There are many conventional treatments for relieving pain, but patients sometimes find that those methods are not as effective as they hoped they would be.
That’s why many people are turning to medical marijuana for pain management — with the added benefit that, unlike opioids, it’s not physically addictive.
Marijuana has been known as a natural painkiller for centuries.
Throughout history, in almost every corner of the world, people discovered marijuana’s pain-killing properties and have been using it ever since, for different types of painful conditions, from headaches to childbirth.
Marijuana has a wide range of uses in modern medicine. One of the most common is for managing pain, such as inflammation, migraines, neuropathic pain, sore muscles, cramps, and even spinal injuries and arthritis.
Here are some eye-opening statistics from the American Academy of Pain Medicine –
“There are 1.5 billion people around the world suffering from chronic pain.”
“Approximately 3-4.5% of the global population suffers from neuropathic pain…”
With a growing number of studies proving its effectiveness and safety, the use of medical marijuana as for pain relief is increasingly being accepted by medical professionals.
The truth is –
Cannabis does help relieve many types of pain, but an effective treatment lies in finding the right strain (hitting the best ratio of THC to CBD) and figuring out the right dosage.
This complete guide to using marijuana for pain will help you better understand how cannabis treatment could help your condition and, ultimately, help you get started on the journey of discovering the best strain for your particular pain.
What is pain and why do we feel it?
Pain is caused by an injury, illness or some other external factor and is transmitted to the brain by our nervous system.
Pain gives us information about the injury or the illness itself. Our perception of pain helps us locate the damaged tissue or organ, and determine the intensity and nature of the illness.
There are different ways of classifying pain.
First of all, depending on duration and the cause, pain can be 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 considered to be acute pain. Acute pain is usually resolved when the damaged tissue is healed.
Chronic pain is persistent and keeps coming back, even after the injury is healed. This type of pain can occur after surgery or after cancer treatment.
Based on the way pain signals travel to the brain, medicine distinguishes three types:
- Somatic pain usually feels like a dull ache in the injured region.
- Visceral pain 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 pain is caused by the changes in the nervous system and is present even when the injury heals. It mostly feels like burning and is usually associated with skin sensitivity.
Can cannabinoids (cannabis) provide pain relief?
Pain seriously impacts the quality of people’s lives, and while many current pain medications can be effective, long term use can cause unpleasant side effects and physical dependence.
With the current epidemic of opioid addiction and abuse, patients and physicians are increasingly interested in finding other solutions for pain management.
But what does the science say?
Weed has many health benefits but its pain-killing properties have been the most extensively studied.
The discovery of the endocannabinoid system and cannabinoid receptors in the human body in the 1980s and 1990s made clinicians ask: Can marijuana be used to treat pain?
Cannabinoids have been proven to be very effective at reducing neuropathic pain and inflammation. (2)
Cannabinoids have antinociceptive mechanisms that are different from common, man-made, painkillers. There is a lot promising research on treating neuropathic and inflammatory pain with marijuana.
One recent clinical trial which showed significant results was led by Mark Ware at McGill University in 2010. (3)
The team compared four groups of patients suffering from neuropathic pain and analyzed their responses to a placebo and to the inhalation of marijuana with three different levels of THC.
After taking the medication, patients were asked to rate their pain on the scale of 0 to 10.
The results showed that higher doses of THC reduce pain more effectively than low doses and even more so than no doses at all (the placebo group), proving that marijuana is an effective analgesic.
In the last 15 years, across North America, more and more patients were turning to marijuana for pain relief.
This caught the interest of an assistant professor of medicine, Marcus Bachhuber, at the Montefiore Medical Center. He and his team decided to investigate whether the legalization of marijuana in some states had affected the number of opioid overdose deaths. (4)
The results of their comparative study were remarkable:
“In states which have legalized marijuana, between 1999 and 2010, opioid overdose deaths were decreasing by 25% each year, compared to states which have not legalized marijuana yet.”
We can safely say that marijuana has been proven to both reduce chronic pain as well as reduce some of the devastating effects of opioid use.
We will wrap this section up with a quote from one of the studies referenced above.
“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.”
Indica or sativa for pain?
Indica and sativa are the two most common subspecies of marijuana, but they can also be crossed to create hybrids.
While both indica and sativa strains have pain-killing properties, successful treatment still depends on the type of pain, overall tolerance to marijuana and the desired effects.
In general, indica strains provide a full-body pain relief, while sativas provide a cerebral high with mild pain-killing effects.
Indica strains typically have high levels of both THC and CBD with the percentages varying from strain to strain. Indica is often recommended for more severe types of pain.
This subspecies has helped patients suffering from all kinds of pain: from persistent chronic pain to muscle spasms, and more severe illness like multiple sclerosis and cancer.
Indicas are recommended for nighttime use, as they make users sleepy while relaxing muscles at the same time.
Sativa strains, on the other hand, with their high levels of THC, are usually preferred by most recreational users because of their famous, uplifting high.
Still, sativas have a therapeutic effect on minor pain, such as post-workout muscle cramps and localized aches. Although the evidence is mostly anecdotal, sativa strains are also used for neuropathic pain and headaches.
Unlike indicas, sativas are usually recommended for daytime use because of their cerebral, mind-altering effects which can keep users awake and alert.
And depending on the type of pain and your overall health, your best strain for pain management could be a hybrid of indica and sativa. If you are suffering from minor pain, clinicians often recommend indica-dominant hybrids which provide full-body pain relief (from their indica genetics) with just a slight head buzz (thanks to their sativa genetics).
THC or CBD for pain?
Two most common chemical compounds in marijuana, THC (tetrahydrocannabinol) and CBD (cannabidiol), both have potent painkilling properties.
THC is the main player in pain management, while CBD makes people more relaxed, less high. We often hear how the best strains for pain are high in THC and low in CBD.
Most patients using medical marijuana for pain go for THC-rich strains, and CBD is to go-to compound for other symptoms such as reducing stress.
In fact, these two cannabinoids have a synergistic relationship.
THC gives you a cerebral high, but CBD is calming and uplifting at the same time and is proven to soothe cramps and muscle spasms.
Some pain sufferers find that strains rich in THC are more powerful analgesics but they often complain about being too “high”.
Others have much more success with CBD rich strains, which are known to reduce inflammation and improve mood.
CBD has pain relieving properties in itself.
One of the first studies on CBD’s pain crushing effect was done in London, back in 1988.
The study compared two potential painkillers — CBD and aspirin. As it turned out, CBD was 4 times more effective, especially for reducing the inflammatory pain.
Most strains for generalized pain are made to contain 1:1 ratio of both THC and CBD, these can be more beneficial than ones containing mostly, or only, THC.
When combined, these two cannabinoids amplify the effects of each other – they both reduce inflammation in the brain and regulate pain signaling in your body.
But it’s not that just THC and CBD are useful for pain relief.
There are other compounds in marijuana (aromas and flavor molecules) that have proven to be beneficial.
Like every other vegetable or fruit, marijuana also has terpenes, which make its unique flavor, and recent studies have shown that they have an analgesic effect as well.
List of the 15 best cannabis strains for pain relief
Uncover the best medical cannabis strains for you with Strainblazer™, our tool that helps you search through all strains produced by ACMPR licensed producers.
When it comes to choosing the best strain for pain relief, some are definitely better than the others.
Unfortunately, it’s highly unlikely that you’ll find the strain that works for you straight away.
Each person has a unique experience with marijuana and its wide variety of different strains.
Many patients have to take time and experiment with different varieties of cannabis before finding the one that works the best for their pain and specific situation.
Also, it is important to experiment with different forms of marijuana — smoking may not be an option for you, in which case vaping or edibles would be a better choice.
Some strains are recommended for daytime consumption and will make it very hard for you to fall asleep. These are usually pure sativas or sativa-dominant hybrids.
On the other hand, some strains will relieve pain and muscle tension but will make you “locked to the couch” and very sleepy. You can bet that those strains are indica-dominant.
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, inflammation
Harlequin is one of the most popular medical strains in general, with its vast range of health benefits. It’s usually the first choice for patients suffering from pain. It is a sativa-dominant hybrid with a 5:2 CBD to THC ratio. What does that mean? It means that this strain will not get you as high, your mind will stay clear, and you can even use it both during the day and in the evening.
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 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
A sativa named after the famous marijuana activist and enthusiast — Jack Herer — is well known as nature’s painkiller. Dominant in THC and the terpene pinene, which has an analgesic effect while also reducing inflammation.
White Widow (THC 20%, CBD 1%)
Best for: Generalized pain, neuropathic pain, inflammation
This very popular strain comes from the Netherlands and will have an immediate effect on your mood and pain sensation. It is a half-and-half hybrid between sativa and indica that will make your entire body relaxed. This is why this type of strain is the best after-work choice. If you have sore, inflamed muscles, White Widow will provide a relief from swelling and even protect your muscle tissue.
Girl Scout Cookies (THC 25%, CBD < 1%)
Best for: Generalized pain
Girl Scout Cookies (GSC) has shown to be very effective in reducing severe pain. It often the first choice for many, especially when it comes to pain relief. With high levels of THC, this strain will not make you sleepy, which makes it great for the day. However, 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 is recommended for nighttime use.
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 uplift in your mood. These features make it one of the favorites among medical marijuana patients.
Bubba Kush (THC 25%, CBD < 1%)
Best for: Back pain, Multiple Sclerosis, muscle tension, headache
Bubba Kush is an indica that provides a very strong narcotic effect, making it perfect for easing all sorts of pain, especially for more 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 sativa-dominant strain, with 19% of CBD, has almost no psychoactive effects and has shown to be very helpful for 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 strain, perfect for minor pains and inflammations. 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, sleepless nights, as well as 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 for back pain. OG Kush also provides a strong cerebral effect 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 helping you forget about your pain. This is an indica strain and is best used in the evening. It is also very beneficial for fighting stress, an issue that goes hand in hand with chronic pain.
Blueberry (THC 18%, CBD < 1%)
Best for: Fibromyalgia
Blueberry is an indica hybrid and it 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.
From after-workout cramps to chronic neuropathy, marijuana is proven to be highly effective for pain management.
The way you approach this matter is entirely up to you. The way you approach this matter is entirely up to you. My advice would be to find a cannabis-friendly doctor with experience in pain management who can work with you on your treatment plan and prescribe the best marijuana strains for your specific pain.
- 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; Current Neuropharmacology; July 2006; 4(3):239–257.
- Wei Xiong, Tanxing Cui, Kejun Cheng, Fei Yang, Shao-Rui Chen, Dan Willenbring, Yun Guan, Hui-Lin Pan, Ke Ren, Yan Xu, Li Zhangcorresponding; Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors; The Journal of Experimental Medicine; Jun 2012; 209(6):1121–1134.
- Mark A. Ware, Tongtong Wang, Stan Shapiro, Ann Robinson, Thierry Ducruet, Thao Huynh, Ann Gamsa, Gary J. Bennett; Jean-Paul Collet; Smoked cannabis for chronic neuropathic pain: a randomized controlled trial; Canadian Medical Association Journal; October 2010; 182(14):E694-E701
- Marcus A. Bachhuber, Brendan Saloner, Chinazo O. Cunningham, et al.; Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States 1999-2010; JAMA Internal Medicine; 2014; 174(10):1668-1673.