Due to lifestyle and habit changes, people these days are becoming more prone to a variety of physiological illnesses. One such example is back pain. In America alone, over 80% of the population experiences an episode of lower back pain at any given time. It may be brought upon by muscle strain, improper lifting, bad posture, being overweight, other diseases, or lack of exercise.
While there is a plethora of over-the-counter medicine for back pain such as Nonsteroidal Anti-inflammatory Drugs (NSAIDs), Acetaminophen, and opioids, these synthetic drugs also come with a long list of side effects. Some of these are nausea, stomach pain, and ulcers. When taken in high doses, NSAIDs can lead to kidney problems, fluid retention, and high blood pressure. There is also an increased risk of side effects for older adults which is ironic because older adults are the ones who are more prone to back pain.
Fortunately, some people found reprieve in natural remedies such as cannabis. Although it is widely known for its psychoactive properties, some people consume it not to induce a psychedelic high but instead, to manage pain. The medicinal properties of the herb have been celebrated and sought after for centuries now. Be it a simple health issue or a complicated one, anecdotal reports and clinical research have proven the efficacy of the plant in pain management.
Types Of Back Pain
Back pain is among the most common reasons why people seek medical care. It can range from a chronic, dull ache to a sharp, debilitating pain that interferes with day to day activities.
Also referred to as axial pain, this is the most common cause of lower back pain. The pain mainly originates from problems in ligaments, muscles, spinal bones, and joints. Noticeably, the pain is often localized in lower areas such as buttocks, lower back or the top of legs.
This type of back pain occurs when the spinal nerve root becomes inflamed or impinged. Pain radiating down to the leg or buttocks, or nerve root patterns may be felt. Radicular pain has a distinct sensation – an electric, sharp and burning type of pain, sometimes accompanied by weakness or numbness. There is a considerable chance that this pain will only be felt on one side of the body.
Radicular pain can be further categorized into two types: nociceptive and neuropathic pain.
Nociceptive pain is usually acute, and it develops in response to a specific situation. It tends to ease away as the affected body part heals. For instance, nociceptive pain due to a sprained ankle gets better as the ankle heals.
Nociceptors are specialized nerve cells that detect pain and other stimuli that alerts the body of potential threat or harm. It senses injury to in tendons, ligaments, muscles, joints, skin, bones or other organs. Nociceptive pain is often described as deep, throbbing, gnawing, aching or sore pain.
Neuropathic or nerve pain develops when the nervous system is damaged or not working correctly. It may be due to injury or diseases such as diabetes, multiple sclerosis, stroke, and cancer. This type of pain is usually chronic.
Cannabis For Back Pain
For centuries since its discovery, cannabis – sometimes referred to as panacea (cure for all) – was used mainly for alleviating pain. In present times, medicinal marijuana is increasingly becoming the preferred treatment of patients with chronic back pain. This is because studies show that the potency and efficacy of cannabis are comparable to opioids. However, unlike opiates, short-term use of marijuana does not seem to exhibit any severe adverse side effects when properly dosed.
Cannabinoid receptors in the central and peripheral nervous systems have been shown to modulate pain perception. Such is the case when exogenous cannabinoids bind into these endocannabinoid receptors, spinal and thalamic nociceptive neurons are suppressed; thereby inhibiting pain signals. An aggregate of studies of cannabinoid analgesia during the past century could attest that cannabinoids block all types of pain.
Cannabis has also been shown to be effective in managing back pain. A 2016 study published in the International Journal of Anesthesiology & Pain Medicine substantiated this claim. This study found out that short-term usage of smoked medicinal cannabis appeared to decrease pain levels and improve both physical and mental function of the patients with chronic low back pain.
Routes Of Administration
There are several ways by which one can administer medicinal cannabis. Some courses prove to be better than others in terms of efficacy and absorption.
For pain that is episodic in nature such as back pain, inhalation is usually the preferred route of administration since it allows for a rapid onset of action and maximum effects – occurring within 15 minutes of administration. It also leads to better absorption and fewer complications.
Smoking. Research shows that smoking cannabis does not cause lung cancer nor does it increase the risk of developing it. However, inhalation through smoking may cause coughing. Additionally, it has been proven that cannabis smoke is no different from tobacco smoke in the sense that it contains many of the same carcinogenic chemicals found in tobacco smoke.
Vaporization. Generally, inhaling cannabis through a vaporizer is more preferred than smoking. It does not involve combusting other chemical irritants that would otherwise be inhaled through the smoke. It also has a relatively smaller quantity of toxic by-products. Another advantage of inhaling vapors is that it allows for more efficient and faster extraction of THC.
Ingesting cannabis by oral means is a safer method than smoking, but it is generally not an ideal route of administration for acute pain because it results to an inherently slower onset of action (delayed for an hour or more), lower peak blood levels of cannabinoids, and a longer duration of pharmacodynamic effects compared to the inhalation method.
However, oral administration provides longer-lasting pain relief which makes it the best steady, baseline pain control choice for patients who have constant, incessant pain.
This route of administration is ideal for self-titration as it is easy to control minimal dosage using sprays and tinctures. Moreover, this allows the cannabinoids to enter the bloodstream swiftly. However, when administered sublingually, blood levels of THC and other cannabinoids are lower than those achieved by inhalation of the same dose of smoked cannabis. This is fast becoming one of the most popular ways to consume CBD for pain.
Topical cannabis is usually prescribed when dealing with pains in localized regions. However, because cannabinoids are highly hydrophobic, transporting it across the aqueous layer of the skin renders the topical administration ineffective. Up to date, no clinical studies exist to prove the percutaneous absorption of cannabis-containing ointments, creams, or lotions.
8 Best Strains For Back Pain
The primary components present in cannabis are tetrahydrocannabinol (THC) and cannabidiol (CBD). Both have analgesic properties, but THC is famous for its psychoactive properties and stimulating effects whereas CBD is non-psychoactive and relaxing in nature. It is known to counteract the exciting effects of THC by dampening it. The two work best when consumed together because they act synergistically to enhance the overall pain-relieving effect of the herb.
There are thousands of cannabis strains. Each strain contains many chemical compounds that each have diverse pharmacological properties such as cannabinoid and terpene count. Some strains have more specialized functions in pain reduction.
1. White Widow
- Genetic Structure (Indica/Sativa): 60%/40%
- THC: 13-22%
- CBD: 0.3-1.56%
White Widow is an Indica dominant hybrid. It is derived from the combination of South Indian Indica and South American Sativa strain. This strain offers excellent pain relief as well as an uplifting, energetic, and euphoric feeling. It is known for treating stress, depression, lack of appetite, nausea, pain, and PTSD.
This strain is potent and can last for hours. It is the ideal strain for daytime or evening use.
2. Cataract Kush
- Genetic Structure (Indica/Sativa): 99%/1%
- THC: 23-24%
- CBD: 0.07-0.83%
This strain is a heavy-hitting hybrid cross between LA Confidential and OG Kush. It is suitable for patients needing relief from pain associated with spinal injury and for those with a high THC tolerance because of its potent THC content. It has powerful pain-relieving properties.
However, caution must be observed when consuming this strain because overconsumption of THC beyond the recommended dosage may lead to prolonged psychedelic high – thereby causing impairment in day-to-day functions. It is not recommended for light-weight smokers because of its overwhelming potency.
To counteract the potent effects of THC, the CBD balances it with its calming properties. Thereby providing a comforting mood that lulls the person in pain to sleep. It generally relaxes the body, relieves stress, stimulates appetite.
3. Bubba Kush
- Genetic Structure (Indica/Sativa): 95%/5%
- THC: 17-22%
- CBD: 0.01-0.08%
Also known as Bubblegum Kush, this Indica-dominant strain provides a very relaxed and sleepy effect all while giving excellent back pain alleviation. Additionally, it offers relief from stress, depression, insomnia, pain-induced by Multiple Sclerosis, muscle tension, and headache.
Because of the heavy sedative, profoundly euphoric high, this strain is only recommended for patients with extensive experience with high Indica cannabis.
- Genetic Structure (Indica/Sativa): 50% /50%
- THC: 0.42-2%
- CBD: 13-19%
ACDC is a hybrid strain ideal for patients seeking pain relief options that do not possess high psychoactive properties. This CBD dominant strain (THC to CBD ratio of 1:20) brings forth a strong analgesic effect and relief from inflammation, back pain due to nerve damage, and tension build-up. It also helps with nausea, seizures, and muscle spasms. This herb can be labeled as a THC free strain as it induces a clear headed high with strong analgesic effect without psychoactive influence. Thus, it does not impair daily activities and can be used for day or night medicinal use.
5. Sour Diesel
- Genetic Structure (Indica/Sativa): 0%/100%
- THC: 15-24%
- CBD: 0.7-1.61%
This pure Sativa cannabis is a fast-acting strain named for its diesel-like aroma. It delivers long-lasting cerebral (head high) effects that help relieve stress, pain, and depression. Patients who are seeking immediate solace from mild and persistent back pain can rely on this strain.
With a potent portion of THC, it is not advisable for novices as it entails an overpowering impact. Users are advised to take necessary precaution in administering correct doses as it can cause light-headedness if not handled properly. Sour Diesel marijuana is suitable for daytime use due to stimulating and mood uplifting properties.
6. Blue Dream
- Genetic Structure (Indica/Sativa): 40%/60%
- THC: 14-22%
- CBD: 1-2%
Blue dream is a cross between Blueberry Indica and Sativa Haze. This THC-dominant strain creates a powerful energetic-head high that delivers long-lasting back pain relief without heavy sedation. Meanwhile, the complementary low levels of CBD make it pleasant for both experienced and first-time users due to its mellow onset.
The Sativa-dominant mix provides the body relaxation effect of Indica and uplifting cerebral euphoria, indicative of Sativa strains. One who is exhausted from mild series of back pain may expect a revitalizing effect. It also alleviates depression, relieves stress, promotes good pain control. Blue Dream cannabis is suitable for both daytime and evening use.
7. Northern Lights
- Genetic Structure (Indica/Sativa): 100%0%
- THC: 16-21%
- CBD: 0.1%
Northern Lights is a pure Indica strain from Holland. It provides a relaxing and calming effect that induces a peaceful feeling. Due to its potent Indica effects, it became one of the most well-known natural painkillers used to fight off stress and chronic pain. It is also celebrated for its instant, powerful and long-lasting body buzz.
Northern Lights is also the go-to strain when it comes to treating nausea and insomnia because it promotes sleep. This potent herb is not recommended for beginners and is best used during nighttime.
8. OG Kush
- Genetic Structure (Indica/Sativa): 55%/45%
- THC: 19-26%
- CBD: 0.3%
OG Kush is a popular hybrid in California. Its exceedingly potent THC content is a sought-after remedy for all types of pain, especially for back pain. This strain is cherished for its ability to treat nausea, pain, depression, anxiety and bipolar disorder. It can also crush even the most intense stress under the weight of its heavy euphoria and strong cerebral effect. First time users and patients who are sensitive to THC should steer clear from this strain due to its THC potency and eternal trance similar to a mind-body melt.
Duration Of Side Effects
Adverse effects associated with the use of cannabis include short-term feelings of altered psychological perception or psychedelic high, sedation, confusion, and neurocognitive impairment.
Nevertheless, one must consider that these side effects are dose-dependent. For instance, cognitive changes appeared to be more pronounced with higher doses of THC. These side effects will be minimized with lower doses. Additionally, these side effects are relatively less severe in comparison with the life-threatening side effects of opioids.
Several studies have evidenced that long-term and heavy marijuana usage – usually for recreational purposes – is associated with impairment in cognitive, memory, and learning functions. A study in New Zealand showed that teens who smoked marijuana heavily had an ongoing marijuana use disorder and lost an average of 8 IQ points between ages 13 and 38. The lost mental abilities did not fully return to those who quit marijuana as adults. On the other hand, those who started smoking cannabis as adults did not show notable IQ declines.
Research also reveals that some regular, long-term marijuana users tend to develop Cannabinoid Hyperemesis Syndrome. This disease causes users to experience regular cycles of severe nausea, vomiting, and dehydration, sometimes requiring emergency medical attention.
In light of the preliminary findings, it is important to note that these long-term effects were observed on subjects who used cannabis heavily on a regular basis for recreational purposes. As such, the dosage was usually high on THC to induce the psychoactive effects of the drug. Conversely, people who use marijuana as a form of medication take precise and lower amounts of cannabis – sometimes mainly taking in just CBD and leaving out THC to avoid its psychoactive effects.
Nature’s Gift For Pain Relief
Back pain, whether it is a dull, persistent ache or a debilitating one, is something that no one would ever wish to experience – especially on a daily basis. While advancements in medical science continue to offer synthetic drugs to ease the pain, its detrimental side effects far outweigh its benefits.
Thankfully, Mother Nature bestowed upon humanity a panacea capable of providing solace from different illnesses. However, it does not come without a price to pay for it too, has its adverse effects if not taken with due caution and proper dosage. But then again, when it comes to treating a nuisance that robs one of peaceful sleep at night, it all boils down to choosing the lesser evil. And in this case, the much-stigmatized cannabis wins the battle.