The vast majority of medical marijuana remains federally illegal and unrecognized by the Federal Drug Administration (FDA), – except for Epidiolex – but as research has expanded and some states have implemented limited medical programs, the effects of cannabis for medical purposes are becoming more widely known. The field is complex and knowledge is slow-coming because of legal issues, but it's important to remember that it goes beyond just, "Does marijuana have medical benefits?" There are different types of marijuana and different types of pain; one of the most basic is nociceptive pain, and marijuana is believed to have a known effect.
What is Nociceptive Pain?
There are three types of physical pain that one feels: nociceptive pain, neuropathic pain, and centralized pain. Nociceptive pain is the most common; it is the pain that comes with breaks, burns, bruises, and the like. It usually includes sharp, throbbing, or aching pain. Certain receptors called nociceptors serve the purpose of alerting people when their bodies are harmed, detecting physical, chemical, and thermal damage. The nociceptors send electrical impulse signals to the brain when activated, working through the nervous system to inform the brain of injury.
There are few types of nociceptive pain, including radicular pain and somatic pain. Radicular pain is felt when the roots of nerves are irritated, and it is mostly focused around the arms or legs and through the spinal cord. An example might be a pinched nerve.
Somatic pain is focused in the tissues, as in skin, muscles, or bones. Pain receptors there are activated and send signals to the brain. A cut or a headache might lead to somatic pain.
Treating Nociceptive Pain with Cannabis
A variety of treatments are available for nociceptive pain; it largely depends on the length and intensity of the pain, as well as what structures in the body are causing the pain. With intense nociceptive pain, the goal is to reduce the pain signals being sent from the injury site where inflammatory and immune cells are attempting to repair the damage.
The tetrahydrocannabinol (THC) and cannabidiol (CBD) properties in marijuana can reduce this nociceptive pain. They have strong anti-inflammatory power. THC activates CB2 receptors in immune cells that weaken the pain response to injuries, and CBD has the ability to change pro-inflammatory cells to anti-inflammatory cells. It appears to spark both a physical and mental effect, as it actually can affect pain receptors and also just lead to a better mood, and then there's a mind-over-matter effect, as well.
Cannabis is rarely the first drug that someone takes to ease nociceptive pain, as more accessible substances like nonsteroidal anti-inflammatory drugs (NSAIDs) can help with inflammation, as well. NSAIDs are a good option for daily use. Substances like alcohol, tobacco, and opioids are also proven to help fight nociceptive pain, and while they vary in efficacy and intensity, because of their addictive properties – especially in the case of opioids—they are obviously not recommended as treatments.
As cannabis is researched as a method of treating pain, it is sometimes lumped into these categories, though, making it difficult for companies and doctors to endorse. While studies have been done and continue to run, currently, according to "Cannabis and Pain: A Clinical Review," "Of note, long-term studies of analgesia with exogenous cannabinoids would be necessary to adjudicate the question of whether pain could be continually suppressed in this manner, or whether the same hyperalgesic response to cannabinoids that is currently observed with opioids would ensue." In short, cannabis is a risky pain treatment because it often has subjective results that are difficult to predict in the long term.
After some time, the positive effects of consuming cannabis may weaken, and it may become less adept at lessening nociceptive pain. To avoid building up a tolerance, it is important to have medical cannabis use regulated by a licensed physician and to thoroughly understand how things like THC and CBD may affect the body.
Which Strains Best Help with Nociceptive Pain?
As alluded to above, it is important to be well-educated about medical cannabis use, as there are different strains with different levels of THC and CBD and different effects. Marijuana plants may be Cannabis indica, Cannabis sativa, or a hybrid. Research has shown that indica strains are best for pain management, especially for treating things like migraines, joint pain, and the like. Sativa strains are known to improve energy and mood, which may also help deal with symptoms of intense pain.
Overall, it comes down to dosage in order to maximize the potential power of cannabis. Be sure to consult a professional and appropriately regulate your cannabis use as a pain-reliever.