This article summarizes research supporting the effects of cannabinoids for reducing musculoskeletal pain, more so when used short term. It also discusses the need for further research so healthcare providers can make more informed recommendations to patients.
With more states expanding legal marijuana use for medical and recreational purposes, there has been an increased interest in the cannabinoids these products contain. One question many researchers are asking is whether cannabinoids can help ease musculoskeletal pain. According to several reviews, the answer is yes when they are used short-term.
Cannabinoids may provide short-term pain relief
A 2020 systematic review and meta-analysis involved 36 trials with a total of 4,006 participants experiencing chronic pain not due to cancer. Cannabinoids provided a significant pain reduction when compared with placebo treatments, especially when treatment duration was between two and eight weeks. Additionally, oral cannabinoids were slightly better for reducing pain than oromucosal sprays or smoked cannabis, and adverse effects were rare.
A 2021 review of randomized controlled trials cited a 30% to 50% pain intensity reduction in subjects taking certain cannabinoid-containing medicines. Other than cannabis, using nabiximols – which are oromucosal sprays containing cannabinoid formulations – for more than seven days seemed to provide positive effects. However, nabiximols were also associated with more adverse effects when used for pain management.
A different 2020 review, this one involving only orthopedic patients, also reported significant chronic pain reduction with cannabinoids compared to placebo. However, the authors questioned whether the difference between the two groups achieved clinical significance, further noting that when treatment extended beyond two weeks, increased adverse effects were reported.
Research published in April 2024 looked at numerous studies involving cannabinoids for low– back pain. While not all reported positive effects, some finding no difference in pain after cannabinoid treatment, many did. For instance, one piece of research discussed found decreased pain intensity and improved quality of life with four-week cannabinoid treatment sessions. Other studies in the review noted similar results, though with no mention of their duration.
How cannabinoids might relieve pain
Different theories exist about how cannabinoids can help reduce pain. The 2024 research suggest there may be a genetic component to this effect. By targeting specific cannabinoid receptors in the endocannabinoid system, pain may be reduced. Research published in 2018 indicates cannabinoids also affect ion channels and enzymes, enhancing their positive effects on pain.
Further investigation is needed
Regardless of individual study research findings, a majority of their authors agree that more research is needed on this subject. This can help determine the type of pain cannabinoids may potentially help treat, along with providing dosage amounts, administration methods and durations of treatment needed for treatment effectiveness.
Additional research is also needed to better understand the short- and long-term effects of cannabinoid-based treatments, including their safety and risk of adverse incidents. Others suggest a need for differentiating between products and situations of use.
Final thoughts
As more is learned, there is hope that DCs can make a more informed decision about whether to recommend cannabinoids to patients with pain issues. If they are recommended, future research can also help DCs deliver more personalized treatment recommendations based on a patient’s specific condition, pain severity, duration and other factors.
Until this time, chiropractic professionals are left to make their own decisions when it comes to guiding patients on cannabinoid use for musculoskeletal pain. Staying updated on the latest research can help in this regard. Sharing this information with patients can also help them make their own decisions based on the latest evidence.
