According to the American Academy of Pain Medicine, 1.5 billion people around the world suffers from chronic pain, and as much as 4% of the global population suffers from neuropathic pain.
Among the many conditions cannabis relieves, chronic pain is by far the most cited by patients. A study published in 2014 by the Marijuana Policy Group found that 94% of medical marijuana patients in Colorado identified chronic pain as their primary symptom. (6)
Through its pain-relieving properties, cannabis is also battling the opioid overdose crisis—a large body of scientific evidence claims that states that legalized medical cannabis saw a large reduction in opioid use.
In my research, I found that cannabis does help relieve chronic pain and that an effective treatment lies in finding the right product (with correct THC, CBD and terpene contents) and then administering that product in precise doses, to ensure maximum pain relief.
Read on to find more on using cannabis for pain and feel free to download our complimentary cannabis dosage eBook which will help you apply everything you learn in this guide.
What is pain?
Pain is a signal that helps the brain locate the damaged tissue. It’s usually caused by an injury or an illness and is transmitted to the brain through the nervous system.
There are different types of pain, however, it’s mainly classified as either acute or chronic.
Acute pain is usually the result of an injury, such as a broken bone, a hurt muscle or a burn. Headaches are also a good example of acute pain.
Chronic pain is persistent and keeps coming back, even after the injury has healed. This type of pain can occur after surgery or after cancer treatment.
Pain can also be:
- Somatic—usually feels like a dull ache in the injured region.
- Visceral—occurs as a result of damaged internal organ tissue in the area of the abdomen. This kind of pain usually feels like stomach pain.
- Neuropathic—caused by damage to the nervous system. It can be present even after the injury heals and it mostly feels like burning.
Cannabinoids for pain relief in research studies
Chronic pain is usually treated with prescription opioid pain relievers, which got popularized by pharmaceutical companies in the 1990s. These medications initially got advertised as something people can’t get addicted to but pretty soon the rates of opioid-related deaths started growing. Today, over 115 people die from opioid overdoses every single day in the United States.
Cannabis is well-known for its pain relieving properties and is generally considered much safer than opioids, due to having a completely different molecular pathway—opioids influence the receptors in the brain that control breathing and heart rate, which is why taking too much may result in death.
Cannabis does not have to ability to influence opioid receptors and works in a much safer way, by activating and supplementing the endocannabinoid system.
Marcus Bachhuber, who works with the Montefiore Medical Center, decided to investigate whether legalizing cannabis can affect the number of opioid overdose deaths. His research found that in states which have legalized cannabis between 1999 and 2010, opioid overdose deaths decreased by 25% with each passing year. (4)
In fact, cannabinoids are very effective in reducing neuropathic pain and inflammation:
“Several recent clinical studies have demonstrated that combination of THC and CBD can be an effective therapeutic option for patients with neuropathic pain and other types of chronic pain.” (2)
For example, in 2010, a group of researchers from McGill University tested four groups of patients suffering from neuropathic pain and analyzed their responses to both placebo and THC (one of the most researched active compounds from cannabis).
Patients were asked to rate their pain on the scale of 0 to 10.
The study concluded that higher doses of THC reduce pain more effectively than low doses and significantly more than placebo, providing evidence that cannabis could very well be an effective analgesic. (3)
Besides this, there have been a total of five comprehensive systematic reviews on using cannabis for pain, one of which identified a total of 28 high-quality, randomized trials (with a total of 2,454 participants).
This comprehensive review concluded that “there was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity.” (7)
However, one of the issues with evaluating clinical research is that the quality of cannabis used in those studies may not resemble what one can realistically purchase legally.
Also, methods of administration may be different: Only one study investigated the pain-relieving effects of vaporized cannabis flower and found that these effects are largely dose-dependent. In this study, a cannabis strain with 7% THC showed a significant reduction in pain, while many people in the cannabis community consider that a low-potency strain.
THC vs CBD for pain?
Exclusive bonus: Download a free dosage guide that will show you the exact step-by-step process Dr. Dustin Sulak used to successfully treat more than 18,000 patients with cannabis.
THC (tetrahydrocannabinol) and CBD (cannabidiol) are the two most prominent active compounds found in cannabis. They both have painkilling properties.
According to research, THC plays a crucial role in regulating pain. Cannabidiol reduces the psychoactive (intoxicating) effects of THC and improves the overall quality of life in patients.
Most patients who use medical marijuana for pain go for THC-rich strain, but it’s important to know that these two cannabinoids have a synergistic relationship. Also, the effects of cannabis are often quite subjective: If one person has found relief with high-THC cannabis, another may find that high-CBD (or a strain with an equal ratio of both cannabinoids) works better for them.
Take note that CBD has pain relieving properties as well. According to one study, CBD is 4 times more effective at relieving inflammatory pain than aspirin. (5)
Most strains for generalized pain contain 1:1 ratio of both THC and CBD. When combined, these two cannabinoids amplify each other’s effects—they can both reduce inflammation and regulate pain signaling.
Besides THC and CBD, there are other compounds in marijuana that can aid in relieving pain. Like every other vegetable or fruit, marijuana has terpenes—aromatic molecules which also have an analgesic effect.
Best cannabis strains for pain
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To help you get started on your journey of managing pain with cannabis, I made a list of what I believe to be some of the best marijuana strains for different types of pain.
Harlequin (THC 10%, CBD 12%)
Best for: Arthritis pain, inflammation
Harlequin is one of the most popular medical strains for nerve damage, with a vast range of health benefits. It’s usually the first choice for patients suffering from pain. It is a sativa-dominant hybrid with a close to equal CBD to THC ratio. This strain will not get you high, your mind will stay clear, and you can use it throughout the day without being intoxicated.
Blue Dream (THC 15%, CBD 2%)
Best for: Generalized pain, neuropathic pain, migraine, inflammatory arthritis, back pain
Perfect for daytime use, Blue Dream has become very popular among pain sufferers. This sativa-dominant strain with a high THC to CBD ratio will undoubtedly make you happy. With a touch of mild euphoria, it will also help you forget about the pain and allow you to easily go through all your daily activities.
Jack Herer (THC 23%, CBD < 1%)
Best for: Generalized pain, chronic pain, stress
This sativa, named after the famous marijuana activist, is well known for its pain-smashing properties. It’s dominant in THC and pinene—a terpene which has analgesic and anti-inflammatory effects.
White Widow (THC 20%, CBD 1%)
Best for: Generalized pain, neuropathic pain, inflammation
Born in Netherlands, this strain will provide an immediate reduction of pain. It is a 50/50 hybrid that will make your entire body relaxed, which makes it a great after work choice. If you have sore and inflamed muscles, White Widow will provide relief from swelling.
Girl Scout Cookies (THC 25%, CBD < 1%)
Best for: Generalized pain
Girl Scout Cookies (GSC) is very effective in reducing severe pain. It’s often the first choice for many, especially when it comes to pain relief. With high levels of THC and limonene, this strain will make you uplifted and energetic. GSC is not a beginner strain as it is very potent and can get you very high in just a few puffs.
Blackberry Kush (THC 19%, CBD < 1%)
Best for: Generalized pain, severe pain
Blackberry Kush is high in THC, so you can expect that it will numb you down and reduce the pain sensation. This strain should be avoided if you have important work to do that day—it should be ideally used at night.
Sour Diesel (THC 25%, CBD 2%)
Best for: Chronic pain
Sativa-dominant hybrid with very high levels of both main cannabinoids, Sour Diesel is a good choice for mild and persistent pains. While it will undoubtedly provide a pain-free feeling, it will also ensure an uplifted mood. These features make it one of the favorites among medical marijuana patients looking for pain relief.
Bubba Kush (THC 25%, CBD < 1%)
Best for: Back pain, Multiple Sclerosis, muscle tension, headache
Bubba Kush is a famous indica strain which provides a very strong narcotic effect, making it perfect for severe pain. Keep in mind that it is best to use Bubba Kush after work hours since its relaxing high will probably make you sleepy. Also, prepare some snacks before taking Bubba—it is known to boost appetite as well.
ACDC (THC 3%, CBD 19%)
Best for: Back pain, chronic pain, Multiple Sclerosis
This is a sativa-dominant strain, with 19% of CBD, and it has almost no psychoactive effects. Supposedly, it’s very effective at controlling pain. If you have work to do, this strain will make you focused and communicative, while allowing you to go through your day undisturbed.
Redwood Kush (THC 13%, CBD < 1%)
Best for: Generalized pain, inflammation, muscle spasms
Redwood Kush is an indica-dominant hybrid, perfect for minor pains and inflammation. It provides gentle sedation and relaxation. It is not recommended for daytime use because you’ll probably only want to chill and relax once you smoke it.
Granddaddy Purple (THC 20%, CBD 1%)
Best for: Chronic pain, muscle spasms
Pure indica, with high levels of THC, Granddaddy Purple is mostly used for fighting stress and sleepless nights caused by pain. With its painkilling attributes, this strain is perfect for patients looking for that “chill-and-relax” high.
OG Kush (THC 24%, CBD < 1%)
Best for: Back pain, generalized pain
OG Kush is a famous hybrid, rich in THC and perfect for all types of pain—especially back pain. OG Kush also provides a strong cerebral high and should be avoided by those who are sensitive to THC. If you’re a complete beginner, you might want to skip this one as well.
AK-47 (THC 15%, CBD 1%)
Best for: Generalized pain
The name might sound dangerous, but actually, this strain will make you feel rather tipsy and relaxed. AK-47 is effective in easing many different kinds of pain, it helps with relaxation, and leaves you feeling uplifted.
Northern Lights (THC 17%, CBD < 1%)
Best for: Severe pain, chronic pain, back pain, arthritis
Northern Lights has a relaxing, calming effect, making your body feel peaceful and whole. It is also very beneficial for fighting stress, a symptom that often comes with the “chronic pain package”.
Blueberry (THC 18%, CBD < 1%)
Best for: Fibromyalgia
Blueberry is a notorious pain assassin. Even though this strain is a muscle relaxant, it does not induce sleepiness and drowsiness, which makes it a perfect daytime painkiller. It’s also effective for relieving everyday stress.
Better than opioids
From after-workout cramps to chronic neuropathy, cannabis is proven to be highly effective for pain management.
I hope that we will continue battling the opioid overdose crisis with cannabis and that spreading the word about this promising plant will bring forth more research. After all, with so many people going through terrifying pain bouts every single day, what’s the harm in experimenting with cannabis?
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- Xiong W, Cui T, Cheng K, Yang F, Chen SR, Willenbring D, Guan Y, Pan HL, Ren K, Xu Y, Zhang L; Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors; The Journal of Experimental Medicine; Jun 2012; 209(6):1121–1134
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