By JOSH KAPLAN
Cannabis is known to relieve pain, but pain can arise for a variety of reasons which makes choosing the right cannabis product tricky. Knowing which cannabinoids (e.g. THC, CBD) have been shown to treat different pain types is useful information to take with you on your next dispensary visit.
The different types of pain fall into three general categories:
- Nociceptive pain
- Neuropathic pain
- Central pain (there’s no firm agreement on the name for this type of pain; fibromyalgia is a common example).
Since each type of pain has a different origin, each type has an optimal treatment strategy.
Pain results from the coordinated activation of brain cells. While these brain regions lead to the sensation of pain, they can also modulate the strength of the pain signals. In some instances, you can have physical injury (i.e., nociceptive pain) without the sensation of pain (imagine a car accident victim who can walk around pain-free in the initial moments after the accident).
But the opposite is also possible, where you can have pain in the absence of physical injury (i.e., central pain). This highlights the importance that factors like mood, context, and attention-to-injury play in the sensation of pain, which can also be used to inform optimal cannabis-based treatment strategies.
Cannabis and Nociceptive Pain
Nociceptive pain (i.e., inflammatory pain) results from tissue damage. It is subjectively described as sharp, aching, or throbbing pain that follows physical damage. When you get injured, the damaged tissues recruit numerous inflammatory and immune cells to repair the damage. These cellsrelease proteins and chemicals that activate receptors on nerves that make their way into the spinal cord and up to the brain, causing the sensation of pain.
Nociceptive pain can be weakened by reducing the pain signals at the site of injury by blocking the inflammatory process itself or the signals they elicit. Another strategy is to dampen their effects as they make their way up the spinal cord to the brain. Cannabis can target both of these processes to reduce pain.
The abundant cannabinoids, THC and CBD, can reduce pain at the site of injury. Both have potent anti-inflammatory effects. THC’s anti-inflammatory properties are primarily driven through activation of CB2receptors on immune cells which dampens the body’s pain-inducing response to injury. CBD also reduces inflammation by blocking inflammatory mediators and shifting the activation macrophage repair cells from the pro-inflammatory type to the anti-inflammatory type. Indeed, the benefits of THC and CBD on relieving nociceptive pain have been well-documented in rodent models of inflammation and in human clinical trials.