The endocannabinoid system (ECS) is obviously very important, given how widely expressed it is throughout the body, and especially in the peripheral and central nervous systems. With the ECS active in these areas, it’s logical to explore potential treatments which involve regulating this system with endocannabinoids and phyto-cannabinoids such as cannabidiol (CBD), that come from cannabis.
Over the past few years, the anecdotes for CBD as an effective remedy for neuropathic pain have started to pile up. In this post, we’ll explore the condition in more depth, and consider any existing evidence on CBD as a useful medication.
Neuropathic pain causes irregularities in the sensory system – injury or disease can both be responsible for the condition. The effect of neuropathic pain is disruption between the sensory system and the brain, with the former unable to send messages to the latter. For the patient, this can have two polarizing effects; it either leads to numbness or intense pain.
While sensory system disruptions like carpal tunnel syndrome can be a trigger for neuropathic pain, diabetes, vitamin deficiencies, and drug abuse have also been associated with the illness. Unfortunately, there are few high-quality treatments for neuropathic pain, which often has long-term, debilitating consequences for the patient. However, the extent and severity of symptoms do vary. Evidence supporting dysregulation in the peripheral nervous system as a cause of neuropathic pain has been found; spinal cord and brain injuries are also confirmed causes.
One of the worst things about neuropathic pain is that symptoms are very acute, and do not simply subside. Acute pain is a familiar feeling – we’ve all knocked our elbows or stubbed a toe at some stage – but after a short while, the pain wears off and we can get back to normal. But this isn’t the case for those with neuropathic pain, hence why it can be so disastrous.
Frustratingly, medical experts still have much to learn concerning neuropathic pain and are not completely sure on the overall, detailed effects that the condition has on the body. However, some have suggested that an increased emission of pain-signaling neurotransmitters, more than can be regulated by nerves, is behind the stinging pain. As the nerves in these areas are increasingly affected, persistent pain is an inevitability.
Research into strokes has revealed that brain damage can cause deterioration in the organ which prevents it from blocking pain signals. Moreover, spinal cord issues may result in more pain signals being sent to the brain for no apparent reason.
Cannabis and endocannabinoid system science is cutting-edge in the world of medicine, but still in its infancy. However, there is plenty of encouraging research going on regarding cannabinoids and neuropathic pain. Cannabinoids have been found to reduce and regulate inflammation, while easing neuropathic pain through interactions with alpha-3 glycine receptors, according to a 2012 study published in the Journal of Experimental Medicine.
There is already some precedent for medical cannabis being used to treat neuropathic pain, with Sativex, a pharmaceutical-grade cannabis oil made with CBD and tetrahydrocannabinol (THC) available for patients with multiple sclerosis in some countries.
Research into CBD as a pain reliever is of great interest since this cannabinoid is non-psychoactive doesn’t induce a “high” and is therefore viable for a much larger number of patients than, say, opioid-based drugs. While it’s been shown that the ECS has control over pain perception, the relevance of CBD in administering this effect is less certain.
Although, we are aware that CBD’s inhibition of the FAAH enzyme is crucial to increasing anandamide, a neurotransmitter, and endocannabinoid. This compound, which has also been compared to THC (and was only discovered thanks to the earlier identification of THC), interacts with two receptors that are thought to regulate pain perception: the CB1 receptor and the vanilloid receptor (TRPV-1) – both of these are g-protein coupled receptors. Anandamide has only been known about since 1992, and there are suggestions that up to 20 to 30 percent of Americans have a deficiency in this crucial compound, as part of a wider potential condition called Clinical Endocannabinoid Deficiency (CECD).
The possible therapeutic effects of CBD do not begin and end at reducing pain. The cannabinoid is an anti-inflammatory, antidepressant, as well as an effective sleep aid and treatment for anxiety. The benefits of regulating immune system response are numerous and helps prevent autoimmune diseases. CBD has a very low toxicity and no physical addiction risk and considering its health perks and known activity in the central and peripheral nervous systems, it’s definitely worth trying to treat neuropathic pain.
As the symptoms of neuropathic pain are acute, the quick response that comes from sublingually-absorbed CBD oil is essential if using CBD to combat neuropathic conditions. Since the pain often worsens in a matter of minutes, it’s also important to administer treatment as soon as possible. For those who find that vaping or oils provide some level of relief, perhaps move to CBD concentrates, which are more potent but can be dosed with just as quickly.
Patients with neuropathic pain that is not overly intense but ever-present may find that medicating with edibles is more efficient, as the effects of CBD often last more than 100 percent longer than when vaporized.
The jury is still out on how useful CBD is for neuropathic pain, but there are reasons for patients to be excited about cannabinoid-based therapy for various conditions. And we know that for some neuropathic conditions, like multiple sclerosis, CBD and THC definitely works to some extent.
While the World Health Organization (WHO) has remained hesitant about being supportive of cannabis-based medication, a committee meeting in late 2017 led to a change in stance. The WHO now says that CBD has no “abuse potential.”
Therefore, if all options have failed in treating neuropathic pain, there’s no harm in looking into the benefits of CBD.