The endocannabinoid system is a complex network of receptors and neurotransmitters that helps regulate pain, mood, and other bodily functions. Two of the most abundant endogenous cannabinoid ligands are anandamide and 2-arachidonylglycerol. These endocannabinoids are produced on demand in the central nervous system to reduce pain by acting as a circuit breaker. Two compounds in cannabis, THC and CBD, are believed to contribute to the ability of cannabis to relieve pain.
THC can alter pain perception by reducing anxiety and stress, while CBD fights pain through its anti-inflammatory action. Cannabis-based medicines come in several forms and can be inhaled with a pipe or cigarette, or they can be taken orally as an aerosol or in capsules. A recent systematic review found that, compared to placebo, cannabis-based medications can provide moderate to substantial pain relief and can reduce pain intensity, sleep problems, and psychological distress. Unfortunately, these benefits are often associated with side effects such as sedation, confusion, and psychosis.
For some people, these side effects may be severe enough to outweigh the pain relief benefits of cannabis. Overall, the quality of research on cannabis for neuropathic pain relief is low. That's not to say that people with neuropathic pain should ignore cannabis as a treatment option; it may work for some, but not for others. The bottom line is that there is currently a lack of solid evidence to support cannabis-based drugs for neuropathic pain relief.
More high-quality research is needed to confirm its benefits. New research may be particularly important in older adult populations and people with health problems that predispose them to nerve pain. Meanwhile, cannabis can be a useful option for people who don't get adequate relief from established treatment options. Topicals and oils can be a good option for this, as they can be used when nerve pain is particularly sensitive. The analgesic potency of 11 structurally similar cannabinoids is positively correlated with cannabinoid potentiation of α3 GlyR.
Cannabinoids such as THC and CBD activate CB1 and CB2 receptors and help regulate neurotransmitters and the central nervous system, helping to relieve pain. When combining the four trials with smoked cannabis, the provisional conclusions are that an analgesic effect is evident, that this effect, although not very large, may be useful for some patients and that it often entails some adverse effects on the central nervous system (although this is obviously not the case in this trial).Taken together, glycinergic cannabinoids represent a new class of therapeutic agents that selectively relieve pathological pain by targeting α3 GlyR. A legitimate question remains as to whether cannabinoids can interact with α3 GlyR following activation of PGE2 (EP2R) receptors. And because CBD has relatively mild side effects, using CBD to help relieve this type of pain can be an acceptable alternative to other potential pain relievers, such as opioids. This finding is not unexpected because glycinergic cannabinoids act on GlyR as allosteric modulators rather than agonists or antagonists. In conclusion, while there is still much research to be done on the efficacy of cannabinoids for neuropathic pain relief, there is evidence that suggests it may be beneficial for some people who don't get adequate relief from established treatment options.
A neurologist should always be consulted before trying any new treatment option.