Study: Smoked Cannabis More Powerful Than CBD Extracts for Back Pain

A new Israeli study has confirmed that smoked cannabis extracts offer a more effective way to treat back pain than ingested CBD extracts. The small-scale study involved a total of 24 adults, with each study subject undergoing MRI or CT scans that indicated herniation or spinal stenosis. 

Patients were recruited by Israeli researchers to sample two unique types of cannabis treatment, a CBD-rich cannabis extract and THC-rich smokable cannabis. CBD (cannabidiol) is the second most commonly occurring ingredient in cannabis. Unlike THC (tetrahydrocannabinol), the most prevalent active ingredient in the cannabis plant, CBD is non-intoxicating (i.e., does not induce a high).

During the study, participants dropped a sublingual CBD extract beneath the tongue for 10 days. Aside from sublingual CBD extracts, medical cannabis patients also dropped sublingual cannabis extracts beneath the tongue every day for 10 months. 

Following one treatment-free month, the same group of study subjects smoked cannabis flower containing THC four times per day for 12 months. Pain medications, such as acetaminophen and oxycodone, were used as needed.

Cannabis for Back Pain: What Did the Study Discover?

Featured in the Rambam Maimonides Medical Journal, the study results demonstrated minimal to no improvement in back pain when patients used the extract. However, major improvements were noted when cannabis was smoked. Analgesic (painkilling) drug use also sank among smokers.

“The current study is the first, to our knowledge, to indicate that THC-rich smoked therapy is more advantageous in ameliorating LBP (lower back pain), than low THC CBD-rich sublingual extracts. Despite the small number of patients, our data indicate that THC-rich smoked therapy helps mitigate LBP,” wrote the researchers.

Dizziness, drowsiness, fatigue, and nausea were the most commonly reported adverse effects of using cannabis for back pain during the extract phase. During the smoking phase, drowsiness and sore throat were reported.

Despite dropping out of the study’s extract phase, three patients resumed the experiment during the smoking stage. Once a dose tolerance was reached, all adverse symptoms—most of which were noted in female study subjects—disappeared.

Many medical cannabis users prefer consuming edibles (as opposed to smoking the plant) due to the perceived health benefits. Previous research has shown that cannabis smoke contains may have (harmful) effects on people with cardiovascular or respiratory problems, mainly due to the fact that it contains chemicals and carcinogens similar to those contained in cigarette smoke.

Previous Studies Have Spotlighted Similar Findings

Past research efforts have highlighted similar findings. For example, a 2019 study published by Pain News Network discovered that the pain-relieving effects of smoked cannabis were stronger than ingested cannabis, regardless of the THC content. To reach their conclusion, researchers from the University of New Mexico (UNM) gleaned data from the Releaf App. 

More than 3,300 people submitted their responses in almost 20,000 user sessions using the Releaf App. The mobile software program analyzed self-reported data from more than 3,300 people, each of whom recorded their experiences after using various cannabis products, including natural dried flower, edibles, tinctures, and ointments. 

Since back pain can also spark the onset of muscle spasms, cannabis could be a viable treatment option. There is plenty of evidence to suggest that cannabis’ main psychoactive ingredient, THC, as well as other cannabinoids, may reduce muscle spasticity and pain.

One research project at the University of Colorado’s Spine Center observed 200 patients with back pain or degenerative disc problems. As per the results, 89% claimed that cannabis reduced their pain moderately or greatly. An additional 89% noted that it worked as well as, or better than, narcotic pain medication. That same group also noted that they didn’t need to consume cannabis more than once or twice daily. 

Moreover, since cannabis could improve quality of life, help patients steer clear of addictive or dangerous medications, and reduce or ease the unpleasant side effects that come with chronic back pain—such as anxiety, depression, and insomnia—patients could benefit from talking with a licensed healthcare professional about using cannabis-based medicines.