Can Cannabis Help Sciatica Pain?
Jul 15, 2020
Cannabis is well-tolerated for neuropathic pain and other conditions that cause chronic pain.
While we don’t have specific studies on cannabis and sciatica, we do have sufficient evidence showing that cannabis can help reduce chronic pain.
Since cannabis helps with pain and more specifically neuropathic pain, this suggests cannabis may also help with the sharp and shooting pain that occurs in the lower back and radiates down the legs known as sciatica. In places where medicinal cannabis is available, chronic pain is always one of the approved conditions, as is neuropathy.
Research shows that the expression of cannabinoid receptors in the body are where the pain-relieving properties of cannabis come from. These receptors also appear to be how cannabis may help reduce neuropathic pain.
Medical studies on sciatica and cannabis
To answer the question of whether cannabis can help sciatica — which has yet to be studied — we can look to studies that examine the effects of cannabis-based medicines on neuropathic pain and chronic pain in general.
- The results from a 2015 review on 28 studies show that there is moderate-quality evidence supporting the use of cannabinoids for treating chronic pain.
- One 2007 meta-analysis examined cannabis-based treatments for neuropathic and multiple sclerosis-related pain. Cannabinoids, including Sativex (THC:CBD, 1:1 ratio), were shown to be superior to placebo in treating neuropathic pain. These results are relevant to the neuropathic pain present in sciatica, as multiple sclerosis often causes neuropathic pain.
- In a 2017 meta-review on cannabis literature, the National Academies of Science and Engineering reported that there is enough evidence to state that cannabis is effective for treating chronic pain in adults.
- One 2006 randomized double-blind trial looked at how Sativex affected 58 patients with rheumatoid arthritis, and found that those administered the cannabis-based treatment experienced significant pain relief. Rheumatoid arthritis can cause back pain, and although it’s uncommon, rheumatoid arthritis can sometimes result in neuropathy.
- One 2016 study examined the benefits of cannabis for people with various types of treatment-resistant chronic pain. The results show that cannabis not only helps reduce pain but also significantly decreases the use of prescription opioid medications, which are sometimes used for pain caused by sciatica.
With plenty of clinical trials showing cannabis is effective for chronic pain and neuropathic pain, cannabis appears to have potential as a treatment for sciatica as it helps to reduce neuropathic pain in conditions like multiple sclerosis and chronic pain in other conditions. To be sure about cannabis’s efficacy for sciatica, specific studies are needed.
CBD and sciatica
While CBD alone has not been studied as much as THC alone or CBD and THC combined for neuropathy, some studies have shown that CBD helps with neuropathic pain in diabetes. We also have some evidence showing that CBD helps to reduce pain such as this 2018 review, and other studies showing CBD helps reduce pain and inflammation without causing a tolerance build-up.
Studies on sciatica and CBD haven’t been published yet so there’s no way to know for sure how effective CBD would be for this condition. With some evidence showing CBD helps reduce pain and inflammation — two key symptoms of sciatica — there may be potential for CBD to help. Future studies are needed.
How cannabis works on sciatica
The endocannabinoid system (ECS) exists in all vertebrates and helps regulate crucial functions such as sleep, pain, mood and appetite. The human body produces cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.
There is strong evidence the endocannabinoid system is involved with neuropathy, a nerve disorder that can cause neuropathic pain. Animal models have shown that dysfunction of the endocannabinoid system is associated with neuropathic pain.
Studies show that the expression of the endocannabinoid system in neurons and immune cells plays a crucial role in the development of neuropathic pain.These studies suggest a potential role of cannabinoid receptors in neuropathic pain. While scientists still have much to learn about the endocannabinoid system and how cannabis works, the endocannabinoid system does appear to play a role in neuropathic pain.
In theory, using cannabis will activate receptors in the endocannabinoid system and reduce neuropathic pain caused by sciatica in the lower back, hips, and legs.
In studies on people with neuropathy, side effects are modest and usually resolve within a few hours.
Studies on cannabis use in chronic pain, particularly with neuropathic pain, show a significant proportion of pain-relieving effects is generally contingent on the amount of THC consumed.
With THC being the intoxicating cannabinoid in cannabis, higher doses of THC can cause side effects such as changes to mood and perception, increased appetite, drowsiness, and impairment at work and other daily activities.
The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.
Sciatica is when the sciatic nerve, which runs down your lower back, through your hips and buttocks, and down your legs, becomes inflamed and painful. It’s usually caused by a herniated disk or bone spur pressing on part of the sciatic nerve, sending shooting pain, tingling and numbness down your leg. It usually affects only one side of the body.
Sciatica can be extremely painful and disabling, but it usually gets better by itself within a few weeks. Only around 20-30% of cases have persistent pain after one year. It’s thought that up to 40% of the population will experience at least one episode of sciatica at some point in their lives, with your chances rising as you get older.
Although sciatica is characterized by pain running from the lower back, through the buttocks, and down the leg, no two episodes of sciatica are exactly the same. You might feel:
- Stabbing, burning or shooting pain
- Tingling, like pins and needles or an electric shock
- More symptoms when raising the affected leg
- Dullness and soreness
- Numbness in your buttocks and legs
- Throbbing heat
At times, the pain is barely present and not a factor, while at other times it might be so bad that you can’t stand, walk or even move much. Sciatica pain can also be felt anywhere in the lower back, buttocks, down the back of your thigh and calf, and in your feet and toes. It often gets worse when you sit for long periods of time.
Most people recover from sciatica without any lasting damage, but on rare occasions, it can cause long-term nerve damage. That’s why it’s important to get immediate medical treatment if you feel any loss of feeling or weakness in the affected leg or loss of bowel or bladder function.
Sciatica is usually diagnosed based on a physical examination and your description of your symptoms. Your doctor will perform a physical and neurological exam, checking the strength of your legs, reflexes, and sensation to see how much the nerve is impacted. When lifting your leg, if you have significant pain in your leg and back, that can be a telltale sign of sciatica.
If you have severe sciatica that doesn’t improve within 4-6 weeks, you might be sent for imaging, such as a CT or MRI scan. Another test that might help with diagnosis is electromyography (EMG) nerve conduction study (NCS) to test the integrity of the individual nerves of the leg.
About 90% of the time, sciatica is caused by a herniated disc in your lower spine that presses on the root of the sciatic nerve, sending pain along it. Discs are made of connective tissue and rest between your vertebrae to cushion them, but when they get worn down, due to injury or old age, the center can push out from inside the hard outer ring and press on the nerves passing through the spine.
Occasionally, sciatica is caused by bone spurs or tumors pressing on the nerve, or by lumbar stenosis, which is when the part of your spine that the nerves pass through becomes narrowed. It can also be caused by a back injury, or by spondylolisthesis, which is when one of the bones of the spine slips out of position.
Risk factors for sciatica include:
- Age: As you get older, there’s more risk that your disks will wear out and slip out of place to press on the sciatic nerve, or of bone spurs growing that press on the nerve.
- Obesity: Excess body weight puts more stress on your spine, which can lead to pressure on the sciatic nerve.
- Sedentary lifestyle: If you sit for long periods, you’re more likely to develop sciatica.
- A lot of heavy lifting or twisting: could increase your risk of sciatica, but it’s not been proven.
- Diabetes has been found to increase the risk of nerve damage.
- Smoking leads to poor injury repair and can prolong healing significantly
Most of the time, sciatica gets better on its own without needing surgery or invasive procedures.
Doctors used to recommend bed rest for sciatica, but now you’ll be advised to keep moving carefully and stretching gently. A therapist can show you stretches and exercises that can relieve pressure on your sciatic nerve. Physical therapy is the cornerstone of sciatica treatment, and important for everyone trying to recover and eliminate the symptoms.
Ice packs and heat treatment can also help ease the pain of sciatica.
Over the counter painkillers like ibuprofen and naproxen sodium can help relieve sciatica pain. If they don’t help, your doctor might prescribe:
- Anti-inflammatories such as Voltaren, Naproxen, and Advil
- Muscle relaxants such as Cyclobenzaprine (Flexeril) and Tizanidine
- Neuropathic medications such as Gabapentin (Neurontin) and Pregabalin (Lyrica)
- SNRIs such as Duloxetine (Cymbalta) and Venlafaxine (Effexor)
- Narcotics such as Codeine, Vicodin, and Percocet
If oral medication doesn’t help, you might be prescribed corticosteroid injections around the root of the sciatic nerve. These reduce inflammation and stop sciatica pain, but too many injections can lead to serious side effects. This is often done in pain clinics.
If your sciatica pain continues for three months or more, keeps getting worse, and/or causes muscle weakness you might need surgery. Surgery for sciatica pain involves removing the part of the disc that’s pressing on the sciatic nerve. Sometimes the whole disc is taken out itself.