Medically reviewed by Katherine Golden, RN
Written by Denise Gonzalez-Walker

We receive many calls on the Leaf411 cannabis nurse hotline from people who are curious to learn how cannabis might help with their pain.

In today’s post, we’ll share some information based on the questions we hear. We also provide suggestions on how to match the right cannabis product to your pain.

Our goal to help callers find a solution allows them to be functional. Of course, you’re always welcome to call our hotline with questions as well!

Much like any other medicine, cannabis is not a magic pill but it’s a tool. From the research and our own experiences working with patients, we believe that the cannabis plant may be an effective alternative to opiates or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and acetaminophen, which can carry unwanted side effects if overused.

Cannabis for Pain: A Powerful Tool

When it comes to pain, everyone is different. How you experience pain, as well as your pain tolerance level, is shaped by a lot of different factors.

In the same way, people respond to medicines differently. That’s one reason why so many different painkillers are on the market today!

Cannabis is emerging as a different option, proving to be a powerful new tool for controlling pain. The cannabinoids in the cannabis plant, especially cannabidiol (CBD) and tetrahydrocannabinol (THC), have been shown to reduce inflammation and pain. Other cannabinoids and plant compounds like terpenes also play a role in reducing pain. (You can read more about terpenes in one of our past posts ).

Federal restrictions in the United States continue to limit research on how cannabis impacts pain; however, other countries such as Israel have completed considerable research on cannabis’s therapeutic benefits.

xray of broken collarbone, a source of acute pain.

Quick Primer on Types of Pain

Understanding the different types of pain and their sources can help you find the best cannabis options.

  • Acute pain usually comes about as the result of an injury, overuse, or medical procedure. While the initial pain can be mild or severe, it gets better over time as your body heals. Slamming your finger in a door results in acute pain. Post-workout soreness, broken bones and surgery recovery also fits into this category.
  • With chronic pain, “the pain itself becomes the disease,” explains Eduardo Fraifeld, MD, in this article. Doctors typically categorize pain lasting over 3-6 months as chronic pain. Chronic pain can be associated with arthritis, migraines, diabetes or multiple sclerosis (MS), among other conditions. It can be a side effect of chemotherapy or other long-term medical treatments. When an injury heals yet the pain remains, that also fits the description for chronic pain.

Pain can also be broken down into the following categories:

  • Nociceptive pain: Pain in soft tissues, tendons or joints caused by injury, overuse, stress or illness. Arthritis and other types of inflammatory pain also fit in this category. Nociceptive pain tends to get better over time, except for arthritis. With this type of pain, inflammation triggers nearby nerves, resulting in aching or throbbing pain. 
  • Neuropathic pain: Neuropathic pain, or nerve pain, originates in the nervous system, and is chronic in nature. It often feels like pins and needles, an electric shock, or a burning sensation. Some common causes of neuropathic pain are carpal tunnel syndrome, post-shingles symptoms, sciatica or pinched nerves, diabetes, and chemotherapy treatment. 
  • Nociplastic pain: A relatively new category for pain that doesn’t fit well into the other two categories. Fibromyalgia, non-specific low back pain, irritable bowel syndrome, and pain associated with and exacerbated by centralized and peripheral sensitization are all examples of nociplastic pain.

THC or CBD? It Depends on the Person and the Type of Pain

Before we jump into the pros and cons of THC versus CBD, we have to mention that to some extent, every human body is different. Cannabis plant compounds (cannabinoids) work on the CB1 and CB2 receptors in your body’s endocannabinoid system (yes, that’s a real thing!). Your body even makes its own cannabinoids.

Everyone’s endocannabinoid system is just a bit different, just like everyone has their own pain tolerance levels. Keep this in mind if your neighbor recommends a specific product that ends up not working for you.

However, we can share some general guidelines for using CBD and THC for pain.

CBD: Many people successfully use CBD products to reduce inflammation-based pain . Full spectrum CBD hemp products containing all the plant compounds, including less than 0.3% THC, tend to be the most effective, since minor cannabinoids, terpenes, flavonoids and essential fatty acids work together synergistically to create the “entourage effect.”

CBD has potent anti-inflammatory properties that can help reduce either acute or chronic inflammation. CBD also works as a muscle relaxant and has been shown to reduce muscle spasms associated with MS and other health conditions.

By reducing inflammation, CBD indirectly helps reduce pain. However, it doesn’t bind directly to the receptors that control pain like an opioid does. For that, you need a different cannabinoid, THC.

THC: We’ve heard a lot of people immediately rule out products with THC because they’re concerned that it will make them act silly or that they’ll get too high.

It’s important to know that small amounts of THC may have minimal intoxicating effects. At the same time, THC—even small amounts—can be a gamechanger when it comes to pain.

THC acts on the same receptors in your body that opiates do; however, you don’t get some of the problematic side effects that opiates can bring—nausea, constipation, and risk of physical addiction.

Close-up of clinician’s hands, with one hand holding cannabis flower and the other holding pills, showing different options.

Cannabis Compared to Opiates

Ironically, long-term use of opiates for chronic pain can make you more sensitive to pain—an effect called opioid-induced hyperalgesia. What’s the recommended protocol in response to opioid-induced hyperalgesia? To wean off of opiates and find a safer alternative for managing pain. Cannabis is showing promise on this front, based on emerging research.

Cannabis does not cause pain sensitization but in fact can help treat it. While THC and other cannabinoids work through the same receptors that opiates do, the way that they reduce pain—their chemical process—is different.

Neuropathic pain is difficult to treat even with conventional pharmaceuticals. Generally, opioid use for chronic neuropathic pain is ineffective. One study considered the risk and benefits of opioids for the treatment of neuropathies and stated that “long-term opioid therapy didn’t improve the functional status but rather was associated with a higher risk of subsequent opioid dependency and overdose.” 

If you are going to try cannabis for your neuropathic pain, many different ratios and cannabinoids may need to be explored before finding something that may ease some of the pain so you need to manage your expectations accordingly.

Group of five young adult friends with two dogs walking across field at sunset, healthy and happy.

The Goal: To Restore Function

We wish that we could tell you that CBD or THC products will completely eliminate all pain; however, that’s not the case. If there were a magic one-size-fits-all cure for pain, the pharmaceutical companies would’ve discovered and patented it by now!

Instead, when we talk to people on the hotline, we always set the goal to reduce pain to a manageable level and restore function. When you restore function, you open the possibility of adding on additional supportive activities such as exercise and relaxation that further promote healing.

In our next post, we’ll take a closer look at the best CBD:THC ratios and products for pain. We’ll also talk about how to layer different products to provide optimal short-term and long-term pain relief. Check back next week for more information!

Can’t wait to get started? Our FREE Leaf411 hotline is available now to answer your questions about using cannabis to manage pain. Call us at 844-LEAF411 (844-532-3411).

The Leaf411 cannabis nurse hotline provides free, anonymous education and directional support to the general public about the safe use of legal cannabis. We partner with select business members who meet our rigorous standards to extend our education and outreach efforts.