The use of cannabis can be an effective option to treat back pain with an acceptable side effect profile but long-term follow-up is lacking and more evidence is needed to allow healthcare providers to confidently recommend cannabis therapy for back pain. These are the key findings from a recent study published in the Global Spine Journal by Richard Price (Swedish Neuroscience Institute, Seattle, USA), et al.
The systematic review was designed to critically analyse the evidence and efficacy of cannabis to treat surgical and nonsurgical back pain.
Speaking to Spinal News International, Price said: “This paper highlights the potential efficacy of cannabis to treat back pain. Though there are only several clinical articles currently published on the topic, results suggest that cannabis may be effective at treating certain types of back pain with a low side effect profile.
“These results suggest that cannabis may be a viable option for an ailment that affects so many people around the world. Ultimately, this may reduce dependence on other addictive substances such as opiates. Further research into this subject is certainly needed to make a definitive conclusion.”
The researchers conducted a literature search of the MEDLINE and Embase databases. Only randomised controlled trials and prospective cohort studies with concurrent control were included in the study. Risk of bias and quality grading was assessed for each included study.
Database searches returned 1,738 non-duplicated results, with initial screening excluding 1,716 of these. As such, a total of 22 full text articles were assessed for eligibility and only four of these articles met pre-determined eligibility and were included in the study.
Two of the studies addressed post-spinal cord injury pain while the other two addressed low back pain. No studies specifically examined the use of cannabis for surgical back pain. The type of cannabis varied between study and included tetrahydrocannabinol (THC), dronabinol, and Nabilone. A total of 110 patients were included in the four studies reviewed.
In three out of four studies, there was a statistically significant reduction in pain reported in the cannabinoid group when compared to the control group. The singular study which found no difference between cannabinoid versus control pain management included only seven patients. There were also no serious adverse effects reported.
The researchers noted that: “As medicinal cannabis is being used more commonly for analgesic effect and patients are ‘self-prescribing’ cannabis for back pain, additional studies are needed for healthcare providers to confidently recommend cannabis therapy for back pain.”