There is limited research available on the use of specific marijuana strains for pain and other symptoms. As a result, strain-specific recommendations are not medically proven. The results of an online survey, comprising 95 participants, featured in the Journal of Alternative and Complementary Medicine in 2014. The researchers found that participants preferred indica strains for pain management, sedation, and sleep while they would opt for sativa strains to improve energy and mood. Regarding pain management, participants reported a statistically significant effect when using indica for:
non-migraine headaches
neuropathy
spasticity
joint pain
t is, however, important to note that this study had several limitations. It was small in scale, anonymous, and asked people to self-report on their symptoms. Respondents did not use the marijuana in a controlled setting, potentially resulting in differences in drug composition, dosage, and potency.
Another study examined the use of organically grown sativa and indica strains in the treatment of several medical conditions. Just over half of the participants were using marijuana to treat HIV.
The study followed participants for 3 years and asked them about the effects of the drug on their condition during this time. The results indicated that indica strains are more likely to improve energy and appetite, while both sativa and indica strains can alleviate nausea to a similar degree.
How does marijuana work for pain?
Marijuana, or cannabis, contains compounds that may relieve pain, nausea, and other symptoms. The components of marijuana that most studies focus on for pain relief are cannabidiol (CBD) and tetrahydrocannabinol (THC).
THC vs. CBD
THC resembles the cannabinoid chemicals that occur naturally in the body. When people ingest or inhale THC, it stimulates the brain’s cannabinoid receptors.
This activates the brain’s reward system and reduces pain levels. THC is a psychoactive compound as it binds to cannabinoid receptors and produces an elevated state of mind, known as a high.
CBD does not cause a high, although it does interact with pain receptors in the brain to exert pain-relieving and anti-inflammatory effects.
What the research says
In recent years, many studies have looked at the effects of marijuana for chronic pain. Some studies used parts of the marijuana plant and some have used the entire plant so more research is needed. Using parts of the marijuana plant (like CBD oil) helps study specific actions of that ingredient, but when the whole plant is used there is what is called an entourage effect, where the parts work together to have more effect.
A 2015 review of research on the use of marijuana and cannabinoids for various chronic pain conditions reports that several trials had positive results. The researchers suggest that marijuana or cannabinoids may be effective for treating some types of chronic pain including neuropathy (nerve pain).
A research paper from 2016 found that marijuana use for cancer pain led to a 64-percent reduction in opioid use, improved quality of life, and caused fewer medication side effects. It also led to participants using fewer medications.
Smaller studies have reported benefits for other types of chronic pain. For example:
Of about 17,000 people with cancer, 70 percent reportedly experienced an improvement in pain and general well-being after marijuana use. People with chronic migraines experienced a decrease in migraine episodes after using the drug.
However, there is still a need for more research into the area of marijuana use for chronic pain, especially into the use of different strains, dosages, and methods of delivery.
An Australian study, published in July 2018, concluded that marijuana use did not reduce the symptoms of pain or the need to use opioid medications. However, the findings were mostly based on reports from people who used the drug recreationally.
Using marijuana specifically for medicinal purposes might yield different results.