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Can Cannabis Help Spinal Cord Trauma?

Overview

Cannabis is an increasingly popular therapeutic option for people living with spinal cord injury. Indeed, many sufferers report significant reductions in pain and muscle spasticity, the two main symptoms of this debilitating condition.

Recent research reveals that the effectiveness of cannabis in spinal cord injury management may be due to its interaction with the body’s endocannabinoid system (ECS).

This system plays an important role in the healthy function of the spinal cord and may act as a protective mechanism after spinal cord injury. 

What’s the link between the ECS and spinal cord injury? Is there any evidence that cannabis can ease its symptoms and even enhance recovery? Here’s what the research says.

 

How Cannabis Works on Spinal Cord Injury 

The endocannabinoid system exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own 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.

This system is present throughout the human body, including the central nervous system (CNS). The spinal cord is a significant component of the CNS, and contains a high concentration of CB1 receptors alongside a smaller number of CB2 receptors.

Research indicates that the endocannabinoid system plays an important role in the normal function of the spinal cord, including the control of reflexes (such as pulling your finger away from heat) and pain.

Studies also show that spinal cord injury is followed by an increase in the levels of 2-AG and anandamide — the two main endocannabinoids — around the injury site in rats. Similar increases occur with CB1 and CB2 receptors. 

Researchers have also demonstrated that blocking the cannabinoid receptors after spinal cord injury in mice results in poorer recovery; others have found that administering a synthetic form of the endocannabinoid 2-AG improves recovery following brain injury in mice.

These findings suggest that after an injury to the spinal cord and the brain, the endocannabinoid system acts as a defense mechanism against further damage.

As such, there is promise in using cannabis to not only ease spinal cord injury symptoms such as pain but directly improve recovery.

In particular, cannabis shows potential in protecting against the so-called secondary damage of spinal cord injury, caused by inflammation, oxidative stress, and excitotoxicity. 

Whereas the immediate damage is unavoidable, this secondary damage, which starts minutes after the primary spinal cord injury and can last for several weeks, may respond well to cannabis treatment.

 

Medical Studies on Spinal Cord Injury and Cannabis

Although there hasn’t been a lot of research looking at cannabis and spinal cord injury, the current findings are promising, suggesting that it can relieve pain, muscle spasticity, and other symptoms.

A 2003 study looked at the benefits of cannabis extract in people with spinal cord injury and related nerve damage issues such as multiple sclerosis and brachial plexus injury. Compared to placebo, cannabis produced significant pain relief, an improvement in bladder control, and decreased muscle spasms and spasticity, with minor side effects. Indeed, cannabis is medically approved for spasticity and chronic pain.  

A 2007 study examined the effects of THC on spasticity caused by spinal cord injury. Compared to placebo treatment, THC reduced the spasticity sum score, a measure of spasticity severity, from an average of 16.7 to 8.9. The researchers concluded that “THC is an effective and safe drug in the treatment of spasticity.” 

Meanwhile, a 2016 study looked at the benefits of vaporized cannabis in people with neuropathic pain caused by spinal cord injury and disease. Compared to placebo, people who vaped cannabis with 2.9% or 6.7% THC experienced significant pain relief.

Additionally, several observational studies have highlighted the popularity of cannabis for relieving the pain and spasticity caused by spinal cord injury (SCI):

  • A 2018 Colorado study found that 48% of surveyed adults with SCI used cannabis to relieve spasticity and improve sleep
  • A 2019 study in New Zealand examined eight people with SCI, finding that they successfully reduced their pain with cannabis when standard medication proved ineffective and caused drowsiness

Lastly, there’s evidence that cannabis can relieve symptoms of multiple sclerosis (MS), a condition characterized by nerve damage that’s similar to spinal cord injury. Cannabis is approved for the treatment of symptoms associated with MS in many areas where cannabis is prescribed medically.  

One 2018 review analyzed the findings of multiple high-quality studies looking at cannabis use for easing symptoms of MS. This review found that cannabinoids were effective at reducing neuropathic pain and muscle spasticity, two symptoms also experienced by people with SCI.

In all, there’s a growing body of medical evidence that cannabis can relieve the pain and spasticity associated with SCI. However, more research is needed to see whether cannabis can also improve recovery following such injury.

 

Side Effects

Cannabis is a relatively safe medication, but it can cause some side effects. 

Cannabis Side Effects

Human studies of cannabis use to treat symptoms of SCI have reported psychoactive side effects such as euphoria, increased anxiety, impaired memory, and difficulty paying attention, collectively known as the cannabis high. However, these effects were tolerated well by study participants and not deemed serious.

Such side effects can be further reduced by using CBD-rich cannabis preparations, since CBD is non-intoxicating and may counteract the psychotropic effects of THC, the main cannabinoid responsible for the cannabis high.

Cannabis can also cause increased heart rate, red eyes, dry mouth, sleepiness, hypotension, and dizziness. However, these effects are relatively minor.

 

About Spinal Cord Trauma Overview

Spinal cord injury, or SCI, is when the spinal cord or the nerves at the bottom of the spinal cord, are damaged in some way. The spinal cord is a soft rope of nerves that runs down the center of your spine, carrying messages from the brain to the rest of the body. 

Traumatic spinal cord injury is when the spinal cord is damaged by a traumatic incident, like a car accident, sports injury or a fall. 

Non-traumatic spinal cord injury is when the damage is caused by disease or deterioration within the body, like arthritis, inflammation, or disk degeneration.  This could be a natural process or can be a result of chronic strain or work. 

When someone suffers from spinal cord trauma, there is often permanent residual damage. The effects of spinal cord injury depend on where the spinal cord was injured — and the higher the site of the injury, the greater the impact. 

It’s been estimated that spinal cord trauma that every year, between 250,000 and 500,000 people injure their spinal cord, mostly due to preventable traumatic causes like falls, violence and motor vehicle accidents. Spinal cord injury is more likely to happen to men than women, and just over half of those with SCI are aged 16-30. 

 

Symptoms

The symptoms of spinal cord injury can vary widely, but they mainly depend on two factors:

  • The location of the injury on the spine. The higher the site of the injury on the spinal cord, the more severe the symptoms. 
  • Whether the injury is complete or incomplete. 
    • Complete injury means that there’s no feeling or response at all below the level of the injury. About 50% of spinal cord injuries are complete.
    • Incomplete injury means that there is some feeling or response below the level of the injury. There are different levels of incomplete injuries.

Symptoms of acute spinal cord injury include:

  • Inability to move your arms, legs, or chest voluntarily
  • Trouble breathing
  • Loss of feeling in your chest, arms, or legs
  • Loss of bowel and bladder function
  • Muscle weakness
  • Pain, tingling, burning, which can be severe in the chest, arms or legs.

SCI can cause quadriplegia, which is paralysis of the arms, legs, and trunk, or paraplegia, which is paralysis of the legs and lower body. 

Other symptoms of spinal cord injury include:

  • Altered or loss of sensation, like having trouble feeling heat, cold and touch
  • Exaggerated reflexes or spasmodic muscle movements
  • Changes in sexual sensitivity, sexual function or fertility
  • Trouble coughing or clearing your throat

You might not be able to tell how serious SCI is when it’s just happened. That’s because the spine may go into shock, which lowers your ability to feel and move your muscles, and reduces reflex reactions. Swelling and bleeding can also occur slowly after the injury, causing or aggravating symptoms sometime after the incident. 

It can take up to a few days to see the full symptoms of SCI, which is why it’s important to consult a doctor if you have any kind of injury to your spine, even if it doesn’t seem to be serious at first. 

Diagnosis

If you suspect that you might have SCI, you should go straight to the ER. As part of the diagnostic process, you can expect your doctor to:

  • Ask you what caused your symptoms
  • Check your reflexes
  • Ask you to carefully move different parts of your body
  • Order an x-ray to check for fractures, tumors, or degeneration in the spine
  • Check your response to pinpricks, light touch, and light pressure
  • Order a CT scan to check for abnormalities in the spine
  • Order an MRI scan to look for blood clots, herniated disks, or masses that could be pressing on the spinal cord

Because it can take time for all the symptoms of SCI to develop, your doctor might keep you under observation for a few days and then repeat some or all of the tests.

 

Causes

Your central nervous system is made up of your brain and your spinal cord. The spinal cord sends messages to the rest of your body to control muscle movement and sensory response. The spinal cord is protected by the vertebrae of the spine, but when vertebrae are crushed, fractured, compressed, or dislocated, the spinal cord can be damaged, causing spinal cord injury. 

Common causes of spinal cord injury include:

  • Motor vehicle accidents, which cause more than 50% of new spinal cord injuries each year
  • Falls, which is the cause of most spinal cord injury among people aged over 65, and of 35% of SCI overall
  • Violence, like knife wounds and gunshot wounds
  • Sports accidents, like jumping on trampolines, diving, and football collisions cause around 10% of spinal cord injuries
  • Disease, including cancer, arthritis, and infections that inflame the spinal cord or cause an abscess on the spinal cord
  • Birth injuries usually affect the spinal cord in the neck area

Treatment

There’s no way to undo damage to the spinal cord, but emergency treatment can prevent SCI from getting worse, and rehabilitation can help you to live an active and fulfilling life.  

Emergency treatment includes:

  • Immobilizing the neck and spine
  • Preventing shock
  • Ensuring that you can still breathe
  • Preventing secondary health complications, like blood clots

Sometimes, surgery is needed after SCI to remove fragments of bone, move vertebrae, or realign herniated disks that are pressing on the spinal cord. 

Doctors might insert a catheter to drain your bladder, a feeding tube to ensure that you get nutrition, and/or place you on a ventilator to help you breathe. These can be short-term interventions while your body recovers from the shock of the accident and the swelling in your spine goes down, or they could continue for the long term. 

You might be given corticosteroids to help reduce swelling in your spine.

Rehabilitation helps you learn how to adapt to your new condition. It usually includes:

  • Physical therapy, to help you keep as much movement as possible in your limbs and learn adaptive ways to manage daily activities of living
    • This helps prevent the muscles from getting too tight which can lead to severe pain. 
  • Psychotherapy to help you cope with the loss of function
  • Medication when relevant to maintain your heart and respiration, relieve your pain, improve bowel and bladder control, and reduce spasticity
Home > Conditions > Spinal Cord Trauma
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10 min

Can Cannabis Help Spinal Cord Trauma?

by Gleb Oleinik

Listen

Overview

Cannabis is an increasingly popular therapeutic option for people living with spinal cord injury. Indeed, many sufferers report significant reductions in pain and muscle spasticity, the two main symptoms of this debilitating condition.

Recent research reveals that the effectiveness of cannabis in spinal cord injury management may be due to its interaction with the body’s endocannabinoid system (ECS).

This system plays an important role in the healthy function of the spinal cord and may act as a protective mechanism after spinal cord injury. 

What’s the link between the ECS and spinal cord injury? Is there any evidence that cannabis can ease its symptoms and even enhance recovery? Here’s what the research says.

 

How Cannabis Works on Spinal Cord Injury 

The endocannabinoid system exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own 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.

This system is present throughout the human body, including the central nervous system (CNS). The spinal cord is a significant component of the CNS, and contains a high concentration of CB1 receptors alongside a smaller number of CB2 receptors.

Research indicates that the endocannabinoid system plays an important role in the normal function of the spinal cord, including the control of reflexes (such as pulling your finger away from heat) and pain.

Studies also show that spinal cord injury is followed by an increase in the levels of 2-AG and anandamide — the two main endocannabinoids — around the injury site in rats. Similar increases occur with CB1 and CB2 receptors. 

Researchers have also demonstrated that blocking the cannabinoid receptors after spinal cord injury in mice results in poorer recovery; others have found that administering a synthetic form of the endocannabinoid 2-AG improves recovery following brain injury in mice.

These findings suggest that after an injury to the spinal cord and the brain, the endocannabinoid system acts as a defense mechanism against further damage.

As such, there is promise in using cannabis to not only ease spinal cord injury symptoms such as pain but directly improve recovery.

In particular, cannabis shows potential in protecting against the so-called secondary damage of spinal cord injury, caused by inflammation, oxidative stress, and excitotoxicity. 

Whereas the immediate damage is unavoidable, this secondary damage, which starts minutes after the primary spinal cord injury and can last for several weeks, may respond well to cannabis treatment.

 

Medical Studies on Spinal Cord Injury and Cannabis

Although there hasn’t been a lot of research looking at cannabis and spinal cord injury, the current findings are promising, suggesting that it can relieve pain, muscle spasticity, and other symptoms.

A 2003 study looked at the benefits of cannabis extract in people with spinal cord injury and related nerve damage issues such as multiple sclerosis and brachial plexus injury. Compared to placebo, cannabis produced significant pain relief, an improvement in bladder control, and decreased muscle spasms and spasticity, with minor side effects. Indeed, cannabis is medically approved for spasticity and chronic pain.  

A 2007 study examined the effects of THC on spasticity caused by spinal cord injury. Compared to placebo treatment, THC reduced the spasticity sum score, a measure of spasticity severity, from an average of 16.7 to 8.9. The researchers concluded that “THC is an effective and safe drug in the treatment of spasticity.” 

Meanwhile, a 2016 study looked at the benefits of vaporized cannabis in people with neuropathic pain caused by spinal cord injury and disease. Compared to placebo, people who vaped cannabis with 2.9% or 6.7% THC experienced significant pain relief.

Additionally, several observational studies have highlighted the popularity of cannabis for relieving the pain and spasticity caused by spinal cord injury (SCI):

  • A 2018 Colorado study found that 48% of surveyed adults with SCI used cannabis to relieve spasticity and improve sleep
  • A 2019 study in New Zealand examined eight people with SCI, finding that they successfully reduced their pain with cannabis when standard medication proved ineffective and caused drowsiness

Lastly, there’s evidence that cannabis can relieve symptoms of multiple sclerosis (MS), a condition characterized by nerve damage that’s similar to spinal cord injury. Cannabis is approved for the treatment of symptoms associated with MS in many areas where cannabis is prescribed medically.  

One 2018 review analyzed the findings of multiple high-quality studies looking at cannabis use for easing symptoms of MS. This review found that cannabinoids were effective at reducing neuropathic pain and muscle spasticity, two symptoms also experienced by people with SCI.

In all, there’s a growing body of medical evidence that cannabis can relieve the pain and spasticity associated with SCI. However, more research is needed to see whether cannabis can also improve recovery following such injury.

 

Side Effects

Cannabis is a relatively safe medication, but it can cause some side effects. 

Cannabis Side Effects

Human studies of cannabis use to treat symptoms of SCI have reported psychoactive side effects such as euphoria, increased anxiety, impaired memory, and difficulty paying attention, collectively known as the cannabis high. However, these effects were tolerated well by study participants and not deemed serious.

Such side effects can be further reduced by using CBD-rich cannabis preparations, since CBD is non-intoxicating and may counteract the psychotropic effects of THC, the main cannabinoid responsible for the cannabis high.

Cannabis can also cause increased heart rate, red eyes, dry mouth, sleepiness, hypotension, and dizziness. However, these effects are relatively minor.

 

About Spinal Cord Trauma

Spinal cord injury, or SCI, is when the spinal cord or the nerves at the bottom of the spinal cord, are damaged in some way. The spinal cord is a soft rope of nerves that runs down the center of your spine, carrying messages from the brain to the rest of the body. 

Traumatic spinal cord injury is when the spinal cord is damaged by a traumatic incident, like a car accident, sports injury or a fall. 

Non-traumatic spinal cord injury is when the damage is caused by disease or deterioration within the body, like arthritis, inflammation, or disk degeneration.  This could be a natural process or can be a result of chronic strain or work. 

When someone suffers from spinal cord trauma, there is often permanent residual damage. The effects of spinal cord injury depend on where the spinal cord was injured — and the higher the site of the injury, the greater the impact. 

It’s been estimated that spinal cord trauma that every year, between 250,000 and 500,000 people injure their spinal cord, mostly due to preventable traumatic causes like falls, violence and motor vehicle accidents. Spinal cord injury is more likely to happen to men than women, and just over half of those with SCI are aged 16-30. 

 

The symptoms of spinal cord injury can vary widely, but they mainly depend on two factors:

  • The location of the injury on the spine. The higher the site of the injury on the spinal cord, the more severe the symptoms. 
  • Whether the injury is complete or incomplete. 
    • Complete injury means that there’s no feeling or response at all below the level of the injury. About 50% of spinal cord injuries are complete.
    • Incomplete injury means that there is some feeling or response below the level of the injury. There are different levels of incomplete injuries.

Symptoms of acute spinal cord injury include:

  • Inability to move your arms, legs, or chest voluntarily
  • Trouble breathing
  • Loss of feeling in your chest, arms, or legs
  • Loss of bowel and bladder function
  • Muscle weakness
  • Pain, tingling, burning, which can be severe in the chest, arms or legs.

SCI can cause quadriplegia, which is paralysis of the arms, legs, and trunk, or paraplegia, which is paralysis of the legs and lower body. 

Other symptoms of spinal cord injury include:

  • Altered or loss of sensation, like having trouble feeling heat, cold and touch
  • Exaggerated reflexes or spasmodic muscle movements
  • Changes in sexual sensitivity, sexual function or fertility
  • Trouble coughing or clearing your throat

You might not be able to tell how serious SCI is when it’s just happened. That’s because the spine may go into shock, which lowers your ability to feel and move your muscles, and reduces reflex reactions. Swelling and bleeding can also occur slowly after the injury, causing or aggravating symptoms sometime after the incident. 

It can take up to a few days to see the full symptoms of SCI, which is why it’s important to consult a doctor if you have any kind of injury to your spine, even if it doesn’t seem to be serious at first. 

If you suspect that you might have SCI, you should go straight to the ER. As part of the diagnostic process, you can expect your doctor to:

  • Ask you what caused your symptoms
  • Check your reflexes
  • Ask you to carefully move different parts of your body
  • Order an x-ray to check for fractures, tumors, or degeneration in the spine
  • Check your response to pinpricks, light touch, and light pressure
  • Order a CT scan to check for abnormalities in the spine
  • Order an MRI scan to look for blood clots, herniated disks, or masses that could be pressing on the spinal cord

Because it can take time for all the symptoms of SCI to develop, your doctor might keep you under observation for a few days and then repeat some or all of the tests.

 

Your central nervous system is made up of your brain and your spinal cord. The spinal cord sends messages to the rest of your body to control muscle movement and sensory response. The spinal cord is protected by the vertebrae of the spine, but when vertebrae are crushed, fractured, compressed, or dislocated, the spinal cord can be damaged, causing spinal cord injury. 

Common causes of spinal cord injury include:

  • Motor vehicle accidents, which cause more than 50% of new spinal cord injuries each year
  • Falls, which is the cause of most spinal cord injury among people aged over 65, and of 35% of SCI overall
  • Violence, like knife wounds and gunshot wounds
  • Sports accidents, like jumping on trampolines, diving, and football collisions cause around 10% of spinal cord injuries
  • Disease, including cancer, arthritis, and infections that inflame the spinal cord or cause an abscess on the spinal cord
  • Birth injuries usually affect the spinal cord in the neck area

There’s no way to undo damage to the spinal cord, but emergency treatment can prevent SCI from getting worse, and rehabilitation can help you to live an active and fulfilling life.  

Emergency treatment includes:

  • Immobilizing the neck and spine
  • Preventing shock
  • Ensuring that you can still breathe
  • Preventing secondary health complications, like blood clots

Sometimes, surgery is needed after SCI to remove fragments of bone, move vertebrae, or realign herniated disks that are pressing on the spinal cord. 

Doctors might insert a catheter to drain your bladder, a feeding tube to ensure that you get nutrition, and/or place you on a ventilator to help you breathe. These can be short-term interventions while your body recovers from the shock of the accident and the swelling in your spine goes down, or they could continue for the long term. 

You might be given corticosteroids to help reduce swelling in your spine.

Rehabilitation helps you learn how to adapt to your new condition. It usually includes:

  • Physical therapy, to help you keep as much movement as possible in your limbs and learn adaptive ways to manage daily activities of living
    • This helps prevent the muscles from getting too tight which can lead to severe pain. 
  • Psychotherapy to help you cope with the loss of function
  • Medication when relevant to maintain your heart and respiration, relieve your pain, improve bowel and bladder control, and reduce spasticity

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