Article written by
Dipak HemrajHead of Research and Education
Content reviewed by
Dr. Lewis JasseyMedical Director - Pediatric Medicine
Table of contents
Chronic pain is persistent pain that more than three months. This pain could be continuous or may come and go.
Chronic pain differs from acute pain, which occurs in response to an injury or disease and resolves when the injury or disease resolves. An injury or disease may cause body changes, leaving a person more susceptible to pain. These changes can be long-lasting, resulting in chronic pain. Chronic pain may also be caused by inflammation or dysfunctional nerves.
Traditional treatments for chronic pain are acupuncture, cognitive behavioral therapy (CBT), and medications. Common medications include anticonvulsants, corticosteroids, muscle relaxers, nonsteroidal anti-inflammatory drugs (NSAIDs), Tylenol/paracetamol, and opioids/narcotics.
Cannabis is also thought to help relieve the symptoms of chronic pain. While many can help, some of the best strains to use specifically for pain are:
- Northern Lights
- White Widow
Which Strains Are Best For You?
Don't guess. Book a one-on-one cannabis counseling appointment and get advice on how to find the best strains for your needs.Book an Appointment
How Cannabis Could Help Chronic Pain
Cannabinoids, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), are found in cannabis. When ingested, these cannabinoids influence receptors in the body known as CB1 and CB2. CB1 receptors are located primarily in the brain and the nervous system and regulate the psychoactive effects of cannabis. CB2 receptors are numerous in the immune system and are found throughout the body. When activated, CB2 receptors play a role in the activity of the immune system and inflammation.
CBD can help reduce chronic inflammation and pain. CBD also affects opioid receptors. Opioid receptors are important in regulating pain; this is why opioids are prescribed for chronic pain treatment. CBD binds to opioid receptors and alters how they respond to stimuli, ultimately reducing pain.
THC is the primary component in cannabis that causes intoxicating effects and helps relax the body and bind to the cannabinoid receptors in the brain to reduce pain sensation.
Cannabis also contains several terpenes that may help reduce chronic pain due to their ability to relieve stress, anxiety, and inflammation. These include:
Cannabis vs. Opioids for Chronic Pain
Opioids are lab-made narcotics. Morphine and codeine are common opioids. These medications change how the brain receives messages of pain from the body. Negative effects of opioids include immunosuppression, depression, and obesity. Opioids are addictive; opioid addiction and dependence (known as opioid-use disorder) is the leading cause of drug-related deaths in the USA.
In addition to these negative effects, the body can build up a tolerance to opioids. This means that the body can become accustomed to opioids, and they will no longer have the desired effect. Because of this, doctors often only prescribe opioids for short-term use and opt for other effective treatments where possible.
Cannabinoids can influence how opioid receptors work, resulting in pain relief. Cannabis use is restricted in many places because of its psychotropic effects. Many of the side effects of cannabis occur when first using cannabis and are short-lived.
The main difference between cannabis and opioids is that opioids are better suited for acute, short-term pain when used for pain relief. In contrast, cannabis can be a long-term solution for chronic pain when used at the correct dosage. Additionally, opioid overdose is a leading cause of death, whereas, although the research is limited, cannabis overdose is believed not to cause death.
Best Cannabis Ingestion Methods for Chronic Pain
Oral ingestion of cannabis is the best method for chronic pain treatment. This includes drops under the tongue, edibles, and capsules. Drops of CBD oil under the tongue produce pain-relieving effects in 15 to 30 minutes. Edibles and capsules take 60 to 90 minutes to have an effect as they must pass through the liver and be metabolized before the cannabinoids enter the bloodstream. When ingested orally, the effects of cannabis tend to peak about two to three hours after ingestion but last from 4 to 12 hours.
When administered via inhalation, cannabis can relieve chronic pain faster than when ingested orally, usually taking 15 to 30 minutes to reach maximum effect. However, the benefits of inhaled cannabis only last for two to three hours. For longer relief of chronic pain, orally ingesting cannabis is ideal. Additionally, smoking cannabis may lead to lung disease.
Best Marijuana Strain for Chronic Pain
Under previous classification systems, indica strains are considered the best for treating chronic pain. They tend to have moderate levels of CBD (Afghan varieties in particular) and high levels of THC and terpenes, which are effective for pain relief. However, other cannabis strains, mainly those high in CBD, are also beneficial for chronic pain treatment. The old “indica” and “sativa” distinctions are not necessarily accurate, and many sativa varieties may be equally as effective.
ACDC has the lowest THC concentration on this list (1%). It also has a very high CBD concentration of 12%. This strain is ideal for pain relief when you need to focus, such as during the day. It is not as a sedative as THC-rich varietals and does not have psychoactive effects as the THC content is very low. ACDC also contains myrcene, which is a terpene that is beneficial for reducing pain and inflammation.
Harlequin generally contains approximately 9% CBD and 5% THC. This makes it a popular strain for chronic pain if you are after pain relief without the psychotropic effects. The CBD relieves pain, and the THC concentration is low enough that you can still focus. Harlequin also contains myrcene for further pain and inflammation relief.
With 9% CBD and 4% THC, Cannatonic can provide pain relief without sedation. It’s worth remembering that, in higher doses, CBD can cause sedation. This is especially if it’s combined with THC. Remember: Cannabinoids like THC, CBD, and Tetrahydrocannabivarin (THCV) are biphasic, meaning they can have different effects at different doses.
The most common effects felt when using this strain of cannabis are relaxation, focus, and pain relief. Cannatonic also contains myrcene, providing further pain relief.
Northern Lights has a THC concentration of approximately 18%, giving it euphoric and muscle-relaxing effects, which may reduce pain. It causes sleepiness, so it is ideal for taking if chronic pain affects your sleep. Additionally, Northern Lights contains myrcene, another pain reliever.
White Widow contains myrcene, cannabigerol (CBG), and approximately 15% THC. It relieves pain and has been reported as having stimulating effects.
Blueberry is a relaxing cannabis strain that gives a euphoric effect and is known for relieving pain. It contains approximately 17% THC and myrcene.