Medical Marijuana and CBD For Spinal Cord Injury

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Can medical marijuana help a spinal cord injury? Small studies found short-term relief of spasticity or nerve pain in some people, but none of the studies cited here tested whether cannabis or CBD helps the cord heal.

Being diagnosed with a spinal cord injury can be daunting. In the past, it often meant a life limited to a wheelchair or a bed. With modern technology, more can be done to help patients enjoy fuller and happier lives. Researchers are studying new treatments, and some people ask about CBD for nerve regeneration and cannabis for muscle spasms, but we found no study in people showing that either helps the spinal cord heal. A 2021 systematic review of cannabinoids in SCI found trial results for pain and spasticity varied widely, with unclear clinical meaning.

Living With a Spinal Cord Injury

A spinal cord injury is any damage to the vertebrae, ligaments, or discs of the spinal column, or to the cord itself. A hard hit, gunshot wound, or knife laceration that penetrates or cuts the cord can cause severe injury. Often, the damage occurs due to a traumatic blow to the back that fractures, dislocates, crushes, bursts, or compresses one or more of the vertebrae. Overextending the back too far one way or the other can also cause harm to the spinal column. The most common causes of spinal cord injuries are traumatic accidents. These include car accidents, falls, diving incidences, violence, and sports.

After the initial injury, bleeding, swelling, inflammation, or fluid in and around the wounded area can cause further impairment. Non-traumatic causes of spinal cord injury include inflammation, arthritis, infections, disc degeneration, or cancer.

Types and Levels of Spinal Cord Injury

The two main types of spinal cord injuries are complete and incomplete.

Complete spinal cord damage causes loss of all sensory feelings and the ability to control body movements below the wounded area.

Incomplete spinal cord damage is the loss of some sensory perceptions and motor functions below the injury. Depending on the location and seriousness, an incomplete injury can cause varying degrees of impairment throughout the body.

Damage to the spinal cord often causes some level of paralysis. There are two main types of paralysis. Tetraplegia, also known as quadriplegia, affects a person’s arms, hands, trunk, legs, and pelvic organs. Paraplegia is paralysis in all or some of the torso, legs, and pelvic region.

Treatment for Spinal Cord Injury

At this time, there is no way to reverse severe damage to the spinal cord. The first course of action with spinal cord injury is to immobilize the torso to prevent any further damage. Back and neck braces are often used during recovery and as a means to continually help stabilize the spine. Surgery may also be used to remove any bone fragments or foreign objects or to repair herniated discs or fractured vertebrae compressing the spine.

The best treatment is a team approach. Individuals with spinal cord injuries often remain in hospitals and rehabilitation centers for extended periods. The care providers involved may include medical doctors, physiatrists, rehabilitation nurses, physical and occupational therapists, rehabilitation psychiatrists, dieticians, recreation therapists, and social workers. Ongoing care helps to prevent any secondary problems. Sitting or lying in one position may cause pressure ulcers and blood clots, bowel & bladder issues, respiratory infections, and muscle weakness.

There are no FDA approved medications specifically for the treatment of spinal cord injuries. Prescription drugs are used to alleviate symptoms. Depending on the location and extent of the damage, individuals may experience pain, muscle spasms, bowel and bladder control issues, and sexual dysfunction.

Experimental treatments are another option used to alleviate symptoms and improve recovery. Researchers are also studying ways to protect nerve cells soon after an injury, including medicines and lowering the body’s core temperature, NINDS says. Cannabinoids for nerve regeneration remain a lab and animal research topic; a 2021 review of 34 studies in people with SCI covered pain and spasticity, not nerve repair.

Medical Marijuana and CBD for Spinal Cord Injury: What Studies Show

Some people with SCI use cannabinoids alongside their prescribed care; they are not an alternative to it. Cannabinoids are the chemical compounds found in the cannabis plant. Marijuana is a type of cannabis plant that contains many compounds, including THC (tetrahydrocannabinol), which causes the “high,” and CBD, which does not. That is why CBD is often described as non-intoxicating. Cannabis has a medical history of at least 3,000 years, per the National Cancer Institute, but old use is not proof that it works.

Cannabinoids for nerve regeneration are not a proven treatment for nerve damage. Some people choose CBD because it does not cause a high, but we found no trial showing that it eases SCI pain or speeds nerve healing in people.

A common complication of spinal cord injury is spasticity: stiff muscles and spasms that can develop below the injury, NINDS says. Muscle spasm can be a result of the injury itself or being in a sustained sitting or lying down position for an extended time. Evidence on marijuana for back spasms after SCI is small: in a 2010 crossover trial of 11 men with SCI, the cannabinoid drug nabilone lowered Ashworth spasticity scores but did not change the other measures.

Evidence on CBD oil for spinal cord injury is thin. A 2021 systematic review found that in randomized trials, cannabinoid effects on SCI pain and spasticity varied widely and their clinical meaning was unclear.

In Florida, a medical marijuana card requires a qualified physician’s certification. Spinal cord injury is not on the state list, so certification depends on a qualified physician’s finding that it is of the same kind or class as, or comparable to, one of the listed conditions other than a terminal condition or chronic nonmalignant pain, or on another route in the statute. Patients then buy from a licensed treatment center.

Cannabis is not a proven addition to spinal cord injury care. In small studies, vaporized cannabis eased nerve pain during 8-hour lab sessions in 42 people, while dronabinol did no better than an antihistamine in a pilot of 7. Ask your rehabilitation team first.