If you are struggling with chronic pain, one of the safest and most effective options could be marijuana.

Medical marijuana is becoming one of the most popular alternative treatments for chronic pain – this can range from pain caused by conditions such as migraines or arthritis to pain caused by injury. In fact, 94% of medicinal cannabis patients in Colorado indicated severe pain as to why they require cannabis.

Why use cannabis for pain relief?

With over 100 million Americans suffering from chronic pain, a safe and effective treatment is needed, and this does not exist with the presently available pharmaceutical options. 

The two main treatments currently available for relieving pain include nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid prescription medications. These pain relievers are not nearly as safe as cannabis.

Opioid drugs are one of the most addictive drugs available today, and their use can be fatal if abused: in the US alone, sixty people die every day from opioid overdose.   

What about NSAIDs? 

While NSAIDs are generally effective at reducing pain caused by inflammation, prolonged use is accompanied by many dangerous side effects. These include increased risk of heart attacks and strokes.

Medical marijuana is becoming a popular alternative to over-the-counter and prescription painkillers, and for good reason. As a remedy for pain, pot comes with fewer side effects and no risk of tolerance or overdose. Cannabis sativa and its constituents have proven to be both safe and effective when it comes to pain management. 

With the legality of marijuana spreading across the United States and other countries, many people are now being given the opportunity to switch from dangerous, addictive medications to a natural, safer alternative.

Whether you are suffering from chronic nerve or body pain, or you are experiencing short-term pain from muscle strain, headaches, toothaches, or simply sore muscles, cannabis offers a safer and possibly more effective option than what is typically used for pain today. 

The history of cannabis: Weed and pain control

Throughout history, cannabis has been cultivated and used for its medicinal purposes. Evidence suggests that it was cultivated by humans as far back as 12,000 years ago.

Throughout this time, the cannabis plant has been exalted as miraculous and cursed as a danger to the fabric of society. Yet, throughout this varied past, one thing has remained the same: 

Cannabis has been used as a plant medicine for the treatment of an impressively wide array of diseases.

The earliest evidence of its medicinal use dates back to 2700 BC when Chinese Emperor Shen Nung documented the analgesic (pain-relieving) properties. Shen Nung is considered by many to be the father of Chinese medicine, which has helped to heal people through the use of natural remedies for thousands of years.

We have now entered a time where the benefits of this plant are beginning to come back to the forefront of the discussion. Indeed, countless individuals across the world have access to legal marijuana for chronic pain conditions. 

Yet for these patients as well as cultivators and clinicians, the question is this: 

What is the best marijuana for treating pain? 

Should patients turn to singular compounds found in the plant, or turn to the plant itself? If using the whole plant, what marijuana strains are the best for providing relief from pain?

Whole plant or THC only? The entourage effect

When you compare Western medicine to traditional medicine the world over, one of the most striking differences is the need in the West to pinpoint one specific molecule that is responsible for treating a disease or symptom. This viewpoint stands contrary to the idea of holistic medicine, where you take something in its entirety for medicinal purposes.

The ‘entourage effect’ is a new term coined to describe the idea that all compounds found in the cannabis plant work synergistically, providing more benefit together than the individual compounds would provide alone.

Cannabis sativa and the entourage effect

The Cannabis sativa plant is one of the greatest present-day examples of this tug-of-war between Western medicine and traditional medicine. 

If you live in a state where marijuana is legal, you may have noticed products being advertised as “isolates” or “whole plant extracts.” Proponents of the isolationist Western medicine theories would advocate for isolates, which are simply products containing just tetrahydrocannabinol (THC) or just cannabidiol (CBD), or far less commonly, any of the other individual phytocannabinoids.

THC is the psychotropic phytocannabinoid that is to thank for the “high” effect users get when they smoke weed. It has been found to have a variety of health-related benefits for the user.

CBD is the second most well-known cannabinoid found in cannabis, and like most of the other phytocannabinoids, it is non-psychotropic. 

These are the two most abundant and well-studied cannabinoids in marijuana, and both have been found in numerous published studies to have pain-relieving properties in humans. While they may be the most abundant, THC and CBD are certainly not the only compounds found in cannabis that are known to exert positive effects on human health. 

In every cannabis plant, there is a unique mixture of hundreds of plant compounds, comprised of phytocannabinoids, terpenes, and flavonoids. Research suggests that these compounds too have an influence on our neurochemistry, and together they may work synergistically, producing better improvements in pain relief than anyone would produce on its own. 

This research supports the idea that it is best to use the whole cannabis plant, with CBD, THC, and the natural medley of additional compounds. This harmony between the various plant chemicals found in marijuana is colloquially referred to as the entourage effect.

How CBD and THC influence the user experience together

The most well-studied compounds found in the marijuana plant that support the idea of the entourage effect are THC and CBD, which have been found to work differently together than when separate.

Using these two compounds in concert has been shown to help mitigate side effects and enhance efficacy, with CBD plus THC showing more benefit for some conditions than THC alone. 

Studies have confirmed that CBD helps to counteract some of the sedative, “high” feeling, anxiety, and rapid heartbeat that is associated with THC consumption. It has also been found to extend the half-life of THC, which may help to extend the pain-relieving benefits. This has allowed the use of higher doses of THC in clinical trials for the treatment of pain caused by multiple sclerosis, peripheral neuropathic pain, intractable cancer pain, and rheumatoid arthritis. When used in concert, a greater efficacy in treating these types of pain have been observed.  

You may be wondering, what is the ideal balance, or ratio, of CBD to THC?

Every strain of bud that you can purchase at a dispensary will be labeled with its THC and CBD content, which can be helpful when choosing which strain to choose for pain relief.

Benefits of high-CBD strains for treating pain

CBD has been found to exhibit enhancements in treating pain both when used on its own and when used in combination with THC. When used alone, CBD is largely best for inflammatory pain, such as that caused by arthritis or injuries. 

In one animal study on arthritis pain, it was found that the topical application of CBD led to a reduction in inflammation and pain. Another animal study found that CBD helps to reduce neuropathic pain through the suppression of chronic inflammation.

CBD does not directly bind to the receptors found in the endocannabinoid system but rather works to modulate the effects of the endocannabinoids (the cannabinoids found naturally in our bodies) as well as working as a CB1 receptor antagonist. 

The main mechanism by which CBD is thought to help mediate pain is by reducing inflammation, largely by blocking inflammatory mediators. It is also believed to potentiate glycine receptors, which help to regulate pain at the spinal level. This suppresses both neuropathic and inflammatory pain. 

Benefits of high-THC strains for treating pain

THC is used clinically for the treatment of pain and studies find it helps relieve central and neuropathic pain. It is also used to help reduce pain in cancer, AIDS, and fibromyalgia patients, for which resistance to other pain treatments have been found. 

The mode of action for THC is as a partial CB1 receptor agonist, which means that it will bind to these receptors but not fully which leads to the variability in effects documented when THC is present with other CB1 agonists, antagonists or both. It has been found to impact the serotonergic, dopaminergic, and glutamatergic systems – an action which may contribute to its pain-relieving benefits. Additionally, THC has been found to act as an anti-inflammatory agent.