Cannabis Use and Low-Back Pain: A Systematic Review

First, Lucas; Douglas, William; Habibi, Behnum; Singh, Jaspal; Sein, Michael

doi:10.1089/can.2019.0077

Cited by 25 publications

(16 citation statements)

References 16 publications

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“…First et al reviewed 124 research papers and noted a sparsity of information regarding the effect of cannabis therapy on LBP symptomatology. 22 Only a few studies have investigated the effects of medical CB therapy directly on chronic LBP (including our previous studies). 12,23 Our results also indicated that THC-rich smokedcannabis inflorescence was more effective than CBDrich cannabis-extracts for inducing symptom relief in LBP.…”

Section: Discussionmentioning

confidence: 99%

Comparing Sublingual and Inhaled Cannabis Therapies for Low Back Pain: An Observational Open-Label Study

Robinson¹,

Ritter²,

Yassin³

2022

Rambam Maimonides Med J

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Background and Objective: Medical cannabis is becoming an acceptable treatment modality in medicine, especially for pain relief. Concurrently, cannabis use is becoming more prevalent worldwide, a public demand-driven trend despite the lack of established scientific basis. This observational open-label study sought to investigate the effectiveness of cannabis therapy for alleviating low back pain symptoms. Methods: Two types of cannabis treatment modalities were sequentially administered to chronic low back pain patients. After an initial 1-month washout period (WO1), the first modality was cannabidiol (CBD)-rich sublingual extract treatment administered for 10 months. Following another washout period, the second modality, Δ⁹-tetrahydrocannabinol (THC)-rich smoked inflorescence (whole dried cannabis flowers) was administered for 12 months. Results: Enrolled in the study were 24 patients whose advanced imaging studies (i.e. computerized tomography or magnetic resonance imaging of the lumbar spine) revealed disc herniation or spinal stenosis. Three patients dropped out of extract therapy treatment but resumed study participation to receive THC-rich smoking therapy. After a minimum of 2 years, cannabis therapy had reduced lower back pain symptoms, as assessed by Oswestry Disability Index, the SF-12 patient-reported outcome questionnaire, and the visual analogue scale. Pain reduction was not significant during the extract treatment part of the study; however, pain reduction was significant during the inhaled therapy part of the study. Conclusions: Our findings indicate that inhaled THC-rich therapy is more effective than CBD-rich sublingual extract therapy for treating low back pain and that cannabis therapy is safe and effective for chronic low back pain.

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Section: Discussionmentioning

confidence: 99%

Comparing Sublingual and Inhaled Cannabis Therapies for Low Back Pain: An Observational Open-Label Study

Robinson¹,

Ritter²,

Yassin³

2022

Rambam Maimonides Med J

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“…In the design of future research, multiple factors should be considered, including minimal clinically important difference, placebo-controlled studies, appropriate blinding protocols, and relevant outcome measures [ 60 ]. For trials of neuropathic pain, pain relief scales, patient and physician global impression of change, proportion of respondents (50% and 30% pain relief), validated neuropathic pain quality measures, and assessment of sleep, state mood, functional capacity, and quality of life have also been recommended [ 61 ], as well as functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review on Cannabinoids for Neuropathic Pain Administered by Routes Other than Oral or Inhalation

Quintero

Pulido

Giraldo

et al. 2022

Plants

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The use of cannabis and cannabinoid products for the treatment of neuropathic pain is a growing area of research. This type of pain has a high prevalence, limited response to available therapies and high social and economic costs. Systemic cannabinoid-based therapies have shown some unwanted side effects. Alternative routes of administration in the treatment of neuropathic pain may provide better acceptance for the treatment of multiple pathologies associated with neuropathic pain. To examine the efficacy, tolerability, and safety of cannabinoids (individualized formulations, phytocannabinoids, and synthetics) administered by routes other than oral or inhalation compared to placebo and/or conventional medications in the management of neuropathic pain. This systematic review of the literature reveals a lack of clinical research investigating cannabis by routes other than oral and inhalation as a potential treatment for neuropathic pain and highlights the need for further investigation with well-designed clinical trials. There is a significant lack of evidence indicating that cannabinoids administered by routes other than oral or inhaled may be an effective alternative, with better tolerance and safety in the treatment of neuropathic pain. Higher quality, long-term, randomized controlled trials are needed to examine whether cannabinoids administered by routes other than inhalation and oral routes may have a role in the treatment of neuropathic pain.

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“…Given the concerns about opioid use, many may be turning to cannabis for effect. A systematic review of 6 articles has concluded that there is a lack of primary research investigating cannabis as a potential treatment of low-back pain [58]. There were no RCTs to analyse and none of the studies directly assessed the relationship between cannabis and low-back pain.…”

Section: Back Painmentioning

confidence: 99%

Cannabis-Based Medicines and Medical Cannabis in the Treatment of Nociplastic Pain

Fitzcharles

Petzke

Tölle

et al. 2021

Drugs

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Nociplastic pain is defined as pain due to sensitization of the nervous system, without a sufficient underlying anatomical abnormality to explain the severity of pain. Nociplastic pain may be manifest in various organ systems, is often perceived as being more widespread rather than localized and is commonly associated with central nervous system symptoms of fatigue, difficulties with cognition and sleep, and other somatic symptoms; all features that contribute to considerable suffering. Exemplified by fibromyalgia, nociplastic conditions also include chronic visceral pain, chronic headaches and facial pain, and chronic musculoskeletal pain. It has been theorized that dysfunction of the endocannabinoid system may contribute to persistent pain in these conditions. As traditional treatments for chronic pain in general and nociplastic pain in particular are imperfect, there is a need to identify other treatment options. Cannabis-based medicines and medical cannabis (MC) may hold promise and have been actively promoted by the media and advocacy. The medical community must be knowledgeable of the current evidence in this regard to be able to competently advise patients. This review will briefly explain the understanding of nociplastic pain, examine the evidence for the effect of cannabinoids in these conditions, and provide simplified guidance for healthcare providers who may consider prescribing cannabinoids for these conditions.

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Cannabis Use and Low-Back Pain: A Systematic Review

Cited by 25 publications

References 16 publications

Comparing Sublingual and Inhaled Cannabis Therapies for Low Back Pain: An Observational Open-Label Study

Comparing Sublingual and Inhaled Cannabis Therapies for Low Back Pain: An Observational Open-Label Study

A Systematic Review on Cannabinoids for Neuropathic Pain Administered by Routes Other than Oral or Inhalation

Cannabis-Based Medicines and Medical Cannabis in the Treatment of Nociplastic Pain

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