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neuropathy (nerve pain)

Cannabis for neuropathy (nerve pain)

Illustration of older man holding his lower back, showing red radiating pain coming from his spinal column

Neuropathy (nerve pain) occurs when nerves in the body are damaged, leading to symptoms like burning, tingling, and sharp pain. And it’s common — around one in every 10 U.S. adults age 30 or older has nerve pain.

Nerve pain can occur as a result of:

  • Another chronic health condition, like diabetes
  • A neurological condition, like multiple sclerosis
  • Injuries
  • Shingles
  • Vitamin B12 deficiency
  • Certain medications or treatments

This type of pain can make everyday activities difficult and negatively impact your quality of life.

Cannabis has been used for centuries to treat various types of pain, including nerve pain. In recent years, it has gained popularity as a treatment option for neuropathy due to its potential to relieve pain, reduce inflammation, and improve sleep.

Research on cannabis for nerve pain

Studies suggest that cannabis may help relieve neuropathy symptoms. But research on the effects of cannabis for nerve pain in humans is limited.

For example, studies show medical cannabis and cannabinoids help manage chronic pain, including neuropathic pain, occurring in conditions like:

A 2010 study also found that inhaled cannabis may help reduce pain intensity in people with chronic neuropathic pain.

Another 2017 study showed that tetrahydrocannabinol (THC) and cannabidiol (CBD), two key compounds in cannabis, may help reduce pain and inflammation. Various preclinical studies support this finding. Animal models also show that THC can be combined with the seizure medication gabapentin to treat nerve pain.

Beta-caryophyllene (BCP) is a terpene found in cannabis, black pepper, clove, and other spices. Terpenes are compounds that contribute to cannabis’s unique smell and taste — and they may even enhance its medicinal effects. Animal models show that BCP has anti-inflammatory and pain-relieving properties that can be useful for nerve pain. Other terpenes in cannabis, like myrcene, linalool, and limonene, may also be helpful for managing nerve pain.

Minor cannabinoids, which are present in smaller amounts compared to THC and CBD, may also help neuropathic pain. Tetrahydrocannabivarin (THCV) may have similar positive effects on nerve pain in animal studies. Options like cannabichromene (CBC) and cannabigerol (CBG) may also provide relief from neuropathy due to their ability to protect nerve cells from damage. But again, this has mostly been studied in animals.

Overall, more research is needed, especially larger human studies. While early results are promising, scientists are still learning how cannabis interacts with the nervous system and the best ways to use it for nerve pain. Adverse effects and product safety are still concerns.

Using cannabis for nerve pain

Cannabis can be an effective option for managing neuropathy and related issues like insomnia and anxiety. But it may not be suitable for everyone, so it’s important to weigh the risks and benefits.

Benefits

Medical cannabis can provide many potential benefits for treating nerve pain and related health issues.

  • Relieve pain: Cannabis may help reduce the intensity of nerve pain.
  • Improve sleep: Cannabis can help people with neuropathy get better rest. Compounds like myrcene and cannabinol (CBN) may be particularly helpful for insomnia.
  • Lower inflammation:Cannabis compounds like cannabichromene (CBC) may decrease inflammation, which can help alleviate nerve pain.
  • Reduce reliance on prescription medication: Medical cannabis could help ease nerve pain and related issues enough to reduce the need for various types of prescription drugs, including non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, sedatives, gabapentin and other seizure drugs, and opioids or other prescription pain relievers.

Risks and side effects

As with any medication, medical cannabis comes with some risks and side effects. These include:

  • Drowsiness: Cannabis can cause sleepiness, which may interfere with daytime activities.
  • Dizziness: Some people feel lightheaded after using cannabis.
  • Psychoactive effects and anxiety: High doses of THC can cause euphoria or anxiety for some.

Cannabis is legal for medical use in many U.S. states. However, the laws within each state vary.

In some states, neuropathy itself is a qualifying condition for medical cannabis. In other states, you may qualify for medical marijuana if you have general chronic pain. Or, certain states may approve medical cannabis for conditions that can cause neuropathy, like multiple sclerosis, migraine, or cancer.

Some states may also list out types and subtypes of nerve pain, including:

In certain states, caregivers may legally obtain cannabis for a minor. Often, two physicians’ recommendations are needed. More restrictions may apply regarding qualifying conditions for a minor.

Synthetic THC (dronabinol) may be available through prescription for those with chronic neuropathic pain associated with cancer or HIV/AIDS if other treatments have not been successful.

Check your state’s laws to confirm eligibility.

Best strains and products for nerve pain

Many people find relief with specific strains and products tailored to neuropathy symptoms. But what works best for one person may not work as well for another. So it may take some trial and error to find the best possible option for your individual symptoms and tolerance level.

However, a product or strain that contains a mixture of cannabinoids and terpenes like THCV, CBG, CBC, BCP, myrcene, limonene, linalool, bisabolol, and pinene may offer the best results. These cannabinoids and terpenes have anti-inflammatory, pain-relieving, nerve cell protective (neuroprotective) properties.

Various product types can lower neuropathy pain in different ways:

  • Vaporizers or inhalers may provide immediate nerve pain relief.
  • Edibles or tinctures can produce longer-lasting relief, but take longer to start working compared to inhaled products.
  • Topicals may help with localized pain that affects the skin or joints without producing psychoactive effects.
  • Skin (transdermal) patches can provide a steady release of cannabinoids into the bloodstream and offer a mix of localized and full-body relief.

Strains (aka cultivars)

A number of different strains (aka, cultivars or varieties) of cannabis may help manage neuropathic pain, including:

  • ACDC: Has high CBD content for pain relief with fewer psychotropic effects
  • Harlequin: Contains balanced THC:CBD ratio to manage pain and inflammation
  • Northern Lights: Offers high THC and myrcene content, which is ideal for nighttime use to improve sleep
  • Blueberry: Is rich in terpenes like myrcene and pinene, as well as cannabinoids like THC, which can help with anxiety and insomnia
  • Gelato: Is high in THC and BCP, which can help relieve pain and stress
  • Durban Poison: Is high in THC, THCV, terpinolene, myrcene, and limonene, which provides uplifting effects that may help manage depression and stress

THC:CBD ratios

The following THC:CBD ratios may be especially helpful for nerve pain:

  • 1:1 ratio: This offers balanced relief with mild-to-moderate psychoactive effects. Sativex, a 1:1 CBD:THC product, is effective in treating nerve pain associated with MS.
  • 20:1 CBD:THC: This is best for those who want relief without feeling “high,” especially during the day. CBD has anti-inflammatory properties.
  • High THC: Options with a CBD:THC 1:3 ratio or higher may be best for experienced users. High-THC ratios can be effective for severe pain and insomnia. They can also boost appetite.

Terpenes

Many terpenes in cannabis could help manage nerve pain as well as any anxiety and insomnia that may come with it. Some of the most prominent terpenes in cannabis that may help with neuropathy include:

  • Myrcene: Provides sedative and pain-relief properties
  • Limonene: Helps reduce anxiety and improve mood
  • Caryophyllene: Offers anti-inflammatory effects that can benefit nerve pain
  • Pinene: Relieves stress and anxiety
  • Linalool: Aids in relaxation and sleep
  • Bisabolol: Offers neuroprotective effects
  • Beta-caryophyllene: Reduces inflammation and alleviates nerve pain

Flavonoids

Flavonoids add to the smell and flavor of cannabis. They can also work together with cannabinoids and terpenes to provide therapeutic effects (known as the entourage effect).

Some flavonoids that may help with nerve pain include:

  • Quercetin: May help reduce inflammation and pain
  • Cannflavin A: May offer anti-inflammatory properties
  • Hesperetin: May help reduce inflammation associated with nerve pain in animal models
  • Catechin: May be helpful for neuropathy

More about nerve pain

Neuropathy symptoms include:

  • Burning
  • Numbness
  • Tingling sensations

Diagnosing neuropathy involves physical exams, blood tests, and, in some cases, nerve function tests.

Other conditions that commonly occur alongside nerve pain include anxiety, depression, insomnia, headache or /migraine, and muscle spasms and stiffness.

While some types of neuropathy improve with treatment, others may require lifelong management. Some pain medications, like opioids, are not very useful for neuropathic pain. In these cases, alternative medications are needed for chronic and severe nerve pain. Medical cannabis represents one such alternative.

Other treatments for nerve pain

Treatments aim to manage the symptoms of nerve pain rather than cure the condition.

Traditional therapies

Various kinds of medication and therapy can be used to manage nerve pain. These include:

  • Medications: Options include pain relievers, antidepressants, and anti-seizure drugs.
  • Physical therapy: This may help improve strength and mobility.
  • Surgery: In some cases, a procedure may be needed for nerve compression to find relief.

Natural and alternative therapies

Some complementary therapies may help manage nerve pain and related issues:

  • Acupuncture: This type of therapy may help stimulate nerves and reduce pain, although results from clinical trials are mixed.
  • Supplements: Options like alpha-lipoic acid, vitamin D, vitamin B12, curcumin, and St. John’s wort may help with neuropathy.
  • Mind-body practices:Yoga and meditation can help ease the stress and discomfort associated with nerve pain.
  • Herbal remedies: Options like chamomile, valerian root, and lavender can help relieve stress and aid sleep. Topical capsaicin (the spicy compound in chili peppers) can also help ease nerve pain. Ginger root and some kinds of fungi (such as Turkey Tail) may also help manage inflammation and nerve pain, but more research is needed.

Cannabis as part of your treatment plan for nerve pain

Cannabis may be a valuable addition to a treatment plan for nerve pain (neuropathy). If you’d like to try it, consult with a healthcare provider to determine if cannabis is the right option for you.

In many states, neuropathy qualifies as a condition for obtaining a medical cannabis card.

Frequently asked questions

Get the answers to some common questions about marijuana for nerve pain.

Can marijuana help with neuropathy pain?

Yes. Certain compounds in cannabis, like CBD, THC, and BCP may relieve neuropathy pain.

Can you get a marijuana card for neuropathy?

Several states list neuropathy as a qualifying condition for a medical marijuana card. Other states may list conditions that can cause neuropathy, like multiple sclerosis or cancer. You may also qualify for a medical marijuana card under more generalized chronic pain.

What is the best strain of marijuana for neuropathy?

Popular cannabis strains for neuropathy include ACDC, Harlequin, and Northern Lights (NL). Experiment with different strains to find what works for you.

How effective is marijuana as a painkiller?

Many people find pain relief with cannabis. Research shows that cannabinoids and terpenes have pain-relieving properties.

Which cannabinoids and terpenes are best for nerve pain (neuropathy)?

Products and strains containing balanced THC-to-CBD ratios and a mixture of cannabinoids and terpenes like CBG, CBC, THCV, myrcene, BCP, and linalool may be ideal for managing nerve pain (neuropathy).

Resources

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Animal Study

36

Animal Study -

1

Clinical Meta-analysis

30

Clinical Trial

17

Double Blind Clinical Trial

28

Laboratory Study

5

Meta-analysis

63

Total studies

neuropathy (nerve pain)

180

Positive

143 studies

79%

Inconclusive

25 studies

14%

Negative

12 studies

7%

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