Whether or not you take an external source of CBD, you have cannabinoids in your body.
DCs not believing in cannabinoids is like not believing in calcium, magnesium or iron. Why? Every mammal produces cannabinoids through the body’s endogenous cannabinoid system or endocannabinoid system (ECS). In 1992, researchers discovered the ECS and named it after the cannabis plant due to the molecular similarities between what the plant and the body produce.
DCs are increasingly recognizing the importance of the ECS in maintaining homeostasis, promoting healing and enhancing patient outcomes. This article explores the ECS, its role in health and disease and how it can be leveraged in chiropractic and integrative care to support the body’s natural healing processes.
The endocannabinoid system: An overview
The endocannabinoid system is a complex cell-signaling network discovered in the 1990s, primarily through research on the effects of cannabis. The ECS is composed of endocannabinoids, receptors and enzymes that regulate their synthesis and degradation. It plays a crucial role in regulating various physiological processes, including pain, inflammation, immune response, mood and stress.1
The two main endocannabinoids identified so far are anandamide (AEA) and 2-arachidonoylglycerol (2-AG). These lipid-based neurotransmitters bind to cannabinoid receptors to exert their effects. The two primary cannabinoid receptors are CB1, predominantly found in the central nervous system, and CB2, mainly located in peripheral tissues and immune cells.2
These receptors are involved in modulating the release of neurotransmitters, thereby influencing pain perception, inflammation and overall homeostasis.
The ECS and pain management
One of the most well-documented functions of the ECS is its role in modulating pain. Chronic pain is a significant concern in chiropractic practice, often stemming from conditions such as musculoskeletal disorders, nerve impingement and inflammation. The ECS can regulate nociceptive signaling, which is the process by which pain signals are transmitted through the nervous system.
The mechanisms underlying the analgesic effects of cannabinoids likely include inhibition of presynaptic neurotransmitter and neuropeptide release, modulation of postsynaptic neuronal excitability, activation of the descending inhibitory pain pathway and reductions in neuroinflammatory signaling.3
B1 receptors, when activated, can inhibit the release of certain neurotransmitters, reducing pain perception. For instance, anandamide, often referred to as the “bliss molecule,” binds to CB1 receptors and has been shown to reduce pain and inflammation.4 On the other hand, CB2 receptors play a pivotal role in modulating immune response and inflammation, key factors in many chronic pain conditions.5 By influencing these pathways, the ECS can offer a natural way to alleviate pain without the side effects often associated with pharmaceutical interventions.
The ECS and inflammation
Inflammation is a natural immune response to injury or infection, but chronic inflammation can lead to various health issues, including arthritis, cardiovascular disease and neurodegenerative disorders. The ECS is intimately involved in regulating inflammation. Activation of CB2 receptors on immune cells can reduce the production of pro-inflammatory cytokines, while promoting anti-inflammatory pathways.6
For DCs, this is particularly relevant as many of the conditions treated, such as joint pain, back pain and soft tissue injuries, involve inflammatory processes. By supporting the ECS, practitioners can help reduce inflammation, promoting healing and recovery in their patients.
Stress, mood and the ECS
The ECS also plays a critical role in regulating mood and stress, which are often overlooked in connection to physical health. Stress can exacerbate pain and inflammation, leading to a cycle of chronic discomfort and emotional distress. The ECS modulates the hypothalamic-pituitary-adrenal (HPA) axis, which is the body’s central stress response system.7
Anandamide and 2-AG influence the release of cortisol, the primary stress hormone, helping maintain balance in the stress response. In turn, this can mitigate the effects of chronic stress on the body, including muscle tension, headaches and digestive issues, all common complaints among chiropractic patients.8
Enhancing ECS function through lifestyle modifications, such as diet, exercise and mindfulness practices, can be an effective strategy in integrative care.
Chiropractic care and the ECS
DCs are in a unique position to support the ECS through both direct and indirect methods. Manual adjustments can influence the nervous system, potentially affecting the ECS by altering nerve signals and reducing stress on the body. Furthermore, DCs often advocate for lifestyle changes that can enhance ECS function, such as promoting a balanced diet, regular physical activity and stress management techniques.
Diet and the ECS
Nutrition plays a crucial role in the health of the ECS. Omega-3 and omega-6 fatty acids, found in foods like fish, nuts and seeds, are precursors to endocannabinoids. A diet rich in these essential fatty acids can support the production of AEA and 2-AG, enhancing the body’s ability to regulate pain, inflammation and mood.9
DCs can guide their patients toward an anti-inflammatory diet, which not only supports ECS function but also helps in managing chronic pain and inflammation. Foods rich in antioxidants, such as fruits, vegetables and certain herbs, can also protect the ECS from oxidative stress, promoting its effectiveness in maintaining homeostasis.10
Exercise and the ECS
Physical activity is another powerful tool for modulating the ECS. Exercise has been shown to increase the levels of endocannabinoids in the body, which can enhance mood, reduce pain and improve overall well-being.11 The “runner’s high” often attributed to endorphins is now understood to involve a significant increase in anandamide levels as well.12
DCs can encourage their patients to engage in regular exercise as part of a comprehensive approach to pain management and health maintenance. Even moderate activities, such as walking, swimming or yoga, can positively impact the ECS and contribute to long-term health.
Mind-body practices and the ECS
Mind-body practices, such as meditation, deep breathing and mindfulness, can also support ECS function. These practices have been shown to reduce stress and anxiety, potentially by modulating the ECS.13 By lowering cortisol levels and promoting relaxation, mind-body practices can enhance the body’s natural healing processes.
DCs can integrate these practices into their treatment plans, offering patients tools to manage stress and improve their overall quality of life. This holistic approach not only addresses the physical aspects of health but also supports the mental and emotional well-being of patients.
Final thoughts
The endocannabinoid system is a powerful ally in the pursuit of health and wellness. For DCs and integrative health practitioners, understanding and leveraging the ECS can enhance patient care by addressing the root causes of pain, inflammation and stress. Through manual adjustments, lifestyle modifications and patient education, DCs can support the body’s natural healing processes, offering a holistic approach to health that aligns with the principles of chiropractic care.
As research continues to uncover the complexities of the ECS, its role in health and disease will become increasingly relevant in clinical practice.
JOE KRYSZAK, MBA, is president of Stirling Professional CBD, the brand built by and for DCs. Stirling gives back to the chiropractic industry through state and national chiropractic associations. Since 2014, Stirling has grown, extracted and produced the purest CBD available and offers an industry-leading lineup of 2,500-milligram CBD lotions, THC and THC-free capsules and gels, and four great solutions for better sleep. For more information, visit stirlingprofessional.com.
References
- Lu HC, Mackie K. An introduction to the endogenous cannabinoid system. Biol Psychiatry. 2016;79(7):516-525. PubMed. https://pubmed.ncbi.nlm.nih.gov/26698193/. Accessed September 6, 2024.
- Marzo V, Piscitelli F. The endocannabinoid system and its modulation by phytocannabinoids. Neurotherapeutics. 2015;12(4):692-698. PubMed. https://pubmed.ncbi.nlm.nih.gov/26271952/. Accessed September 6, 2024.
- Starowicz K, Finn DP. Cannabinoids and pain: Sites and mechanisms of action. Neurotherapeutics. 2017;80:437-475. PubMed. https://pubmed.ncbi.nlm.nih.gov/28826543/. Accessed September 6, 2024.
- Russo EB. Beyond cannabis: Plants and the endocannabinoid system. Trends Pharmacol Sci. 2016;37(7):594-605. PubMed. https://pubmed.ncbi.nlm.nih.gov/27179600/. Accessed September 6, 2024.
- Turcotte C, et al. The CB2 receptor and its role as a regulator of inflammation. Cell Mol Life Sci. 2016;73(23):4449-4470. PubMed. https://pubmed.ncbi.nlm.nih.gov/27402121/. Accessed September 6, 2024.
- Kozela E, et al. Modulation of astrocyte activity by cannabinoids, a Nonpsychoactive Cannabinoid. Int J Mol Sci. 2017;18(8):1669. PubMed. https://pubmed.ncbi.nlm.nih.gov/28788104/. Accessed September 6, 2024.
- Hill MN, Patel S. Translational evidence for the involvement of the endocannabinoid system in stress-related psychiatric illnesses. Biol Mood Anxiety Disord. 2013;3(1):19. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817535/. Accessed September 6, 2024.
- Morena M, et al. Neurobiological interactions between stress and the endocannabinoid system. Neuropsychopharmacology. 2016;41(1):80-102. PubMed. https://pubmed.ncbi.nlm.nih.gov/26068727/. Accessed September 6, 2024.
