The chronic pain cycle is a concept that describes how chronic pain can affect various aspects of a person’s physical and emotional well-being. It involves a loop of symptoms that can make pain worse and harder to manage. Medical cannabis is a potential treatment option that may help some people break the chronic pain cycle by reducing pain, inflammation, muscle tension, and emotional stress. However, medical cannabis is not a cure-all and may have some side effects and risks. Here is some information that may help you understand more about the chronic pain cycle and medical cannabis.

The chronic pain cycle consists of several stages that can feed into each other and create a vicious circle¹. The stages are:

– Pain: This is the initial sensation that signals an injury or inflammation in the body. Pain can be acute or chronic, depending on the duration and cause of the pain.

– Muscle guarding and restricted mobility: This is the body’s protective response to pain, which involves tightening the muscles around the affected area to prevent further damage. However, prolonged muscle guarding can limit the movement of the joints and impair the healing process.

– Muscle weakness and atrophy: This is the result of reduced use of the muscles due to pain and guarding. The muscles can become weaker and smaller over time, which can affect their function and stability.

– Muscle inflammation and increased pain: This is the consequence of chronic muscle tension and reduced blood flow to the tissues. The inflammation can trigger more pain signals and make the pain more intense and widespread.

– Decreased function: This is the impact of chronic pain and muscle problems on the ability to perform daily activities and tasks. Reduced function can affect the quality of life and well-being of a person with chronic pain.

– Emotional and mental stress: This is the psychological effect of chronic pain and decreased function on the mood and outlook of a person with chronic pain. Emotional and mental stress can include feelings of anger, frustration, depression, anxiety, and helplessness. These feelings can increase physical tension, lower motivation, and worsen pain perception.

Medical cannabis is a term that refers to the use of cannabis or its components (such as THC and CBD) for medical purposes. Medical cannabis may help some people with chronic pain by interacting with the endocannabinoid system, which is a network of receptors and molecules that regulate various bodily functions, including pain, inflammation, mood, and stress². Some of the possible benefits of medical cannabis for chronic pain are:

– Pain relief: Medical cannabis may reduce pain by activating the CB1 and CB2 receptors, which can modulate the transmission and perception of pain signals³. A systematic review and meta-analysis of randomized clinical trials found that medical cannabis or cannabinoids may provide a clinically important decrease in pain for a small to very small proportion of patients with chronic pain⁴.

– Anti-inflammatory effect: Medical cannabis may reduce inflammation by inhibiting the production of pro-inflammatory cytokines and enhancing the activity of anti-inflammatory cytokines³. Inflammation is a common cause and consequence of chronic pain, and reducing inflammation may help with the healing process and pain management.

– Muscle relaxation: Medical cannabis may relax the muscles by affecting the calcium channels and potassium channels, which are involved in muscle contraction and relaxation³. Muscle relaxation may help with muscle guarding, restricted mobility, and muscle inflammation, which are part of the chronic pain cycle.

– Emotional and mental support: Medical cannabis may improve the mood and outlook of a person with chronic pain by influencing the serotonin and dopamine systems, which are involved in the regulation of emotions, motivation, and reward³. Medical cannabis may also reduce anxiety and stress by affecting the amygdala and hippocampus, which are involved in the processing of fear and memory³. Emotional and mental support may help with coping with chronic pain and breaking the cycle of negative thoughts and feelings.

However, medical cannabis is not without risks and limitations. Some of the possible drawbacks and challenges of medical cannabis for chronic pain are:

– Side effects: Medical cannabis may cause some side effects, such as sedation, dizziness, dry mouth, nausea, increased appetite, and impaired cognition and coordination⁴. These side effects may vary depending on the dose, route of administration, and individual factors. Some side effects may interfere with the function and safety of a person with chronic pain.

– Lack of evidence: Medical cannabis is still a relatively new and controversial topic in the medical field, and there is a lack of high-quality and long-term evidence on its effectiveness and safety for chronic pain⁴. The existing studies have many limitations, such as small sample sizes, short durations, heterogeneous populations, and inconsistent outcomes. More research is needed to establish the optimal dose, formulation, and mode of delivery of medical cannabis for different types of chronic pain.

– Legal and regulatory issues: Medical cannabis is not legal in all countries and regions, and the laws and regulations regarding its use may vary widely. A person who wants to use medical cannabis for chronic pain may need to obtain a prescription from a qualified doctor and follow the rules and restrictions of their jurisdiction. A person who travels with medical cannabis may also face legal problems in some places.

– Cost and availability: Medical cannabis is not covered by most health insurance plans, and the cost and availability of medical cannabis may depend on the supply and demand of the market. A person who uses medical cannabis for chronic pain may have to pay out of pocket and may have difficulty accessing consistent and quality products.

In conclusion, medical cannabis is a potential treatment option that may help some people with chronic pain break the chronic pain cycle by reducing pain, inflammation, muscle tension, and emotional stress. However, medical cannabis is not a cure-all and may have some side effects and risks. A person who is interested in using medical cannabis for chronic pain should consult with their doctor and weigh the benefits and drawbacks of this option. A person who uses medical cannabis for chronic pain should also monitor their response and adjust their dose and frequency as needed. Medical cannabis should be used as part of a comprehensive pain management plan that includes other strategies, such as exercise, physical therapy, psychological therapy, and lifestyle changes.

Source: Conversation with Bing, 08/11/2023

(1) Medical cannabis for chronic pain | The BMJ. https://www.bmj.com/content/374/bmj.n1942.

(2) Chronic pain cycle: How can CBPMs defeat chronic pain?. https://www.mamedica.co.uk/the-chronic-pain-cycle-how-can-medical-cannabis-help-to-defeat-chronic-pain/.

(3) Chronic Pain and Cannabis: It May Help Some People Cut … – Healthline. https://www.healthline.com/health-news/chronic-pain-and-cannabis-research-finds-it-may-help-some-people-cut-down-on-opioids.

(4) Cannabis for chronic pain relief: How effective is it? – Medical News Today. https://www.medicalnewstoday.com/articles/cannabis-for-chronic-pain-new-research-questions-its-effectiveness.

(5) undefined. https://doi.org/10.1136/bmj.n1942.