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Cannabis has shown tremendous value in the treatment and management of pain for generations. Pain is the body’s way of signaling that it has been injured in some way. It is our natural protective response to let us know something is wrong. When a nerve becomes injured, its signaling system becomes muddled and the brain interprets these abnormal signals as pain. Chronic pain affects nearly one third of the American population; not only impacting their quality of life, but also costing between $560 billion and $635 billion each year in lost working hours and productivity (Nordqvist 2015).
Pain comes in different types. There are two main categories of pain, nociceptive pain and neuropathic pain. Within nociceptive pain there is visceral and somatic pain. Within neuropathic pain there is central and peripheral pain. Nociceptive pain is likely the pain that you are more familiar with, and it is the pain felt as the result of an injury like a broken bone or appendicitis. Nociceptive pain can be visceral or somatic. Visceral pain stems from the internal organs, while somatic pain comes from the skin, bones or muscles. Neuropathic pain can be either central or peripheral, but both come from changing sensitivity of the nervous system, and not necessarily from an injury itself. For example, neurons may become hypersensitive and send pain signals to the brain based on a light touch.
In chronic neuropathic pain, there is an abnormal functioning in the processing of pain, and the body becomes more sensitive to every stimulus. The nerve cells may become so sensitive that the brain perceives the lightest touch as extreme pain. The brain remembers past stimuli and relies on past experiences to help determine what each stimulus is in the future. When the brain experiences chronic and persistent pain, it changes the way every new pain feels (Rodriguez 2013).
The endocannabinoid system or ECS is a messenger system within the body that regulates a whole host of different functions and is said to be implicit in pain homeostasis (Fine 2014). Cannabinoid receptors and endocannabinoids are said to be present in pain circuits from the peripheral sensory nerve endings up to the brain (Manzanares 2006). Agonist cannabinoids bind to the receptors and stimulate the production of neurotransmitters that signal to the body. Antagonist cannabinoids do not bind to the receptors and instead block the release of neurotransmitters. CBD acts as an antagonist and is said to modulate nociceptive thresholds and inhibit the release of pro-inflammatory molecules and as such, have tremendous therapeutic value against inflammatory and neuropathic pains. Cannabinoids, such as CBD, are well known to have analgesic or pain reducing properties and have been used for the treatment of pain and sleep disorders since ancient times (Russo 2007). Current treatment of pain often includes opioids, which are powerful analgesics, but also have powerful unwanted side effects, tremendous addiction potential, and have shown little success in lessening the pain caused by neuropathy (Manzanares 2006). THC is said to have twenty times the anti-inflammatory potency of aspirin and twice that of hydrocortisone, while CBD is said to share neuroprotective effects with THC and display antioxidant activity greater than that of vitamin C or vitamin E (EB 2008).
The discovery of the ECS and its role in pain sensations in the body is causing cannabinoids to be revisited for their powerful potential as pain management pharmaceuticals. Clinical trials using CBD to lessen the painful symptoms associated with a whole variety of ailments are showing great promise, and scientists are seeing the potential of this relatively non-toxic drug for use in post-operative pain, neuropathic pain, cancer pain, fibromyalgia pain, migraine pain, and even the pain following an amputation (Manzanares 2006). New synthetic forms of cannabis are now being made to mimic the effects of THC and CBD and are showing great promise in unlocking the secrets of the ECS’s role in pain management.
EB, Russo. “Cannabinoids in the management of difficult to treat pain.” Ther Clin Risk Manag., 2008: 245-459.
Fine PG, Rosenfeld MJ. “Cannabinoids for neuropathic pain.” Curr Pain Headache Rep., 2014: 450.
J Manzanares, MD Julian, A Carrascosa. “Role of the Cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes.” Curr Neuropharmacol., 2006: 239-257.
Nordqvist, Christian. “What is pain? What causes pain?” Medical News Today, 2015: http://www.medicalnewstoday.
Rodriguez, Diana. Why do we feel pain. http://www.everydayhealth.com/
Russo EB, Guy GW, Robson PJ. “Cannabis, pain and sleep: lessons from therapeutic clinical trials of Sativex.” Chem Biodivers, 2007: 1729-43.