With cannabis going mainstream, more and more people are turning to cannabis for pain relief. In fact, chronic pain is considered to be the most common reason why people turn to cannabis, with a recent study finding that over 60% of medical marijuana patients use cannabis to treat chronic pain.

More patients relying on cannabis for pain relief means fewer people relying on opioids or other dangerous painkillers. But can cannabis really treat chronic pain?

Pain And The Endocannabinoid System

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The endocannabinoid system (ECS) is a physiological network of endogenous neurotransmitters and protein cell receptors that are expressed throughout the central and peripheral nervous systems. The ECS interacts with both endogenous (produced by the body) cannabinoids known as endocannabinoids and external cannabinoids (like THC and CBD) known as phytocannabinoids.

The ECS and its accompanying endocannabinoids are believed to play a significant role in modulating basic functions such as sleep, appetite, mood, and pain.

Researchers believe that the ECS is “one of the body’s key endogenous systems regulating pain sensation, with modulatory actions at all stages of pain processing pathways”. It is thought that the pain-relieving and anti-inflammatory effects of cannabis manifest themselves through the interactions between endocannabinoids/cannabinoids and the ECS.

Additionally, research also indicates that the body’s own endocannabinoids also have a role to play in controlling pain. Regardless of whether it’s through interactions with endocannabinoids like anandamide or with phytocannabinoids like THC or CBD, it’s clear that the ECS affects pain and pain perception.

Cannabinoids And Inflammation

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A common cause of chronic pain is inflammation due to sore joints and muscles. It is believed that cannabis may be able to relieve inflammation, and consequently the pain that accompanies it. Chinese healers who have known about the healing properties of cannabinoids since 2000 BC used to believe that cannabis “undoes rheumatism”, an inflammatory joint condition.

THC and CBD are both believed to have anti-inflammatory properties. Exogenous cannabinoids are believed to “suppress T-cell mediated immune cell responses by reducing apoptosis and suppressing inflammatory cytokines and chemokines”. By regulating inflammatory responses, cannabinoids and endocannabinoids are also able to reduce inflammation-related pain.

CBD And Pain

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In addition to its anti-inflammatory effects, the cannabinoid CBD is also believed to modulate pain by interacting with TRPV (transient receptor potential channel subfamily V) receptors – especially TRPV1 receptors – in the ECS.

TRPV1 receptors are known to mediate body temperature, inflammation, and pain perception. TRPV1 receptors are among the most sensitive neuroreceptors in the human body and are triggered by almost any form of pain stimulus.

The consumption of CBD seems to activate and then desensitize these receptors. Through prolonged activation these receptors become desensitized, resulting in less intense pain sensations. For example, researchers believe that CBD’s activation of TRPV1 receptors may make it useful in the treatment or rheumatoid arthritis (RA).

Additionally, CBD may also help endocannabinoids keep doing their job for longer. A study from 2015 found that CBD functions as an anandamide breakdown/reuptake inhibitor. CBD’s ability to inhibit the breakdown of endocannabinoids like anandamide and adenosine could potentially contribute to its anti-inflammatory and anxiolytic (anti-anxiety) effects.

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