Back Pain & Why New Alternatives Are Being Explored
Back pain is one of the most common complaints in medical practice. It can beĀ acute (short-term, often due to injury, strain, or sudden onset) or chronic (lasting beyond the usual healing time, often over 3-6 months). Causes include:
- Muscular strain
- Intervertebral disc problems
- Compression or irritation of nerve roots
- Degenerative changes in joints or discs
- Referred pain from other organs
Standard treatments often include pain-relieving medications (NSAIDs, muscle relaxants), physical therapy, exercise, sometimes stronger drugs like opioids. But many patients donāt get full relief or suffer side-effects or risks.Ā Hence the interest inĀ alternative medicine options, including cannabinoids such as CBD (cannabidiol) and THC (tetrahydrocannabinol).
What Is CBD & THC, And How Might They Work?
- THC is the psychoactive compound in the cannabis plant (the one more likely to produce 'high' effects).
- CBD is a non-psychoactive compound; it does not typically produce a high.
There is a system in the body called the endocannabinoid system, which helps regulate pain, inflammation, sleep, mood, and more. CBD and THC interact with parts of this system, possibly modulating pain signals, inflammatory processes, or nerve sensitivity. But many mechanisms are still under study, and there is variability in how people respond.
What the Research Says: Studies Related to Back Pain & CBD/THC
Here is what existing research shows highlighting both possibilities and the limitations:
| Study / Review | What Was Investigated | Key Findings (non-definitive) | Limitations |
|---|---|---|---|
| Edible cannabis for chronic low back pain (2024) | Orally administered THC + CBD edibles, short-term and over 2 weeks. | Higher THC correlated with short-term pain relief. CBD linked with tension relief. Pain reduced across participants using various forms. | Small sample, self-reporting, short follow-up, variability in use. |
| THC/CBD Spray for Back & Neck Pain (Australia, 2023) | Oro-mucosal spray with 10 mg THC + 25 mg CBD over 4 weeks. | Even lowest doses reduced pain. Higher doses improved daily functioning. Mild, tolerable side effects. | Open-label, small sample (28 patients), short study period. |
| Systematic Review: CBD in Chronic Pain (2023) | Review of CBD studies for chronic pain more broadly. | Promising signals for CBD helping chronic pain, sleep, mood, especially when combined with THC. | Underpowered studies, dosing differences, varied methods. |
| Review of Cannabinoids in Chronic Pain (2023) | History and data on THC, CBD, and other cannabinoids in chronic pain. | Described as āpromising, albeit complexā with potential in neuropathic and inflammatory pain. | Small samples, short follow-ups, side effects possible. |
| Systematic Review: Cannabis & Back Pain (2021) | 4 studies, 110 patients, using THC, dronabinol, nabilone. | Some evidence of pain reduction and improved quality of life. | Very small numbers, inconsistent definitions, short follow-ups. |
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Risks, Side Effects, & Important Considerations
- Side effects: sedation, dizziness, cognitive effects, mood changes, altered perception.
- Drug interactions: CBD in particular may affect metabolism of other medications.
- Dose & ratio: Effects vary by dose, ratio of THC/CBD, and delivery method.
- Legal/regulatory status: Differs by country and region.
- Individual variability: Age, health, medications, genetics, and lifestyle can affect outcomes.
- Long-term effects: Still under investigation.
Practical Guidance for Patients: What to Ask & What to Watch
- Clarify goals (pain relief, sleep improvement, quality of life).
- Start low, go slow with dosing.
- Balance THC and CBD content.
- Choose method of delivery carefully (oral, spray, topical, inhaled).
- Monitor side effects closely.
- Be aware of local laws and regulations.
- Integrate with physical therapy, exercise, and lifestyle changes.
What We Still Need More Research On
- Larger, longer randomised controlled trials focused on back pain.
- Standardized dosing and formulations.
- Long-term safety studies.
- Comparisons with standard therapies.
- Predictors of which patients may benefit most.
Summary
There is growing evidence that CBD, THC, or mixtures may help some people with chronic back pain, especially when other treatments havenāt worked. But the evidence is not yet strong enough to recommend as a first-line treatment.
If you are considering it, do so with medical supervision, clarity about goals and methods, and with realistic expectations.
Sources & Further Reading:
- TGA:Ā Accessing products for a patient; Access pathways & usage data.
- AHRQ (2025): Living Systematic Review update.
- Frontiers in Pharmacology (2024): Edible cannabis for chronic low back pain.
- SAGE review (2021): Efficacy of cannabis in reducing back pain.
