Neuropathic pain is a health condition that unfortunately to date has no concrete cure. Despite making up almost 7% of all general practitioner diagnoses in Australia (Australian Family Physician), medical professionals have found no concrete treatment plan for neuropathic pain. Instead, patients may need to trial a wide range of treatments to help manage the symptoms and improve quality of life.

Current treatments for neuropathic pain vary - from standard traditional medications to alternative and complementary medicines such as yoga, chiropractic care, and acupuncture. However, when it comes to the future of treatment, scientists and medical professionals have begun considering the potential of medicinal cannabis in managing and suppressing symptoms of neuropathic pain. As research on the subject continues, it may be important to start building an early understanding, so that neuropathic pain patients can be prepared for new and improved treatment plans.

Keep reading to learn more about neuropathic pain and its care and treatment options (current and future) below.

What is Neuropathic Pain?

Neuropathic pain is a type of chronic pain that is caused by damage or injury to the nervous system. This can include damage to the spinal cord, brain, or peripheral nerves. The damage can be caused by trauma, surgery, cancer, infection, or other conditions and diseases. Neuropathic pain can be extremely debilitating, as it is often constant and can be difficult to treat.

There are many types of neuropathic pain, including:

• Burning pain
• Shooting pain
• Stabbing pain
• Numbness
• Tingling
• Sensitivity to touch or temperature changes

Neuropathic pain can be difficult to diagnose, as it can mimic other types of pain, such as headache or arthritis. However, there are some key differences that can help your doctor make a diagnosis. Neuropathic pain is often described as “burning” or “tingling.” It is often worse at night and can be aggravated by touch or temperature changes. It may also occur with numbness, weakness, and loss of sensation.

Neuropathic pain is most common in adults over the age of 60, but it can occur at any age. It is also more common in women than in men.

What are the Common Causes of Neuropathic Pain?

There are many potential causes of neuropathic pain. It may be the result of an injury, a medical condition such as diabetes, or even the side effect of certain medications. Whatever the cause, the end result is damage to the nerves, which then results in pain signals being sent to the brain even when there is no reason for them to.

There are a few genetic, lifestyle environmental factors that may contribute to the development of neuropathic pain, including:

• Having diabetes
• Having Shingles
• Having HIV/AIDS
• Alcoholism
• Having Autoimmune diseases like lupus or rheumatoid arthritis
• Experiencing phantom limb pain having gone through amputation
• Having cancer and going through its treatment (chemotherapy, radiation)

Neuropathic pain may also be the result of physical trauma to the nerves, such as from a car accident or surgery.

It is important to note that not all pain is neuropathic pain. For example, if you cut your finger, the resulting pain is not neuropathic because it is caused by an injury to non-nerve tissue. The pain signals travel along your nerves to your brain, but the pain is not caused by damage to the nerves themselves.

hat are the Symptoms of Neuropathic Pain?

The symptoms of neuropathic pain can vary depending on the cause and location of the nerve damage.

However, some common symptoms (in addition to the different types of pain) include:

• Difficulty sleeping
• Fatigue
• Depression or anxiety

The symptoms of neuropathic pain may be constant or intermittent, and they can vary in intensity. As a result, it’s important to closely monitor them and track any changes so that more effective treatment options can be considered.

What are Treatments for Neuropathic Pain?

The first step in finding neuropathic pain relief is to identify the underlying cause of the nerve damage. Once that’s been done, various treatment options can be considered.

These may include:

• Pain relievers: Over-the-counter (OTC) pain relievers like acetaminophen or ibuprofen can help to reduce pain and inflammation. Prescription-strength medications may also be recommended in some cases
• Antidepressants: Certain antidepressants have been found to be effective in treating neuropathic pain. Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are two types that are often used
• Anti-seizure medications: These medications are commonly used to treat epilepsy, but they can also be helpful in treating nerve pain
• Numbing agents: Injections of local anesthetics or topical medications like lidocaine can help to numb the affected area and provide temporary relief from pain
• Physical therapy: A physical therapist can teach you exercises and stretching techniques that can help to improve range of motion and reduce pain
• Surgery: In some cases, surgery may be necessary to correct the underlying cause of nerve damage. For example, a herniated disc may need to be removed in order to relieve pressure on the nerves

In addition to traditional western medicine treatments, some patients with neuropathic pain may also consider complementary and alternative methods such as acupuncture, massage, or yoga.

Another medication for neuropathic pain includes medicinal cannabis.

Neuropathic Pain and Medicinal Cannabis

Medicinal cannabis is a plant-based medicine that may provide relief from a wide variety of conditions and symptoms. The two main active components of cannabis are THC (tetrahydrocannabinol) and CBD (cannabidiol).

THC is the component of cannabis that produces the “high” feeling, while CBD does not have this effect. Medicinal cannabis products with a high CBD:THC ratio may be more effective in treating neuropathic pain than those with a higher THC content.

The mechanisms by which medicinal cannabis works to relieve neuropathic pain are not fully understood, but it is thought to involve the body’s endocannabinoid system. This system includes receptors that are found throughout the body, including in the brain, spinal cord, and peripheral nervous system.

The endocannabinoid system is involved in regulating many important functions, including pain perception, inflammation, and mood. It is thought that by binding to receptors in the endocannabinoid system, medicinal cannabis may help to reduce neuropathic pain.

A number of small studies have found that medicinal cannabis may be effective in treating neuropathic pain. In fact, NPS Medicinewise published a study, stating that patients who used medicinal cannabis products such as nabiximols and THC: Cannabidiol (CBD) extracts are more likely to experience a 50% reduction in neuropathic pain (primary endpoint) and pain scores when compared to placebo trials.

Although not much research on neuropathic pain and medicinal cannabis has been conducted, a publication from Molecules Journal still acknowledges that it is worthwhile to continue cannabis research for the management of pain, while also applying more rigorous clinical methodologies and clinical designs appropriate for useful results.

FAQs - Medicinal Cannabinoids for Neuropathic Pain

Below, we answer some of the most frequently asked questions concerning legal medicinal cannabis products and how they may help with the management of neuropathic pain symptoms.

What is the meaning of medical cannabis?

Medical cannabis, also known as medical marijuana, refers to the use of the cannabis plant and its derivatives to treat a variety of health conditions and symptoms. The cannabis plant contains more than 100 different chemical compounds known as cannabinoids, which interact with the body’s endocannabinoid system.

The two main cannabinoids considered in medical cannabis are tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the principal psychoactive component of cannabis and is responsible for the plant’s characteristic “high.” CBD, on the other hand, is non-psychoactive and is thought to possess a number of therapeutic properties.

When prescribing and using medicinal cannabis, doctors and specialists consider the THC and CBD ratio to ensure patients receive the most therapeutic benefit with the least psychoactive effect.

Who can prescribe medicinal cannabis in Australia?

In Australia, medicinal cannabis products can only be prescribed by a medical practitioner who holds an appropriate licence or permit.

The Therapeutic Goods Administration (TGA) is responsible for approving medicinal cannabis products for use in Australia. Medical practitioners need to lodge an application for an appropriate medicinal cannabis product prescription and have it approved before they can prescribe it to a patient.

There are a few medicinal cannabis products available on the Australian market, but not all have yet been approved by the Therapeutic Goods Administration for use in Australia. These products are considered ‘unlicensed medicines’, which means they have not undergone the same level of evaluation as licensed medicines and their safety and efficacy have not been established.

Medical practitioners who wish to prescribe unlicensed medicinal cannabis products must apply to the TGA for “special access”. Special access allows medical practitioners to request access to unlicensed medicinal cannabis products for individual patients on a case-by-case basis.

The TGA assesses all special access applications to ensure that the product is of an acceptable quality, and that the patient has a serious medical condition that cannot be adequately treated by licensed medicines. The TGA also requires that there is evidence to support the use of the unlicensed medicinal cannabis product for the particular indication.