Background:
People with spinal cord injuries (SCI) commonly experience pain and spasticity,
but limitations of current treatments have generated interest in cannabis as a possible therapy.
Objectives:
We conducted this systematic review to: 1) examine usage patterns and reasons for
cannabinoid use, and 2) determine the treatment efficacy and safety of cannabinoid use, in people
with SCI.
Methods:
PubMed, Embase, Web of Science and Cumulative Index to Nursing and Allied Health
Literature databases were queried for keywords related to SCI and cannabinoid.
Results:
7,232 studies were screened, 34 were included in this systematic review. Though 26
studies addressed cannabinoid usage, only 8 investigated its therapeutic potential on outcomes
such as pain and spasticity. The most common usage method was smoking. Relief of pain,
spasticity and pleasure were the most common reasons for use. Statistically significant reduction
of pain and spasticity was observed with cannabinoid use in 80% and 90% of experimental studies,
respectively. However, on examination of randomized control trials (RCTs) alone, effect sizes
ranged from -0.82 to 0.83 for pain and -0.95 to 0.09 for spasticity. Cannabinoid use was associated
with fatigue and cognitive deficits.
Conclusions:
Current evidence suggests cannabinoids may reduce pain and spasticity in people
with SCI, but its effect magnitude and clinical significance is unclear. Existing information is
lacking on optimal dosage, method of use, composition and concentration of compounds. Longterm, double-blind, RCTs, assessing a wider range of outcomes should be conducted to further
understanding of the effects of cannabinoid use in people with SCI.