Medical marijuana and spinal cord injuries
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Spinal cord injuries are complex injuries that can have a devastating effect on patients. Apart from completely changing how a person lives their life, these injuries also often cause chronic nociceptive and/or neuropathic pain.
While cannabis is well known as a painkiller, new research suggests it may be specifically useful in treating the pain caused by spinal injuries and surgery.
UNDERSTANDING THE SPINAL CORD
Without going into too much detail, it is important to understand the role the spinal cord plays in human function.
The spinal cord is essentially the freeway for communications between your brain and body. It begins at the base of your brain and is made up of thousands of nerve cells that connect to various parts of your body.
The tracts in your spinal cord carry messages from nerve cells all around your body to the brain where they are processed. These tracts control everything from motor movements to sensory information.
WHAT ARE SPINAL CORD INJURIES?
Spinal cord injuries are complex injuries that can happen to any part of the spinal cord, including the nerves at the end of the spinal canal. They are caused by both traumatic or nontraumatic damage to the vertebrae, ligaments, or disks of the spinal column or the spinal cord itself.
They are serious injuries and generally produce permanent changes in a person’s strength, sensation, and bodily functions beneath the point of injury. Spinal cord injuries are beyond repair and patients suffering from these injuries are usually left to make permanent life changes in order to deal with the consequences.
THE SYMPTOMS OF A SPINAL CORD INJURY
Both traumatic and nontraumatic damage to the spine has the possibility to damage nerve fibers that run through the injury site. This can essentially impair the flow of information between the body and brain, ultimately affecting the body’s control over areas below the injury site.
A lumbar spinal cord injury, for example, can affect a patient’s ability to control certain muscle groups in the legs, as well as bowel, bladder, and sexual function. Injuries at the neck can affect the torso, arms, and more.
Some common results of a spinal cord injury include:
- Nociceptive muscle/joint pain, as well as neuropathic pain.
- Loss of muscle function in areas below the injury site.
- Loss of bladder and bowel control.
- Sensory loss in the skin, resulting in an inability to feel things like pressure or temperature.
- Impaired respiratory control, making it hard to breath or cough, for example.
- Loss of physical fitness and wellness as a result of impaired physical function.
- Spasticity or flaccidity.
- Impaired sexual function.
It is important to note that a spinal cord injury results in a vast variety of changes to a person’s lifestyle. These changes can be hard to come to terms with, which is why many patients with spinal cord injuries are also at risk of developing mental health conditions like depression.
Patients who experienced an injury during a traumatic event such as a car accident or act of violence (like a stabbing or shooting) may also be haunted by traumatic memories from the event. This may put them at risk of developing anxiety or even post-traumatic stress disorder (PTSD).
CANNABIS AND SPINAL CORD INJURIES
Cannabis is gaining a lot of attention as a legitimate medicine, helping patients manage a vast variety of symptoms and conditions.
When it comes to spinal cord injuries, some of the major symptoms experienced by patients are nociceptive and neuropathic pain. Well, research suggests cannabis may help manage both of these symptoms.
There is a strong body of research that shows that cannabis is an effective painkiller. The cannabinoids found in the cannabis plant (mainly THC and CBD) have already been shown to provide relief from pain in a variety of studies.
By interacting with certain cannabis receptors in the brain, cannabinoids like THC and CBD are able to inhibit the delivery of pain signals from the body to the brain, ultimately helping mask the intensity of pain experienced by a patient.
In 2016, a study in the Clinical Journal of Pain found that cannabis reduced pain and improved functional outcomes in over 270 patients. Furthermore, a survey of over 1,300 fibromyalgia patients found that medical marijuana was the most effective drug at relieving the pain that characterizes the condition.
Cannabis is also believed to be effective at treating neuropathic (or nerve) pain. A 2010 study published in the Canadian Medical Association Journal found that as little as a single inhalation of a joint taken 3 times daily helped reduce post-surgical neuropathic pain in participating patients.
Most importantly, recent research suggests that cannabis can also help relieve specific spinal pain in patients with spinal cord injuries.
In a recent manuscript accepted by the Journal of Pain, researchers tested the efficacy of cannabis in relieving spinal pain in 42 patients. The patients were given cannabis with either 2.9% or 6.7% THC. They were first given 4 puffs from a joint and were allowed to take either 4 or 8 puffs 3 hours later. The experiment was repeated 3 times.
The researchers found that cannabis significantly helped reduce the pain intensity in participants. This was reflected in a drop in pain scores after medicating with cannabis.
A second study, completed in 2012, looked at how CBD may help patients with spinal injuries. The trial involved rats who underwent surgery to deliberately produce spinal injury. The rats in the test group were injected with 20mg/kg of pure CBD both before and after the surgery, while those in the control group weren’t.
The study found that the rats injected with CBD performed significantly better than non-treated rats in terms of motor skills and mobility and also had less overall tissue injury.
CANNABIS: A PROMISING ALTERNATIVE FOR SPINAL PAIN
Spinal injuries are a serious condition which can results in both neuropathic and nociceptive. A solid body of research has already established that cannabis can be a very effective painkiller, and the evidence discussed above makes a strong case that it may specifically help patients from spinal cord injuries.
As always, it's important to remember the limitations of this research and the need for more trials before making solid conclusion about cannabis as a medicine. Its also important to remember that cannabis cannot reverse or treat the actual damage caused during a spinal cord injury (at least, not yet).
Nonetheless, the case for medical marijuana as a painkiller for spinal pain is compelling and warrants further research into this field.