Spinal stenosis can cause an immense amount of pain. Medical Marijuana may help patients suffering from severe spinal stenosis symptoms. Cannabidiol, or CBD, is a new medical treatment that may be effective for back pain. It has relatively few side effects and does not come with the high associated with marijuana. Spinal stenosis is a physical condition often resulting from a failed surgery. Can CBD help alleviate the pain and other symptoms associated with spinal stenosis? Let’s take a look at how its efficacy and safety compare to conventional treatments.
Medical Marijuana May Ease Pain Symptoms of Spinal Stenosis
Spinal Stenosis is primarily characterized by back pain and nerve-type symptoms that include tingling and numbness in the hands, arms, feet, and legs. Many patients that have back pain caused by stenosis are finding that medical cannabis is useful for pain management.
Medical cannabis contains hundreds of chemicals called cannabinoids. The most well-known and studied cannabinoids are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) . These cannabinoids interact with the CB1 and CB2 receptors, which are receptors to the endocannabinoid system (ECS). The endocannabinoid system consists of fat-based neurotransmitters. When cannabis meets the endocannabinoid system, the neurotransmitter levels shift and help control pain and reduce inflammation , two major components of spinal stenosis symptoms (3).
For more information on how the endocannabinoid system works, please see our page on endocannabinoids here .
Treating Spinal Stenosis with Medical Cannabis
There are several symptoms that are related to stenosis and many of these conditions have clinical evidence that medical marijuana may help you. Cannabis and CBD oil are good options for patients seeking to limit addictive pain relievers or gabapentin.
Arthritis & Inflammation
If your stenosis is caused by arthritis or some other form of inflammation, using both CBD and THC has demonstrated reductions in inflammation by modulating the immune system to reduce attacking itself and thereby reducing inflammation (3).
Please see our arthritis and inflammation pages for more information.
Many patients with spinal stenosis also have pain that comes and goes. This is considered acute pain and may be effectively treated with medical cannabis as it acts like an analgesic, which is a medication that relieves pain. A review from Cannabis and Cannabinoid Research examined studies focusing on acute pain. Six trials with 678 participants examining oral and intramuscular use of cannabinoids show really promising results with a 95% confidence interval backing the results of these studies. Patients who received intramuscular cannabinoids showed a 95% reduction in acute pain compared to placebo (3). While oral consumption of cannabis was equivalent in reducing pain to the placebo, these studies are good groundwork and prove that high-quality research is still needed in this area.
Many patients use the whole cannabis plant or a 1:1 combination of CBD to THC to help relieve their chronic pain. Most pain research focuses on neuropathic pain and patients who do not see symptom relief with traditional pain medications. Improving your chronic pain with cannabis may also help improve your sleep and quality of life (9).
Check out our page on treating chronic pain for more information.
Peripheral Neuropathy & Sciatica
Many spinal stenosis patients experience nerve pain in their arms, hands, feet, and/or legs. To learn more about how to target tingling, numbness, or warm nerve pain associated with your condition, please check out our neuropathy and sciatica information pages.
Different Treatment Recommendations for Spinal Stenosis
As always, it is recommended while beginning cannabis or CBD treatment to start with low doses and to slowly increase the dose over time. You do not have to feel impaired to get pain relief and it is appropriate for patients worried about feeling impaired to begin treatment with CBD only. Research supports that CBD use topically with lotions and patches may potentially reduce neuropathic pain (12) . Of course, CBD use does not guarantee to be completely pain-free and may be part of a multimodal approach between you and your providers.
A task force meeting during PAINWeek 2020 has helped provide treatment guidelines for doctors prescribing medical cannabis for pain, including pain experienced by patients who have spinal stenosis. The task force recommends the following (1):
- Begin with 5mg of CBD twice a day and only add THC if there is no pain improvement with up to 40 mg of CBD .
- 2.5mg of THC should be introduced with CBD and gradually increased to 40mg of THC a day.
- Frail or elderly patients should begin with 1mg of THC per dose and gradually increase.
- Patients who have severe pain or previous cannabis use should begin with 2.5mg of CBD to THC (1:1 ratio) once or twice a day.
Spinal Stenosis and Medical Cannabis: Considerations to Keep in Mind
It is important to talk to your doctor before starting medical cannabis treatment as it is possible that it and the existing medications you are taking may have drug interactions or you may experience side effects. In addition, the long-term effects of cannabis or CBD are unknown in children, pregnant women, and the elderly population.
Cannabis may help improve your quality of life and reduce opiate use over time (3)(11).
Understanding the Locations of Spinal Stenosis
Stenosis or narrowing of the spinal column can occur anywhere along the spine. It is most often seen in the neck, or the cervical area of the spine, and the lower back, or the lumbar portion of the spine. It is also possible to get thoracic stenosis which is characterized by tingling or weakness at or below the abdomen (10). It can be mistaken for other conditions such as herniated disc or intervertebral disc disease.
When spinal stenosis is in the vertebrae of the neck it is called cervical spinal stenosis. It is characterized by neck pain and possible balance problems. In addition, many patients experience issues with their arms or legs which include numbness and tingling sensations, muscle weakness, and loss of function in the hands. In extreme cases, patients can lose bladder or bowel control, which is considered a serious medical emergency (10).
Lumbar spinal stenosis occurs when the spinal column is narrowing in the lower back or the lumbar region of vertebrae. It is the most common type of spinal stenosis that patients experience. Besides the typical symptoms of lower back pain, patients can experience numbness or tingling in the legs or buttocks as well as sciatica (10). The pain and heaviness in the legs typically worsen when standing for long periods of time.
Many patients feel pain relief when they are bending slightly forward while sitting or walking (10). Severe cases can also cause bladder and bowel control issues like cervical spinal stenosis.
Causes of Spinal Stenosis
There are several causes of spinal stenosis. One factor of getting spinal stenosis is being over the age of 50. Other causes include (10):
- Bone overgrowth or bone spurs
- Bulging or herniated spinal disks
- Thickened spinal ligaments
- Spinal fractures spinal injuries
- Spinal cord cysts or tumors
- Congenital spinal stenosis
Note: Veriheal does not intend to give this as professional medical advice. Do not attempt to self-diagnose, or prescribe treatment based on the information provided on this page. Always consult a physician before making any decision on the treatment of a medical condition.
Understanding CBD (Cannabidiol) for Back Pain
Cannabidiol, commonly referred to as CBD, is a new and relatively understudied treatment for pain, including back pain. Studies suggest it may help relieve inflammation, which is often a factor in chronic back pain. 1
CBD is available in many forms; topical creams and gels have shown promising results for inflammation and neuropathy, which may make them a good option for back and neck pain. 2
CBD requires more research in order to prove and explain its effectiveness as well as to better understand potential side effects (especially long-term) and potential drug interactions.
What Is CBD?
CBD oil is derived from a plant called cannabis sativa. The plant has over 100 chemical compounds, called cannabinoids, that have a range of effects, including anti-inflammatory and analgesic (pain relieving) qualities.
The cannabis sativa plant has two main varieties that are grown for specific purposes:
- THC content. THC is the compound associated with the “high” feeling of marijuana use.
- Industrial (non-drug) uses. This form of the plant contains trace amounts of THC (less than .03%) and can be used to make paper, clothing, and some building material. This variation of the cannabis plant is called hemp.
While CBD is present in both varieties, many of the CBD products available to consumers are from the hemp plant. CBD does not come with the high or psychogenic effects of marijuana.
Ways CBD Treats Back Pain
Research indicates that CBD may reduce back pain by:
- Reducing inflammation 3
- Combating anxiety, often associated with long-lasting or chronic back pain 4
- Helping with sleep and improving overall state of relaxation 5
Some studies suggest that CBD can have an effect on how an individual perceives pain, but more robust research is needed. CBD is generally considered a full-body treatment, which means that it does not target back pain specifically—except in the case of topical products—but contributes to an overall feeling of relaxation and pain relief.
Advocates of CBD believe it can be used to treat a range of conditions in addition to back pain, such as anxiety-related disorders. 5
Potential Risks and Side Effects of CBD
Cannabidiol, even in high amounts, is generally safe. Side effects from CBD may include:
- Dry mouth
- Low blood pressure
More severe side effects, while rare, include:
- Mental confusion
As with other natural products, there is potential for adverse reactions when taken with other medications, especially those that come with grapefruit warnings, such as certain blood thinners. These warnings indicate that certain medications should not be taken with products containing grapefruit.
CBD use prior to surgery
Before having surgery, all cannabis use, including CBD and marijuana, should be disclosed to the surgeon or anesthesiologist. A recent study suggests that cannabis use may have an effect on medications used to sedate patients. 6
Can CBD Oil Help with Spinal Stenosis Pain?
CBD has potent anti-inflammatory properties, indicating potential benefits for the symptom control of spinal stenosis, also known as spinal injury.
Spinal stenosis refers to a spine issue associated with high inflammation markers. The discomfort is also followed by nerve pain, further deteriorating the quality of life of many patients. People with spinal stenosis often rely on potent prescription medications — putting themselves at a high risk of dependence and severe withdrawals.
Being unable to rest and function properly throughout the day, individuals suffering from spinal injuries turn to natural remedies for relief.
CBD is touted by the medical community to reduce inflammation and mitigate pain signaling to the brain. These qualities put it high on the list of potential natural alternatives to treating spinal stenosis.
Read this article to find out if CBD can help you with symptom control.
Does CBD Oil Help with Spinal Stenosis Pain?
Some studies suggest that CBD oil could help many spinal stenosis symptoms. In a study published in the Journal of Pain Research in 2018, the research team examined the link between cannabinoids and spinal cord stimulation in patients with spinal stenosis from a failed back surgery.
The Italian study analyzed the situation of 11 patients diagnosed with neuropathic pain after their surgery. All participants discontinued other treatments in favor of a cannabinoid-based solution. They were taking a predetermined dose of THC/CBD, which they could adjust to their response. At the end of the study, the patients reported significant improvement in pain while recovering from surgery compared to the beginning of the trial .
Several spinal disorders, including spinal cord injury, spinal stenosis, and radiculopathy (pinched nerve) due to herniated discs, are common triggers of nerve pain.
A research paper published in 2020 in C current Pharmaceutical Biotechnology analyzed the efficacy of CBD oil in managing neuropathic pain in 29 participants with peripheral neuropathy.
The group that received CBD reported that their severe pain and cold, itchy sensations had been diminished significantly. They also didn’t report any adverse effects. The researchers concluded that transdermal use of CBD oil helps considerably improve pain and other types of discomfort experienced by patients with peripheral neuropathy .
CBD for Other Spinal Stenosis-Related Symptoms
Spinal stenosis — and chronic back pain in general — is often accompanied by anxiety. A study posted in the Journal of Psychopharmacology in 2011 evaluated the effects of CBD on social anxiety disorder (SAD). The authors found that patients with SAD who used a high dose of CBD reported substantial improvements . CBD can help manage anxiety disorders by acting on serotonin and GABA receptors on top of improving endocannabinoid signaling in the brain .
Another study on CBD and anxiety — published in The Permanente Journal — investigated the efficacy of CBD on sleeping disorders and anxiety . The final sample examined 72 adults, 47 of whom reported anxiety as their primary health problem. The other 25 volunteers pointed to sleep deprivation as the main issue.
Almost 80% of participants experienced significant relief from anxiety within the first month. Sleep scores improved in over 66% of the tested subjects . Individuals with spinal stenosis struggle with anxiety and insomnia; when combined, they can take a serious toll on their overall well-being.
How CBD Helps to Alleviate Symptoms of Spinal Stenosis
CBD’s potential in controlling the symptoms of spinal stenosis is largely attributed to its interaction with endocannabinoid receptors, serotonin receptors, and TRPV-1 vanilloid receptors.
In a 2014 study published in the British Journal of Pharmacology , CBD was found to inhibit chemotherapy-induced neuropathic pain. The researchers discovered that the analgesic and anti-inflammatory effects of CBD could be produced partly by its interaction with the 5-HT1A (serotonin) receptor .
Interestingly, this interaction can also reduce anxiety levels, a more stable mood, and better emotional control.
A 2019 study further confirmed these findings in a mice model, showing that CBD decreased anxiety-like behavior and normalized serotonin activity .
CBD can also mitigate pain signals by engaging with TRPV-1 vanilloid receptors, which are the same receptors that respond to the terpenes in vanilla beans; these essential oils are responsible for the pain-dampening properties of vanilla — the reason why it has been widely used in folk medicine.
In a 2012 study published in Pharmaceuticals , the authors found a strong link between TRPV1 cells and autoimmune diseases and inflammation. This fuels the hypothesis that CBD’s impact on TRPV1 receptors helps mitigate pain signals and curb inflammation .
Last but not least, CBD can help the body level its endocannabinoid deficiencies. Not only does it signal the endocannabinoid system to produce its own endocannabinoids, but it also acts as the inhibitor of enzymes that break them down. Higher levels of endocannabinoids such as anandamide have been associated with a higher pain threshold and better stress response.
How to Use CBD Oil for Spinal Stenosis
CBD comes in many different forms. The most common format is CBD oil , which contains a CBD-rich hemp extract that is infused into a carrier oil.
CBD oil is taken sublingually (under the tongue). You need to use a dropper attached to the bottle of your oil to measure out the desired amount — then transfer it beneath the tongue and hold it in your mouth for up to 60 seconds.
From there, CBD, along with other phytonutrients, will travel to your bloodstream using the tiny capillaries under the tongue. Sublingual absorption improves the bioavailability of CBD and speeds up the onset of its calming and relaxing effects. Bioavailability refers to the amount of CBD that ends up in your bloodstream after ingestion.
The leftover amount of CBD oil is swallowed and processed by the digestive system.
CBD oil combines relatively high bioavailability with dosage precision, which is why many people use it as their go-to way to supplement cannabidiol.
The best type of CBD oil for spinal stenosis is the ful l -spectrum one because it contains all the valuable compounds from hemp; CBD and other cannabinoids, terpenes, and flavonoids work synergistically to create the entourage effect — enhancing the therapeutic efficacy of the product.
However, the problem with full-spectrum CBD oil is that it carries a strong earthy flavor, which may not appeal to many users. If you have a sensitive palate, you may want to consider the following alternatives:
CBD Cream for Spinal Stenosis
CBD cream is a decent option for spinal stenosis if you want to add a targeted approach to your treatment. While products like CBD oil or capsules will help reduce inflammation and dampen painful sensations from within, CBD topicals, such as creams, ointments, and gels, offer localized pain relief.
When you apply CBD directly to the skin, it interacts with the CB2 receptors of the skin’s endocannabinoid system. This results in an anti-inflammatory response because CBD acts on adenosine receptors, which block the inflammatory proteins known as cytokines.
Using CBD topically may help you reduce back pain, swelling, redness, and pain of inflammation.
CBD Gummies for Spinal Stenosis
If you dislike the taste of CBD oil, you may try out CBD gummies for spinal stenosis. They are available in different flavors, potencies, shapes, and formulas and resemble regular gummy bears. Gummies offer a fixed dose of CBD per serving and deliver it to your system through the gastrointestinal tract. This method of administration has some significant advantages, but it also has one drawback.
Speaking of the positives, a predetermined amount of CBD in each gummy makes it easier to calculate the dosage. For example, if you benefit from 50 mg of CBD per day and your gummies have 25 mg each, you need to take two gummies to match your dosage.
Once CBD enters the GI tract, it is metabolized by the liver and then gradually released into the bloodstream, ensuring longer-lasting effects (up to 10 hours).
That being said, the effects of oral CBD products have a delayed onset. This phenomenon is known as the first-pass metabolism; it’s also why CBD gummies offer lower bioavailability than oils (around 20%).
CBD Dosage for Degenerative Disc Disease
The CBD space remains unregulated, so there are no dosage guidelines or standard dosage charts for specific conditions, including spinal stenosis pain and other symptoms.
A review of studies assessing CBD dosages in clinical populations concluded that an optimal dose could vary from 1 mg to 50 mg per 10 kg of bodyweight depending on the user’s metabolism, weight, the severity of symptoms, unique body chemistry, and gender.
It’s generally recommended to start with a low dose such as 5–10 mg of CBD and gradually increase the amount until you find a dose that gives you the best results without making you feel dizzy or lethargic.
To learn more about CBD Dosage, head over to this post for a general guideline.
What Is Spinal Stenosis?
Spinal stenosis is a medical name to describe a narrowing of the spaces within the spine; it’s also known as the foramina . This condition reduces the space for the nerves to travel, which can happen in the spinal canal or within the intervertebral foramina.
The spinal cord compression or a spinal nerve can cause tingling, pain, numbness, or weakness. The symptoms can vary depending on the time and the severity of narrowing over time. The location of the issue matters too.
Types of Spinal Stenosis
Spinal stenosis has two main types. The diagnosis depends on the condition’s location; it’s also possible to have both forms of spinal stenosis at the same time.
This type of spinal stenosis occurs when the narrowing affects the neck area of the spine. People with spinal stenosis have spinal cords with less space to travel, which may cause them to compress. The contraction could result in dysfunction and pain anywhere beneath the compressed area.
The symptoms of cervical stenosis include:
- Pain in the neck
- Problems with movements and balance
- Weakness or tingling in an arm, hand, leg, or foot
- Bladder or bowel dysfunction (severe cases)
Patients with lumbar stenosis have the narrowing of the spine at the lower back. Also known as foraminal stenosis, this is the most common type of spinal stenosis:
You may have lumbar stenosis if you experience the following symptoms:
- Back pain
- Cramping in 1 or both legs when walking
- Weakness, numbness, and tingling in a foot or leg
Conventional Spinal Stenosis Treatments & Their Side Effects
Doctors usually diagnose spinal stenosis via tests such as MRI scan, X-ray, or CT myelogram
Treatments for spinal stenosis depend on the location of the condition and the severity of symptoms. A physician may prescribe conventional painkillers, including:
- Anti-seizure drugs like gabapentin or pregabalin
- Non-steroidal anti-inflammatory drugs (NSAID)
- Opioids such as oxycodone or hydrocodone
- Tricyclic antidepressants such as amitriptyline
However, the above treatments come with a risk of dangerous side effects, such as liver damage, kidney failure, weight gain, hormonal imbalances, autoimmune diseases, nausea, and vomiting — not to mention the high potential for dependence and withdrawals when it comes to opioids.
Patients with spinal stenosis tend to become less active physically over time due to the pain experienced when moving. However, this can only cause muscle weakness to deteriorate. Therefore, physical therapy is often recommended as the go-to treatment to improve balance and regain strength and endurance.
Other possible spinal stenosis treatments include:
- Decompression: People with spinal stenosis can ask their doctor about this procedure. Decompression involves removing compressed ligaments from the back of the spine. The process is known as image-guided lumbar decompression and doesn’t require general anesthesia.
- Steroid injections: corticosteroids could alleviate inflammation at the site of the stenosis, dampening pain. Patients can only take a handful of injections annually due to the side effects associated with frequent use, such as weakened bones and connective tissues.
- Surgery: it is performed as a last resort and aims to relieve pressure on the spinal cord or nerve roots. This can be achieved by creating greater space in the spinal canal. Surgical procedures include laminoplasty, laminectomy, and laminotomy.
There are also clinical studies involving the use of stem cells to treat degenerative disc disease. Researchers are also testing several genomic medications.
Summarizing the Potential Benefits of CBD Oil for Spinal Stenosis
Medical researchers are fueling more resources into studies on CBD’s effects on spinal stenosis and other forms of spinal injury. A growing body of evidence suggests that CBD oil can help manage several symptoms related to spinal stenosis, including inflammation, nerve pain, anxiety, and sleep deprivation.
The best part about using CBD for spinal stenosis is that its benefits aren’t accompanied by dangerous side effects, unlike most pharmaceutical medications. CBD is safe and well-tolerated, even in doses as high as 1,500 mg per day.
Research so far suggests that the best approach to treating spinal stenosis with CBD is the combination of a sublingual and topical product. Take CBD oil (or gummies) for general supplementation, and apply topicals directly on the site of the pain to relieve localized discomfort by activating the CB2 receptors with CBD.
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Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.