By Dr Janelle Trees, BSC (HONS), MBBS (HONS), FRACGP
Have you hurt your back? You’re not alone. Back pain is one of the top six injuries and sickness causing loss of quality of life, inability to work, pain and disability in Australia.
Most back sprains and strains are self-limiting, that is, the body will recover in 6 weeks or so, with analgesia, exercise and other treatments, like massage or physiotherapy.
But when back pain lasts longer than three months it is defined as chronic back pain.
Some patients benefit greatly from being seen at a pain clinic, but the waiting list to see a Pain Specialist in Australia can be inordinate, especially in rural and remote areas, where Pain Clinics may be held only a few times a year at a hospital hundreds of kilometres away. Sometimes the GP in a rural or remote area will consult with other specialists over the phone or video conference call to optimise pain relief medication. This can be a boon.
If your life has been affected by chronic back pain, you will wondering whether marijuana based pain medication could help you. Working with your GP in consultation with an Australian medical marijuana clinic will help you find the answer.
The Medicines You Take Have Limitations
Many patients with chronic back pain are taking more medication than they (or their doctors) would like. Most doctors prescribe non-steroidal anti-inflammatory medication (NSAIDs, e.g. Ibuprofen, Naproxen) for acute back pain. With paracetamol, they have a role in acute pain relief. But you can’t take NSAIDs long-term—they can have dangerous effects.
Opiate medications, also helpful at the time of an acute injury, don’t work particularly well for most patients with chronic back pain. The side effects of opioids are well known: constipation, nausea and vomiting and the risk of tolerance, dependency or overdose. Hundreds of thousands of people die from opiate overdose, mostly accidental and overwhelmingly from prescribed medications, each year. It happens when people are trying unsuccessfully to relieve their pain.
Sometimes your currently prescribed medications, even with exercise, rest, good nutrition and the best attitude in the world, is not enough. If you and your family are still suffering the effects of your chronic pain, it is worthwhile to explore your options. Cannabis pain management is becoming a viable option in Australia.
The Challenge of Effective Pain Management—Medical Marijuana for Pain
For some patients with degenerative disc disease, spinal canal stenosis, other common problems associated with overuse and ageing, or who’ve had unsuccessful or only partly successful back surgery, the long-term management of their back and nerve pain can be a real challenge.
The major active ingredients of cannabis are called cannabinoids. THC and CBD are the best-known cannabinoids. They have been isolated or synthesised to make medicinal cannabis. CBD has a known anti-inflammatory affect and is useful in the treatment of nerve (also called neuropathic) pain.
In some pain studies and for some patients, CBD seems to work best when combined with a small amount of THC. This kind of formula relieves pain without any of the cognitive side effects—disorientation, confusion—which are possible with THC alone. An example of this is sold under the brand name Sativex.
Considering and Accessing Medical Cannabis for Back Pain
Medications for chronic back pain, including medical cannabis, can be prescribed by the GP or other specialist.
Many patients with debilitating chronic back pain would like to try medical marijuana for the management of their pain. There is good evidence that medical marijuana is helpful for patients with chronic non-cancer pain where ordinary medicines are not effective, and this includes back pain. The Canadian College of Family Physicians published guidelines for the safer use of smoked marijuana for chronic pain in 2014.
Our knowledge of medical marijuana and the range of available products have blossomed since then. A medical marijuana prescription with a significant component of CBD may be helpful for your chronic back pain. Smoking is not the healthiest way to get cannabinoids into you though.
Talk to your GP about preparations available through your nearest Cannabis Access Clinics, including oral and topical applications. Many patients report that these medicines have turned their lives around, allowing them to reduce or cease their previous medications. You can do this under the guidance of your GP or other specialist.
Chronic back pain doesn’t have to be unmanageable. Keep exploring your options to find a better way to manage your pain and a better way to live.