Neuropathic pain

Understanding neuropathic pain

Neuropathic pain results from a lesion or abnormal function of the nervous system. It may be associated with diabetes, shingles, surgery, trauma, radiculopathy or certain neurological diseases. Diagnosing the cause remains essential.

Medical cannabis and neuropathic pain

Cannabinoids have been studied as a complementary option for some persistent neuropathic pain. The practitioner reviews the diagnosis, first-line treatments already tried, drowsiness risk and functional goals before deciding whether further assessment is appropriate.

What the evidence shows

Recent reviews of randomized trials find statistically lower pain in several populations, but the average reported improvement remains modest. Some studies also report changes in sleep or quality of life.

What it does not establish

Products, doses, routes and causes of neuropathy vary greatly across studies. These findings do not guarantee an individual response and do not show that cannabis repairs a damaged nerve.

Points to discuss during the assessment

• The cause and distribution of pain
• Burning, shock-like sensations or allodynia
• Treatments already tried, including anticonvulsants or antidepressants
• Sleep, mobility and functioning goals

Important precautions

• Adverse effects can include drowsiness, dizziness, impaired attention, anxiety or a faster heart rate.
• THC can impair driving and the operation of machinery; never drive while impaired.
• Particular caution is required during pregnancy or breastfeeding, with some heart conditions, or with a personal or family history of psychosis.
• Tell the practitioner about all current medications and supplements so possible interactions can be assessed.