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How does marijuana relieve various types of pain?

C is known to relieve pain, but pain can occur for a variety of reasons that make it difficult to select the right cannabis product. Knowing which cannabinoids (eg, THC, CBD) have been used to treat various types of pain is useful information you should take with you during your next visit to the doctor.

The different types of pain can be divided into three general categories:

  • Nociceptive pain

    • 19659004] Neuropathic pain
    • Central pain (there is no firm consensus on the name for this type of pain; fibromyalgia is a common Example)

    Because each type of pain has a different origin, each type has an optimal treatment strategy

    Pain is caused by coordinated activation of brain cells. While these brain regions cause pain sensations, they can also modulate the strength of the pain signals. In some cases, you may have physical injuries (ie nociceptive pain) with no sensation of pain (imagine a car accident victim walking around painlessly in the first few moments after the accident.)

    But the opposite is also possible where you Pain in the absence of physical injury (ie, central pain) may have. This underlines the importance of factors such as mood, context and attention-to-injury in the perception of pain that can also be used for optimal cannabis-based treatment strategies.

    Cannabis and nociceptive pain

    Nociceptive pain (ie inflammatory pain) results from tissue damage. Subjectively, it is described as sharp, aching or throbbing pain that follows physical damage. If you injure yourself, the damaged tissue recruits numerous inflammatory and immune cells to repair the damage. These cells release proteins and chemicals that activate receptors on nerves that find their way into the spinal cord and up to the brain, creating a sensation of pain.

    To maintain analgesic efficacy while reducing the risk of tolerance, consideration should be given to balanced THC and CBD products for long-term pain management.

    Nociceptive pain can be weakened by reducing pain signals at the site of injury by blocking the inflammatory process itself or the signals it triggers. Another strategy is to dampen their effects as they go up the spinal cord to the brain. Cannabis can attack both of these processes for pain relief.

    The abundant cannabinoids, THC and CBD, can reduce pain at the site of injury. Both have a strong anti-inflammatory effect. The anti-inflammatory properties of THC are mainly controlled by the activation of CB2 receptors on immune cells, which attenuates the body's pain-inducing response to injury. CBD also reduces inflammation by blocking inflammatory mediators and shifting the proinflammatory type macrophage repair cells to the anti-inflammatory type. In fact, the benefits of THC and CBD for the relief of nociceptive pain in rodent models for inflammation and in human clinical trials have been well documented.

    THC can modulate pain at the level of spinal cord and brain by direct activation of CB1

    receptors indirectly by increasing opioid receptor activation (more on this in the second part of this series). CBD similarly affects pain processing by increasing the endogenous cannabinoid anandamide, which, like THC, activates CB1 receptors.

    CBD also has a number of targets beyond the endogenous cannabinoid system (ECS) that can relieve pain. Of particular relevance, CBD enhances the activity of receptors for the brain's primary inhibitory neurotransmitter, GABA. This inhibitory effect allows CBD to attenuate pain signals as they enter the brain.

    If you feel good, focus less on the things that hurt. Having a positive mood not only shifts your attention away from the things that bother you, it can also directly reduce the amount of pain signals that reach your brain. It is a mind-over-matter phenomenon and can be strong at least initially when it comes to pain.

    Over time, it becomes more difficult to achieve the positive feelings of cannabis use and to weaken its pain relief effects. This is the consequence of tolerance to THCs activation of CB1 receptors, which can be alleviated by CBD. To maintain the analgesic effect while reducing the tolerance risk, balanced THC and CBD products should be considered for long-term pain management.

    CBD can also improve mood by activating serotonin receptors that reduce anxiety and stress. Since depression and anxiety are common in chronic pain, the mood-enhancing effect of CBD is a valuable adjunct in pain therapy.

    Cannabis and neuropathic pain

    Neuropathic pain is distinct from nociceptive pain caused by damage to the nervous system body. And it's pretty common. Neuropathic pain affects 7-10% of the population and can be caused by severe injury, entrapment, or stab wounds that damage the nerves. Illness is also a common cause of neuropathic pain. For example, in multiple sclerosis, the isolation of nerve cells collapses, leading to neuropathic pain. Other diseases that cause neuropathic pain are Parkinson's disease, HIV, diabetes, and shingles, just to name a few. Chemotherapy is another common cause of neuropathic pain due to its destructive effect on many types of cells in the body.

    As with nociceptive pain, overactivation of CB1 receptors with THC may lead to weaker effects. Therefore, balanced cannabis of THC and CBD would be more effective in the long term.

    Neuropathic pain is known to be difficult to treat as it does not result from inflammation targeted by non-steroidal anti-inflammatory drugs such as ibuprofen. Whether disease, amputation or chemotherapy, many are turning to cannabis for the treatment of chronic neuropathic pain. Cannabis is proving to be a promising treatment option, and its benefits have been observed in both cancers and non-cancerous forms of neuropathic pain in rodent models and human clinical trials.

    CBD-rich cannabis protects against the development of chemotherapy-induced pain through activation of serotonin receptors. Importantly, CBD protects without compromising the effectiveness of the chemotherapeutic agent to destroy the cancer, making it a potentially promising prophylactic strategy for chemotherapy patients.

    Sciatica is an example of a non-chemotherapy type of pain in which there is a pinching of the sciatic nerve, which causes low back and leg pain. In sciatica, there is an increase in CB1 receptors that, when activated, reduce pain. The common benefits of activating CB1 receptors in both chemotherapy and non-chemotherapeutic neuropathic pain suggest that cannabis may relieve neuropathic pain by weakening the strength of spinal cord pain signals and their processing in the brain. As with nociceptive pain, overactivation of CB1 receptors with THC can lead to weaker effects. Therefore, balanced cannabis of THC and CBD would be more effective in the long term.

    Cannabis and central pain

    Central pain has recently emerged as a generic term for types of pain resulting from nervous system disorders. While sometimes central pain can result from injury, it often arises in the absence of a known cause. As a result, it can be particularly difficult to treat. Fibromyalgia is a classic example of central pain that arises from dysfunction, in which pain signals find their way to the brain and are processed. Like other types of central pain, the origin of fibromyalgia is largely unknown.

    Because of the variety of central pains, there are only a few studies that investigate the benefits of cannabis in this category of pain. However, the most established benefits of cannabis in the treatment of central pain are fibromyalgia. In a study of 26 fibromyalgia patients, all reported a benefit from cannabis use and half of their other medications. This suggests that cannabis may provide much needed relief for patients with fibromyalgia and possibly other central pain conditions of unknown origin.

    Research Results

    More and more studies show that cannabis is an effective pain treatment with fewer side effects than many alternatives. However, some reports still claim only "weak" evidence of the analgesic effects of cannabis. Some of these adverse effects may be due to the use of high THC and low CBD cannabis strains, which are known to cause adverse side effects and weaken efficacy with tolerance development.

    While High THC Products May Be Effective Pain Initially, they are not an optimal pain relief strategy. Instead, consider balanced THC / CBD products or CBD-rich products as these may provide better long-term treatment for chronic pain conditions.

    Lead image: George Rudy / iStock

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