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Neuropathic pain is a complex and chronic set of pain conditions caused by damage to the nerves, which penetrate all areas of our bodies. The worst part? Chronic neuropathic pain, or neuropathy, often responds poorly to the standard, well-known ways to treat pain. It can get worse over time, and even lead to serious disability. But if you do suffer from neuropathy, there may be some good news. A new clinical trial has recently been published, which suggests that cannabinoids could be an effective alternative way to manage neuropathy1.
In this trial, 16 participants were administered cannabis at one of three different potencies (1%, 4% or 7% THC) or a placebo, which they took by aerosol inhaler. Use of an inhaler may mean that consuming cannabinoids or hemp extract by the increasingly popular method of could be effective. All of the participants had diabetic neuropathy, a common complication of diabetes. Currently, diabetes affects around 387 million people around the world1. At each increasing dose, there was a greater reduction in spontaneous pain – pain without anything even touching them. At the highest dose, there was even a reduction in induced pain. Unfortunately, it also caused a drop in mental performance.
Negative effects on mental performance is one of several reasons why many choose CBD-rich hemp extracts, such as Elixinol, over THC-containing products. But can CBD, and other components of hemp extracts, also help relieve the pain seen in neuropathy? Another trial, this time on 177 patients2 with advanced cancer pain, tested the effects of THC and CBD together versus THC alone and a placebo. Only those taking the THC and CBD together saw a significant reduction in pain. The THC alone did not show a significant difference from the placebo.
In the THC and CBD group, 43% showed at least a 30% improvement in pain scores. Both the THC only and placebo group had 12% of patients experiencing an at least 30% reduction in pain. This may mean that not only does CBD have its own pain relieving abilities, but also that THC requires its presence in order to have any effect on many people.
CBD may fight neuropathic pain in a different way to just acting on our cannabinoid receptors. A study on rats with neuropathy showed that CBD was working on a type of receptor called the vanilloid receptors, but did not need the cannabinoid receptors3. The vanilloid receptors control pain sensation, and if you’ve ever heard of chilli being able to reduce pain, they are why it works. CBD also reduced activity of the inflammatory PGE-2 substances. Inflammation contributes to pain and sometimes even long-term tissue damage.
Other cannabinoids may also help to relieve neuropathic pain.4 CBC and CBG are both anti-inflammatory and analgesic, but have not been studied as much as THC or CBD. CBC is weaker in these respects than THC, but CBG has stronger analgesic ability, and a stronger ability to block an inflammatory enzyme called lipoxygenase. Even flavonoids found in hemp could assist in relieving neuropathy.
Cannflavin A, which is unique to hemp and cannabis, can inhibit PGE-2 30 times more potently than aspirin in the laboratory, but has not been thoroughly studied. Some terpenes, such as myrcene and beta-caryophyllene, are also anti-inflammatory. Overall, CBD-rich hemp may be an effective way to relieve neuropathic pain, but clinical trials are needed specifically on high-CBD, no-THC hemp oil.