Chronic Pain Treatment

For those suffering from chronic and acute pain conditions, the stress and frustration that this pain brings can be incredibly debilitating. Now that medicinal cannabis (including CBD oil) is legal to be prescribed by GPs in New Zealand, many patients suffering from pain conditions have begun exploring this natural alternative treatment to traditional pharmaceuticals.

Current treatments often provide inadequate symptom relief and can have side effects. This has led many patients to explore alternative therapies like cannabidiol (CBD), a non-intoxicating component of cannabis.

One of the primary physiological systems controlling pain is the endocannabinoid system, which has a regulatory effect throughout the pain-processing pathways in the body.

‍Cannabinoids, such as CBD and THC, interact with our endo or natural cannabinoid receptors in the body and brain. They have a range of benefits, including the easing of pain, the lowering of tension and anxiety, and the improvement of memory and learning.

‍They also have an impact on immunological performance, inflammation, and appetite. Due to the synergistic effects of THC and CBD, THC alone does not have the same potent anti-pain effects as THC and CBD combined.

CBD

According to studies, CBD may lessen chronic pain by influencing the activity of endocannabinoid receptors, lowering inflammation, and interacting with neurotransmitters. According to several studies, using CBD alone may help treat some forms of pain symptoms, such as back and nerve pain.

‍CBD is most commonly used as oral oils, gummies, or soft-gels, but can also be inhaled through a vaporiser in the form of a CBD-dominant strain of cannabis flower. 

THC

In our clinical experience, the addition of small doses of THC to a patient’s treatment plan may also help with pain management. THC can be particularly useful for helping with acute pain, or when CBD alone is not sufficient.

‍THC can be used as an oil of varying concentrations, or via cannabis flowers which can be inhaled through a vaporiser or made into teas.

Since it became legal in New Zealand, many Kiwis have turned to medicinal cannabis and CBD oil as a natural plant-based alternative to traditional pharmaceutical treatments. Our patients consult with our experienced doctors about a large range of pain-related conditions including (but not limited to).

Chronic Pain

CBD has been shown to improve about 25% of people with chronic pain by itself, and a further 50% may be helped by combining CBD and THC. Studies have also shown that the reduction of chronic pain also leads to reduced reliance opioids.

Some of the pain symptoms that CBD oil and medicinal cannabis may support include:

• Complex regional pain syndrome
• Injury-related pain
• Shoulder and neck pain
• Neurogenic pain (caused by damage to nerves)
• Muscle spasms
• Inflammation

Back Pain

Some early studies have suggested that CBD may alter how someone experiences pain, but more thorough research is required in this area. CBD oil is a full-body treatment as it brings the body back into homeostasis or balance, so whilst not directly targeted back pain, it may provide a general sense of relaxation and pain reduction.

Read our dedicated page about medicinal cannabis and back-pain, here.

Arthritis

The psychoactive ingredient in cannabis known as THC may also help with pain management. Although CBD doesn’t typically have an intoxicating effect, research indicates that it may also assist reduce arthritis symptoms. Both of these cannabinoids, albeit in distinct ways, have promise for reducing pain. Arthritic conditions where symptoms may be improved include osteoarthritis, rheumatoid arthritis and psoriatic arthritis. 

‍While more research is certainly needed, a 2022 study in people with arthritis (osteoarthritis, rheumatoid, or other autoimmune arthritis) found that CBD alone was associated with significant improvements in pain, physical function, and sleep quality. The overall cohort reported a 44% reduction in pain after CBD use.

Cannabinoids may reduce nausea and neuropathic pain, according to new research. In a 2010 study on people with cancer pain who weren’t responding to conventional opioid medications, researchers found that combining CBD and THC helped to significantly reduce pain – 43% of patients reported a 30% or greater improvement.

Cancer and cancer treatments have been demonstrated to lower appetite, although CBD may counter this effect. Additionally, the anti-inflammatory and anti-anxiety effects of CBD may also help cancer-related pain symptoms.

Read our dedicated page about medicinal cannabis and cancer, here.

Endometriosis

Endometriosis is one of the most common reasons why our Clinic patients are prescribed medicinal cannabis. By using either CBD oil, or a combination of both CBD and THC, the inflammation and pain symptoms associated with endometriosis may be significantly improved.

Some sufferers have advised us that it relieves their symptoms more effectively than other over-the-counter or prescription medications and this is supported by studies which show that cannabis may be particularly beneficial in endometriosis for pelvic pain, gastrointestinal issues and mood.  

Migraines

CBD oil contains anti-inflammatory properties and may help reduce tension and anxiety which sometimes reduces the frequency of migraines. It may also reduce the pain associated with a migraine. By using a starting point of CBD oil daily to help prevent migraines, and a THC-containing product at the start of an attack, medicinal cannabis has been an effective treatment for migraine sufferers at the Clinic.

In a study at the University of Colorado, 121 participants used cannabis daily to stave off migraine attacks. About 40% reported a halving in the monthly frequency of their migraine attacks. A 2024 RTC study (randomised controlled trial, the highest quality form of study) looking at vaporised cannabis found that “acute migraine treatment with THC + CBD was superior to placebo at 2 hours post-treatment with sustained benefits at 24 and 48 hours.” This means that cannabis can have ongoing benefits long after the initial migraine-relieving effects have worn off! ‍Read our dedicated page about medicinal cannabis and migraines, here.

Fibromyalgia

Fibromyalgia is a common condition that we see and treat at the Clinic. By using a combination of CBD oil and THC, we may be able to reduce the intensity and flares of pain symptoms.

‍One recent large observational study of 367 patients looked at how cannabis affects fibromyalgia patients. 80% of patients experienced improvements in sleep and depression. There were also significant improvements in general wellbeing and pain.

Everybody has an endocannabinoid system (ECS) comprising endocannabinoids, cannabinoid receptors, and enzymes. Your body naturally produces chemicals (endocannabinoids) that interact with these receptors to maintain balance throughout almost every body-system. 

The endocannabinoid receptors in your body receive signals, and your cells respond to these signals. The response in the endocannabinoid system from CBD consumption may lead to anti-inflammatory and pain-relieving effects that can help manage pain symptoms.

How do I use CBD for pain relief?

A doctor should be consulted before utilising CBD oil or any other form of medicinal cannabis to treat chronic pain. They will evaluate your unique pain needs and talk to you about how CBD might be able to help. CBD can be used in various methods, including topical treatments, oils and capsules. Taking CBD as a tincture, sometimes referred to as taking CBD sublingually, involves putting a few drops of the substance under your tongue. Your tongue has many capillaries, which promote high levels of absorption.

‍Starting slowly is crucial when introducing CBD oil into your regimen, especially if you’ve never used CBD products before. When starting out with your CBD and medicinal cannabis treatments, it is best to start low and go slow. Ultimately, the dosage required will depend on your body chemistry, weight, and pain severity, affecting how well the CBD oil works.

Does CBD oil have side effects?

While each person will experience side effects differently, potential signs and symptoms include changes in appetite, nausea, dizziness, and diarrhoea. If you have any concerns about how CBD products can affect your use of painkillers, it’s a good idea to speak with your GP. Side effects can include:

• Dry mouth
• Diarrhea
• Reduced appetite
• Drowsiness
• Fatigue