Pain. Internal injuries. Nerve pain. Muscular pain. At one point in time, we have all experienced some type of pain, and needed temporary relief.
In other cases, constant chronic pain conditions result in a person experiencing pain every day.
There are different areas of the body where pain originates from known as visceral, neuropathic, and deep somatic. What are the differences between these types of pain? And can cannabinoids really help in the relief of pain?
Let’s talk pain and cannabis.
Visceral, neuropathic and deep somatic pain originate from different areas of our bodies.
Visceral pain is the type of pain originating from our organs. This type of pain occurs when the intestines, chest, abdomen, and pelvis pain receptors are activated. When the internal organs or tissues are injured or damaged, visceral pain is experienced. The damage can be presented as a distended organ, spasms or deprived of blood; consequently, deprived of oxygen.
The pain sensation of visceral pain can be difficult to describe, as it is not localized or clearly defined. The best-known characteristics of visceral pain is described as aching, pressure, or deep squeezing in the internal areas of the body.
Whereas, neuropathic pain originates from the nerves resulting in chronic pain conditions, usually occurring from infection or injury to the nerves. With neuropathic pain, it is theorized that the nervous system may be dysfunctional. The body then sends pain signals to the brain without any stimuli, prompting the ‘pain’ messages.
When a person experiences neuropathic pain, it presents as a burning or shooting type of pain that is either constant or intermittent. Other side effects may actually be loss of sensation or numbness, and generally gets worse as a person gets older.
Finally, deep somatic pain originates from the nociceptors in the tendons, ligaments, joints, connective tissue and muscles. Similar to visceral pain, deep somatic pain presents as an aching dull pain. Depending on the degree of trauma, the pain can be felt locally, or as a general pain spreading further up the body.
For example, bumping one’s knee presents as localized pain to the area. Whereas, if you break the patella, you can experience pain throughout the entire leg. Deep somatic pain is more commonly known as a broken bone, sprains, or pulled muscle.
Research is conflicted just how cannabinoids can help in the relief of pain.
THC may provide pain relief directly by changing the way the brain perceives the pain, in particular the ‘messages’ sent to the brain when inflammation occurs.
Whereas, CBD may work indirectly.
There are three classes of pain relief – “non-steroidal anti-inflammatory drugs (NSAIDS), paracetamol and opioids.” (Dr Gurvinder Rull).
NSAIDS work by inhibiting enzymes that are involved in the synthesize of prostaglandins. The release of prostaglandins is necessary when an injury occurs. It triggers off the inflammatory response so the immune system can release cells to target the infection or injury to begin the healing process. However, with high levels of prostaglandins present this results in high levels of inflammation and pain. NSAIDS reduces the enzymes that trigger off this response.
Paracetamol is supposed to work similarly to NSAIDS by inhibiting the enzymes. And the good ole opioids take a whole different pathway. Opioids bind to opioid receptors – resulting in feeling and reacting to the pain differently.
And then we have THC. THC activates endocannabinoid receptors found in nerve and immune cells. This activation on nerve cells reduces the sensation of pain. Additionally, the psychoactive element to THC changes the way the brain perceives many things, including pain.
So, what about CBD?
Cannabinoids are effective for a range of reasons, not only treating the symptoms, it can help to treat the cause of the pain and other issues.
Secondly, cannabinoids aid in relaxation, carry anti-depressant properties, and assists in reducing anxiety; all of this aids in reducing the intensity of pain.
Furthermore, cannabinoids can help in the relief of insomnia. When a person has a good night’s sleep it is easier to handle challenges that crop up, and the body recovers more effectively after a good night’s sleep, due to the growth hormone that is released by the pituitary while we are sleeping.
Cannabinoids help to activate the receptors that reduce pain, in particular CB1 receptors, and help to modulate our nociceptors. Additionally, cannabinoids carry anti-inflammatory properties, reducing the amount of inflammation present in the body. Consequently, this reduces the risk of further damage, and more pain from that damage.
Cannabinoids seem to have a synergistic effect with other systems of the body that help to relieve pain; including the nervous system, immune system, digestive system and reproductive system.
When the body maintains homeostasis, and the body is functioning like it should, over time this in of itself will help to reduce overall pain, potentially getting to the root cause of the pain in the first place.
Another aspect about cannabinoids is that it can enhance the effects of other pain relievers, considered to be an effective adjuvant drug. Thus, enabling doctors to lower the doses of other medications, reducing the side effects that accompany those drugs.
In addition, cannabinoids can help to prevent the body from failing to respond to pain relief by reducing tolerance build-up to drugs by the patient not needing as much medication.
One of the important factors to consider is the psychological impact of pain. Cannabinoids can be effective in helping with the psychological impact, even if it is not as effective in reducing severe pain, it can make it easier for a person to deal with that pain.
In terms of medicinal cannabis/CBD. What is the recommended dose for pain relief?
The recommended daily dose for general pain relief starts at 2.5 milligrams, and maximum dose is up to 25 milligrams per day.
The general consensus is to start at a low dose, and work upwards if required. For some, it may be a good idea to spread the dose throughout the day, so that the CBD oil works as a preventative, as well as taking a quick dose for when pain.
References:
Role of the Cannabinoid System in Pain Management. Retrieved 6th March 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430692/
The next article will cover what cancer is, the common side effects of chemotherapy, and the role of cannabinoids in cancer treatment.
To listen to this episode – check out my podcast https://anchor.fm/sharlene-almond/episodes/Educating-on-Cannabis—How-do-Cannabinoids-Target-Pain-e1br76l
Writing, Health, and CBD 