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[6 min read] Medicinal cannabis and chronic back pain

Back pain is one of the top six injuries and sickness causing loss of quality of life, inability to work, pain and disability in Australia. Most back sprains and strains are self-limiting; that is, the body will recover in six weeks or so, with analgesia, exercise and other treatments, like massage or physiotherapy. But when back pain lasts longer than three months it is defined as chronic back pain.

For further CBD training, you may be interested to learn more about the HealthCert Professional Diploma program in Medicinal Cannabis, allowing you to get your medical cannabis certification online.

Some patients benefit greatly from visiting a pain clinic, but the waiting list to see a pain specialist in Australia can be inordinate, especially in rural and remote areas, where pain clinics may be held only a few times a year at a hospital hundreds of kilometres away. Sometimes GPs in a rural or remote area will consult with other specialists over the phone or video conference call to optimise pain relief medication.

If a patient’s life has been affected by chronic back pain, they may wonder whether marijuana-based pain medication could help.

Medications have limitations

Many patients with chronic back pain are taking more medication than they (or their doctor) would like. Most doctors prescribe non-steroidal anti-inflammatory medication (NSAIDs, e.g. Ibuprofen, Naproxen) for acute back pain. With paracetamol, they have a role in acute pain relief. But patients can’t take NSAIDs long-term as they can have dangerous effects.

Opiate medications, also helpful at the time of an acute injury, don’t work particularly well for most patients with chronic back pain. The side effects of opioids are well known: constipation, nausea and vomiting and the risk of tolerance, dependency or overdose. Hundreds of thousands of people die from opiate overdose, mostly accidental and overwhelmingly from prescribed medications, each year. It happens when people are trying unsuccessfully to relieve their pain.

Sometimes prescribed medications – even with exercise, rest, good nutrition and the best attitude in the world – is not enough. If your patient is still suffering the effects of chronic pain, it is worthwhile to explore other options. Research indicates that medicinal cannabis may have a role to play in chronic pain management – however results to date have been mixed, and it’s important to be aware of potential side effects.

Can medical marijuana help for pain?

For some patients with degenerative disc disease, spinal canal stenosis, other common problems associated with overuse and ageing, or who have had unsuccessful or only partly successful back surgery, the long-term management of their back and nerve pain can be a real challenge.

The major active ingredients of cannabis are called cannabinoids. THC and CBD oil are the best-known cannabinoids. They have been isolated or synthesised to make medicinal cannabis. CBD oil has an anti-inflammatory affect and thus may be useful in the treatment of nerve (also called neuropathic) pain.

In some pain studies and for some patients, CBD oil seems to work best when combined with a small amount of THC. This kind of formula relieves pain without any of the cognitive side effects—disorientation, confusion—which are possible with THC alone.

The clinical application of medicinal cannabis is a relatively new space for research. There is still much that we don’t know. While medicinal cannabis appears to have encouraging potential as a treatment modality, further studies are needed to better understand its efficacy, dosing and tolerability.

Prescribing medical cannabis for back pain

Medications for chronic back pain, including medical cannabis, can be prescribed by a GP or other authorised specialist.

Many patients with debilitating chronic back pain would like to try medical marijuana for the management of their pain. There is some evidence that medical marijuana oil is helpful for patients with chronic non-cancer pain where ordinary medicines are not effective, and this includes back pain.

The Canadian College of Family Physicians published guidelines for the safer use of smoked marijuana for chronic pain in 2014. It is important to note that studies also show that medicinal cannabis isn’t always effective, and that it can cause side effects in some patients.

Our knowledge of medical marijuana and the range of available products is growing and expanding each year. After a discussion about potential risks, medicinal cannabis may be helpful in managing patients’ back pain.

For further CBD training, you may be interested to learn more about the HealthCert Professional Diploma program in Medicinal Cannabis, allowing you to get your medical cannabis certification online.

Read another article: Medicinal cannabis and the entourage effect

If you are interested in becoming an authorised prescriber of Medicinal Cannabis in Australia, the TGA SAS-B guidelines require you to prove that you have the knowledge necessary to do so. HealthCert’s Professional Diploma of Medicinal Cannabis pathway can serve as part of your documentation showing that you have undertaken education in this field when you decide to become an authorised prescriber.

This article has been provided by our partner, Southern Cannabis Holdings. Southern Cannabis Holdings builds, integrates and operates high-value brands across the cannabis value chain, including FreshLeaf AnalyticsCannabis Access Clinics and Applied Cannabis Research. HealthCert and Southern Cross Holdings have partnered up to bridge gaps in patient and clinician knowledge on medicinal cannabis.

Contact CA Clinics at info@caclinics.com.au or call 1300 991 477 if you would like more information.


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