By Dr. Demetria Bates, DNP, FNP-BC, CCE, and Health Coach

Peripheral neuropathy is a complex medical condition that involves nerve damage which poses significant challenges in both diagnosis and treatment often resulting in debilitating symptoms such as chronic pain, numbness, weakness, and a diminished quality of life (Adams, Callaghan, & Grant, 2017). Despite the standard treatment options including analgesics, antidepressants, and anticonvulsants, patients with neuropathy continue to experience inadequate relief and are at risk for adverse effects.

In recent years, there has been growing interest in the therapeutic potential of Cannabis, particularly its cannabinoids, due to its analgesic and neuroprotective properties thus alleviating neuropathic pain. In this article, we will explore peripheral neuropathy and the therapeutic benefits of Cannabis as an alternative treatment option.

Peripheral Neuropathy Overview

Peripheral neuropathy is a medical condition characterized by dysfunction, injury, or damage to nerve endings, which are responsible for transmitting signals between the central nervous system (CNS) and the body (Modesto-Lowe, Bojka, & Alvarado, 2018). The etiology of peripheral neuropathy can vary widely ranging from metabolic disorders (such as diabetes mellitus), autoimmune disease, infections (such as HIV), toxic exposures (such as chemotherapy drugs), and genetic predispositions (Modesto-Lowe, Bojka & Alvarado, 2018).

Clinical manifestations of peripheral neuropathy include symptoms such as numbness, tingling, burning pain, and hypersensitivity to touch. Motor symptoms such as muscle weakness, atrophy, and impaired coordination may also occur. These symptoms can advance from severe to debilitating over time.

Neuropathic pain is often chronic and may be constant or intermittent, significantly impacting patients' quality of life by impairing sleep, mobility, and daily functioning (Modesto-Lowe, Bojka, & Alvarado, 2018). Moreover, neuropathic pain can be refractory to standard treatments or undertreated leading to significant challenges in management.

Cannabis and Peripheral Neuropathy

Cannabis contains a diverse array of chemical compounds called cannabinoids, with delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) being the most prominent in the plant. These cannabinoids interact with the body's endocannabinoid system, which plays a pivotal role in regulating various physiological functions such as mood, appetite, pain, cognition, balance, thermoregulation, and motor function (Argueta et al., 2020). THC is the primary cannabinoid in Cannabis that has psychoactive and intoxicating effects. CBD on the other hand is psychoactive but does not get you high or intoxicated. Both cannabinoids have anti-inflammatory, analgesic, and neuroprotectant properties (Russo & Hohmann, 2013).

Research shows that cannabinoids alter the pain pathways of damaged or injured nerve endings thus reducing neuropathic pain (Russo & Hohmann, 2013). The cannabinoids also inhibit nociceptive conduction within the spinal cord due to the presence of CB1 receptors found along the peripheral nervous system and CB2 receptors in immune cells reduce the release of pain-causing compounds (Russo & Hohmann, 2013).

A meta-analysis study found that inhaled Cannabis can potentially provide relief for 1 in 5 to 6 individuals dealing with neuropathic pain (Andreae et al., 2015). Another meta-analysis revealed that out of 246 patients with neuropathic pain 30% were more likely to report improvement in pain (Nugent et al., 2017). In a retrospective analysis, twenty participants received topical CBD 10mg twice a day for chronic pain and reported significant improvement in pain (Hall et al., 2023).

Addressing Neuropathic Pain with Cannabinoid Therapies

Peripheral neuropathy may be complex to manage, often resulting in debilitating symptoms and inadequate relief with standard treatments. However, the therapeutic potential of Cannabis and its major cannabinoids, THC and CBD, offers a promising avenue for alleviating neuropathic pain.

Research suggests that cannabinoids interact with the body's endocannabinoid system to modulate pain pathways and reduce inflammation, providing relief for patients with neuropathic pain. Cannabis is a natural solution for improving pain management and enhancing the quality of life in individuals with peripheral neuropathy.

References

1 - Adams, A.S., Callaghan, B., Grant, R. W. (2017). Overcoming barriers to diabetic polyneuropathy management in primary care, Science Direct, 5(4), 171-173.

2 - Andreae, M. H., Carter, G. M., & Shaparin, N. et al. (2015). Inhaled Cannabis for chronic neuropathic pain: A meta-analysis of individual patient data. The Journal of Pain, 16(12), 1221–1232.

3 - Argueta, D. A., Aich, A., Muqolli, F., & Cherukury, H., et al. (2020). Considerations for Cannabis use to treat pain in sickle cell disease. Journal of Clinical Medicine, 9(12).

4 - Hall, N., James, B., Bhuiyan, M.A.N., et al. (2023). Topical cannabidiol is well tolerated in individuals with a history of elite physical performance and chronic lower extremity pain. Journal of Cannabis Research, 5(11).

5 - Modesto-Lowe, V.u., Bojka, R., & Alvarado, C. (2018). Cannabis for peripheral neuropathy: The good, the bad, and the unknown. Cleveland Clinic Journal of Medicine, 85 (12) 943-949.

6 - Nugent, S. M., Morasco, B. J., O’Neil, M. E., et al. (2017). The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med, 167(5), 319–331.

7 - Russo, E.B. & Hohmann, A.G. (2013). Role of cannabinoids in pain management comprehensive treatment of chronic pain by medical, interventional, and integrative approaches, American Academy of Pain Medicine, 181–193. 

About Dr. Demetria Bates, DNP, FNP-BC, CCE

Dr. Demetria Bates, DNP, FNP-BC, CCE, is a distinguished healthcare professional with a passion for bridging the gap between Cannabis medicine and Western medicine. She is the founder and CEO of Bates Virtual Health & Consultants, LLC which provides medical card services exclusively for Virginia residents. She works with individuals seeking to understand the integration of Cannabis medicine for health and wellness.  

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Effective Cannabis Newsletter is a platform to educate on the vital role of the Endocannabinoid System (ECS) in one's health. The information is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. All content, including text, graphics, images, and information, contained in or available through this newsletter is for general information purposes only. It is not medical advice; it is health awareness.