Lack of efficacy of cannabidiol for relieving back pain: time to re‐set expectations?

Hayes, Chris; Martin, Jennifer H.

doi:10.5694/mja2.51025

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…Patients with neuropathic pain report higher pain intensity, drowsiness, and fatigue than those with nociceptive pain, concordant with another recent study [14]. Furthermore, patients reporting either higher pain intensity, pain-related interference, depression, or lack of appetite scores were mainly prescribed at baseline with THC:CBD treatments, suggesting that THC is more likely to be recommended when pain is severe, whereas CBD-dominant treatment is favored by clinicians for less severe cases, in line with other reports [36].…”

Section: Discussionsupporting

confidence: 90%

Cannabinoid-based medicines in clinical care of chronic non-cancer pain: an analysis of pain mechanism and cannabinoid profile

Rapin

Arboleda

Prosk

et al. 2023

Exploration of Medicine

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Aim: Among treatments for chronic non-cancer pain (CNCP), cannabinoid-based medicines (CBMs) have become extremely popular. Evidence remains modest and limited primarily to delta-9-tetrahydrocannabinol (THC) for neuropathic pain; nevertheless, the use of various CBMs, including cannabidiol (CBD) to treat neuropathic, nociceptive, and mixed pain has increased globally. This observational case-series assessed the impact of CBMs as a complementary treatment by pain mechanism and cannabinoid profile over three months. Methods: An analysis of patients with CNCP and treated with CBMs who consented to an ongoing registry was performed. Outcomes were patient-reported such as the Edmonton symptom assessment system-revised, brief pain inventory-short form, and 36-item short form health survey. Data from patients with complete outcomes for baseline and 3-month follow-up was extracted. Characteristics of adverse drug reactions (ADRs), including a description of the suspected product were also assessed. Results: A total of 495 patients were part of this analysis (mean age = 56 years old; 67% women). At 3-month, the proportional use of THC:CBD balanced and THC-dominant products increased. Patients with neuropathic pain had higher pain-severity scores vs. nociceptive pain. In addition to patients with neuropathic pain, patients with nociceptive and mixed pain also reported improvements in pain severity and secondary symptoms such as anxiety, depression, drowsiness, fatigue, sleep disturbances, and overall, health-related quality of life. THC-dominant treatment is more likely to be recommended when pain is severe, whereas CBD-dominant is favored for less severe cases. ADRs were more frequent among cannabis-naive patients and included dizziness, headache, and somnolence among others. Conclusions: Findings suggest that CBMs can be effective for neuropathic as well as nociceptive and mixed pain. THC is more frequently recommended for neuropathic and severe pain. Future research on CBMs in pain management must include details of CBM composition, and pain mechanism and must consider potential ADRs.

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Section: Discussionsupporting

confidence: 90%

Cannabinoid-based medicines in clinical care of chronic non-cancer pain: an analysis of pain mechanism and cannabinoid profile

Rapin

Arboleda

Prosk

et al. 2023

Exploration of Medicine

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“…The mean pain scores after two hours and length of stay were 6.2 vs 5.8 and 9.0 vs 8.5 hours, respectively, for CBD vs placebo [54]. The current study, however, has several limitations, including the scale used to assess pain is not objective, there is no information about the drugs taken by the patient before arrival at the ER, and CBD was administered only once [53,54].…”

Section: Acute Low Back Painmentioning

confidence: 88%

“…There is a lack of research and evidence on the effectiveness of cannabinoids in acute pain. The only rigorously designed study [53] evaluating the effects of CBD on acute back pain was the CANBACK study [54]. In this clinical trial, 100 participants were enrolled, half of whom received 400 mg CBD and the rest a placebo.…”

Section: Acute Low Back Painmentioning

confidence: 99%

Can cannabidiol (CBD) help with low back pain?

Kulesza,

Mazurek,

Kurzepa

2023

Ann Agric Environ Med.

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Introduction and Objective. Low back pain (LBP) is a major cause of disability and the main reason why individual patients need medical attention. Pharmacological treatment options for LBP are limited and are often associated with serious side-effects. This makes it necessary to search for new painkillers. One potential therapeutic agent is cannabidiol (CDB). Cannabidiol and tetrahydrocannabinol are the most researched components of cannabis, the plant more commonly known as marijuana or hemp. To the best of our knowledge, this is the first narrative review of the effects of CBD alone on acute and chronic back pain. Review Methods. Based on the guidelines provided by the Primary Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), the PubMed/ MEDLINE database was used to identify articles for analysis from the last 30 years. Due to the limited number of studies on this topic, all types of studies that met the inclusion criteria were included. After analysis, 10 studies were included in this review. Brief description of the state of knowledge. Currently, the use of medical marijuana continues to increase and the Food and Drug Administration (FDA) has already approved four cannabis-based drugs. Cannabidiol (CBD) is a relatively safe substance for humans and generally well tolerated. It is a substance that is easily available and often taken by patients with LBP. Summary. Evidence for the effectiveness of CBD in the treatment of acute low back pain is lacking. There was only one clinical trial conducted in the Emergency Department that showed no superiority of CBD over placebo in acute LBP. The majority of studies concern chronic rather than acute LBP. Although most of the results suggest a beneficial effect of cannabinoids in relieving chronic LBP, hard evidence is lacking. Rigorous randomized controlled trials are needed.

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Lack of efficacy of cannabidiol for relieving back pain: time to re‐set expectations?

Cited by 2 publications

References 10 publications

Cannabinoid-based medicines in clinical care of chronic non-cancer pain: an analysis of pain mechanism and cannabinoid profile

Cannabinoid-based medicines in clinical care of chronic non-cancer pain: an analysis of pain mechanism and cannabinoid profile

Can cannabidiol (CBD) help with low back pain?

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