THC and CBD on the nervous system is a key reason for cannabis’s effectiveness in treating inflammatory pain. This may also be related to CBD’s ability to boost serotonin production, improving mood and reducing stress, which can make pain feel less intense.

However, cannabis’s effectiveness has its limits. Frequent use can lead to tolerance, reducing the sensitivity of CB1 receptors. This can be managed by taking breaks from cannabis or by using products with higher CBD content, which may have a stronger sedative effect but help restore CB1 sensitivity. Using moderate doses and maintaining a balanced THC:CBD ratio can help prevent significant tolerance. Whole-plant products, such as flower or full-spectrum extracts, may enhance therapeutic effects due to the synergy between cannabinoids and terpenes.

Medical Cannabis for Neuropathic Pain

Neuropathic pain is different from inflammatory pain because the problem lies within the nerves themselves. While less common, affecting about 7–10% of the global population, neuropathic pain is often associated with serious chronic illnesses like multiple sclerosis, Parkinson’s disease, advanced diabetes, HIV, and some skin conditions. It can also be a side effect of chemotherapy, which damages healthy nerve tissue along with cancer cells.

Neuropathic pain is harder to treat than inflammatory pain, and even strong opioids may not be effective. However, cannabinoids—especially CBD—have shown promise in managing neuropathic pain in both cancer and non-cancer conditions, as demonstrated in numerous studies involving both animals and humans.

Some researchers believe CBD’s effectiveness may be due to its ability to increase serotonin production, which has a neuroprotective effect on nerves. Other studies suggest that neuropathic pain may be linked to increased CB1 receptor density around the pain site, making cannabinoids more effective in these areas. However, high doses of THC can sometimes worsen neuropathic pain, so products with higher CBD and lower THC, or balanced ratios, are generally recommended for this type of pain.

Medical Cannabis for Central Nervous System (CNS) Pain

While CNS pain may seem similar to neuropathic pain, there are key differences. Neuropathic pain is usually a symptom of nerve disease or injury, while CNS pain often occurs without any obvious cause, possibly due to general nervous system dysfunction or age-related changes. Fibromyalgia is a classic example, causing chronic pain without inflammation or nerve damage. The exact cause of CNS pain is still not well understood.

Because CNS pain is not universally recognized, there is limited research on treating it with cannabis. However, some small studies suggest that a balanced mix of THC and CBD can significantly reduce CNS pain, with some patients able to stop using other painkillers altogether. While more research is needed, these early results are promising.

Key Takeaways

• Research supporting the effectiveness of medical cannabis for various types of pain continues to grow.
• Negative effects, such as increased pain, are usually linked to products with very high THC and low CBD, or high doses of isolated cannabinoids.
• Unlike opioids and many pharmaceuticals, cannabis has fewer and less severe side effects.
• THC provides strong, rapid pain relief, especially for inflammatory pain, but may be less effective or even counterproductive for other types.
• For most pain types, a balanced THC:CBD ratio or higher CBD content is recommended for longer-lasting, more universal relief.

For more information, visit the original source at Leafly.