How Effective is Cannabis for Chronic Back Pain?

Every once in a while, you may experience temporary back pain. Whether you hit the gym for a hard workout or engaged in an activity at home where your back muscles were put to heavy use, it’s common to experience soreness and some muscle spasms or stiffness.

Periodic back pain management is easy. Rest, combined with hot or cold therapy, analgesic patches placed on the location where you are experiencing pain, and some over-the-counter muscle relaxers or medications.

Chronic back pain is a debilitating condition that can be caused by a variety of health conditions and specific types of injuries. Think of the worst temporary back pain that you have ever had, and imagine living every day with that degree of discomfort.

In the United States, more than 16 million adults (or 8% of the population over eighteen) experience persistent moderate to severe chronic back pain. Some studies reviewed the healthcare and indirect costs associated with back pain treatment alone, missed days of work, and disability payments to patients suffering from the condition; it was estimated at $12 billion per year. That makes back pain the sixth most costly health condition in America.

For patients living with chronic back pain, every day presents mobility and pain management challenges that can negatively impact quality of life. Let’s talk about the causes and potential treatment plans that patients with chronic back pain can explore and how some are turning to medical cannabis to provide temporary relief.

What Are The Causes of Chronic Back Pain?

There are many different causes, from injuries to diseases, that may contribute to the development of chronic back pain. Acute back pain and peripheral neuropathic pain are the top two debilitating chronic pain conditions in the United States.

The adverse effects of chronic back pain can be caused by the following:

Spinal Cord Injury

Any spinal cord injury (SCI) leads to motor function and sensory impairments. The spinal cord is responsible for communicating all messages from the brain through the central nervous system. When the spinal cord messaging is impaired, it can lead to systemic neurological challenges that can cause paralysis, chronic pain, and nerve sensory deficits.

Degenerative Disc Disease

Over time, the cushioning cartilage between spinal discs can wear down. It can be caused naturally by age or through daily exertion of lifting, pushing, and pulling, common with manual labor jobs. The discs in the spine lose hydration and elasticity, and then chronic pain can be felt anytime the patient bends, lifts, or extends back muscles.

Chronic back pain from Degenerative Disc Disease (DDD) may improve with surgical intervention. There are procedures now that can help inflate the spaces between spinal discs or create a spinal fusion to alleviate pressure on individual discs. However, common treatment methods include physical therapy and pain medications.

Herniated Disc

A herniated disc causes pain when the soft core of the disc protrudes and impinges on other nerves. You may also hear it referred to as a slipped or ruptured disc, and it can cause chronic pain, numbness, and tingling sensations in the back and radiate down into the legs.

Therapies to manage pain for a herniated disc condition include physical therapy, prescription medications, and sometimes surgery. Lifestyle changes and rest are also part of reducing pain for patients who have one or more herniated discs.

Scoliosis

This condition is caused by an abnormal curvature of the spine. With Scoliosis, irregular positioning of the spine changes pressure points and causes muscle imbalance and strain. Nerves can also be impinged, causing discomfort and chronic back pain.

Physical therapy, back supports or bracing, prescription medications, and sometimes surgery are the treatment plans for patients who have Scoliosis. Patients with this condition may be at a higher risk for mental health disorders, such as anxiety or depression, due to the discomfort from chronic neuropathic pain, which is difficult to resolve.

Ankylosing Spondylitis

A type of inflammatory arthritis, Ankylosing Spondylitis (AS), causes high levels of inflammation and sometimes structural changes to the spine. This condition impacts the sacroiliac joints and the spinal column, and the inflammation stimulates new bone production, which can fuse spinal segments, reducing mobility and causing chronic back pain.

Treatment for this condition focuses on reducing inflammation and providing pain relief through prescription medications.

Osteoarthritis

When you have Osteoarthritis, it is defined as a degenerative joint disease that can cause chronic pain due to the breakdown of cartilage in the spine. When cartilage is worn thin or gone completely, there can be bone-on-bone contact, where joints no longer have cushioning in between.

Osteoarthritis can also cause the development of bone spurs, which further exacerbate chronic pain and symptom severity. Intervertebral discs can also reduce in size and strength, which can increase compression and contribute to chronic back pain.

Rheumatoid Arthritis

The autoimmune disease Rheumatoid Arthritis (RA) causes chronic inflammation and damage to joints throughout the body. The human immune system attacks the synovium (lining of the bone joints), which contributes to increased inflammation, stiffness, and acute pain.

Therapies for RA include prescription medications, autoimmune drugs, and physical therapy. There are ways to suppress or reduce inflammation caused by Rheumatoid Arthritis, but there is no cure or common surgical procedure that may help.

Spinal Stenosis

Patients living with Spinal Stenosis face long-term acute pain symptoms. This disorder causes the spinal canal to narrow, which compresses the spinal cord and nerves. Spinal Stenosis can be caused by aging, injury, or other conditions like herniated discs.

Sometimes, surgical interventions are successful in relieving pain, but prescription medications are frequently used for pain management. Activities like walking, bending, or standing can be painful for patients with Spinal Stenosis.

Spondylolisthesis

Sometimes, due to injury or aging, one vertebra slips forward over the vertebra underneath, often located in the lumbar spine. This slippage can also be caused by stress fractures and congenital abnormalities.

The slipped vertebra impinges on muscles, nerves, other discs, facet joints, and also ligaments. This can result in persistent or chronic back pain and muscle spasms. Bracing and physical therapy are two treatment methods for Spondylolisthesis, as well as muscle relaxants and prescription pain medications.

Fibromyalgia

Around 4 million people in the United States have been diagnosed with Fibromyalgia, or approximately 2% of the adult population. However, more than 70% of diagnoses occur with female patients aged 20-50 years.

Fibromyalgia can contribute to chronic back pain by:

• Increasing muscle tightness and tension.
• Increasing central sensitization (hypersensitivity to pain signals).
• Contributing to insomnia and sleep disruption due to pain symptoms.
• Increasing incidents of chronic fatigue can cause sedentary positioning for long periods of time, which can exacerbate lumbar, shoulder, and neck pain.
• Postural imbalance and sustained positioning which can increase pain and discomfort.

Heightened central nervous system sensitivity is the main culprit responsible for causing symptoms of chronic back pain for patients with Fibromyalgia. Because of the neuropathic pain, it is difficult to treat, and many patients resort to alternative health options for pain relief.

Myofascial Pain Syndrome

The sensitization of trigger points in the connective tissue surrounding muscles (fascia) can contribute to back pain. Myofascial Pain Syndrome (MPS) is the development of trigger points on the paraspinal muscles.

Trigger points on back muscles can spread pain to other regions of the body (called pain referral). Patients can also develop referred pain patterns, where pain is referred to other areas like the shoulders and cause neck pain.

One of the main causes of aggravated back pain with MPS is altered movement patterns. When you experience chronic pain in your back, you may adjust your positioning to put less pressure on that area. The compensatory movement causes muscles to be strained, contributing to back pain.

Inflammatory Bowel Disease (IBD)

Conditions like Crohn’s disease and ulcerative colitis fall in the category of Inflammatory Bowel Disease (IBD). The symptoms of IBD are primarily in the gastrointestinal tract; however, some patients experience extraintestinal problems that impact joints and the musculoskeletal system.

People with Inflammatory Bowel Disease can experience the following conditions, which may cause chronic joint or back pain:

• Peripheral Arthritis.
• Spondyloarthritis.
• Inflammatory Back Pain.
• Systemic Inflammation.
• Autoimmune-related Inflammation.

Inflammatory back pain is most common among people diagnosed with Inflammatory Bowel Disease (IBD). Inflammation can spread from the digestive tract to the spine.

Cancer

Patients who are undergoing cancer treatments can experience chronic pain triggered by chemotherapy and prescription therapeutics. The level of chronic pain severity depends on the type of cancer, where it is located, and what stage of cancer development the patient is in.

Cancer cells can metastasize from the original location to other parts of the body. Metastasis in the spine occurs when cancer cells penetrate the bones of the spine, which can cause spinal nerve compression and chronic pain.

Tumors that grow near the spine can apply pressure on surrounding tissues and cause radiating nerve pain through the upper and lumbar areas of the back. Sedentary rest postures (laying down for long periods of time) and inflammation caused by cancer can all contribute to chronic back pain.

Kidney Stones

Back pain is a common symptom experienced by patients who have kidney stones. There are a number of ways that kidney stones can contribute to chronic back pain. For example, the stones can obstruct normal urinary flow, causing a pressure build-up and pain.

Urinary obstructions can also stretch the kidney capsule (thin tissue surrounding the organ called the renal capsule). This is usually felt as pain just below the rib cage, radiating into the lower abdomen, groin, and back.

Spinal Infections

While rare, spinal infections can be caused by viruses, bacteria, and fungi. The infection can be within the fluid of the spinal cord, vertebrae, discs, and all surrounding tissues. When the infection infiltrates spinal bone masses, a condition called osteomyelitis can occur, which weakens the bones, causing pain and discomfort.

An infection of the spinal discs is called discitis, and it can cause a breakdown of the structure of discs, causing back pain. Nerve compression can also occur with spinal infections, and in some cases, abscess formation or pockets of pus can form in the spinal area, increasing inflammation and triggering back pain.

What Do The Symptoms of Chronic Back Pain Feel Like?

Chronic back pain can vary in terms of intensity, from mild to moderate or severe. The clinical definition of back pain required for diagnosis is discomfort or pain daily, which lasts for twelve weeks or longer. The pain symptoms may range from a dull ache to sharp stabbing pains, throbbing, or burning in any area of the back.

Some symptoms to look out for include:

• Muscle tension or spasms.
• Radiating pain.
• Pain experienced with physical activities (bending, lifting, prolonged sitting, etc.)
• Difficulty finding a comfortable position when resting or sleeping.
• Chronic fatigue and reduced energy levels.

As with other chronic pain conditions, patients can experience mental health challenges when coping with back pain. From a limited range of motion to difficulties managing daily activities of self-care, exercise, and recreation, chronic back pain can have a debilitating effect on the lives of patients. This can result in symptoms of anxiety or depression, as a result.

Therapies And Treatment Plans for Chronic Back Pain Management

There are ways to address chronic back pain, and while the treatments do not resolve the source of the pain, they may help moderate the symptoms and provide relief. Neuropathic pain relief is the hardest to treat, as it is often not localized in one specific area.

Common treatments for back pain include:

• Physical therapy.
• Prescription medications.
• Cognitive Behavioral Therapy (CBT).
• Acupuncture.
• Chiropractic care.
• Stretching and exercise programs.
• Steroid epidural or facet joint injections.

Pain control is the objective for patients who live with chronic back pain. However, chronic pain relief may involve using more than one treatment modality to achieve pain reduction.

How Can Medical Cannabis Help With Back Pain?

Over time, patients who have had long-term chronic back pain may develop a tolerance to prescription pain medications, including opioids and NSAIDs. It has been clinically proven that pain medications become less effective when used for long periods.

That leaves patients seeking alternative medicine to help with chronic back pain symptoms. There are many ways that doctor-supervised medical cannabis can help manage back pain and temporarily decrease the severity of pain symptoms experienced.

Pain Relief

Cannabinoids interact with the human endocannabinoid system, which regulates pain perception. Some studies suggest cannabis can modulate pain signals and provide relief for people who experience chronic back pain.

Help With Inflammation

Cannabidiol, or CBD, is a naturally occurring major cannabinoid found in the cannabis plant. Medical cannabis strains that are high in CBD content may provide anti-inflammatory properties that reduce inflammation and help relieve pain.

Muscle Relaxation

Randomized pain and muscle spasms are common symptoms experienced by people with chronic back pain. Cannabis can help relax muscles, improve overall comfort, and reduce the occurrence and severity of muscle spasms. Cannabis is also used by patients diagnosed with epilepsy for the same purposes.

Help With Symptoms of Anxiety or Depression

Certain strains of cannabis may impact your mood in favorable ways. For example, medical cannabis products made from Sativa-dominant strains can provide stress relief, increase energy (helpful for chronic fatigue symptoms), and create feelings of relaxation and euphoria.

Can Improve Sleep Quality

Medical cannabis products made from Indica-dominant strains can provide effective pain relief that helps you get to sleep and reduce pain-related sleep disruptions. Indica-dominant or pure Indica strains have a sedating effect for most patients.

Mixing cannabis with pain medications can be harmful to your health. If you have considered trying medical cannabis, it is important to disclose the prescription medications you are currently taking when you talk to your cannabis healthcare provider. Cannabis can conflict with some types of prescription drugs and increase your risk of adverse effects.

Does Chronic Pain Qualify Patients for Medical Cannabis?

In most states where medical cannabis is legalized, chronic pain is a qualifying health condition, whether that is back pain, neuropathy, or another type of chronic pain. Suppose you have been formally diagnosed with a chronic pain condition. In that case, you may be eligible to become a registered patient in your state medical cannabis program and get your medical card.

MedWell Health and Wellness Centers provides telemedicine consultations with experienced cannabis healthcare providers. Get certified online from the comfort of your home, and get helpful guidance to complete your application and get your Massachusetts medical marijuana card.