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Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?

The treatment of chronic, non-cancer musculoskeletal pain has become a topic growing interest as it is believed to be one of the reasons for the current opioid epidemic. The medicinal use of cannabis has a long history as a number of active compounds in cannabis have been shown to interact with the...

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Autores principales: Johal, Herman, Vannabouathong, Christopher, Chang, Yaping, Zhu, Meng, Bhandari, Mohit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333482/
https://www.ncbi.nlm.nih.gov/pubmed/32655704
http://dx.doi.org/10.1177/1759720X20937968
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author Johal, Herman
Vannabouathong, Christopher
Chang, Yaping
Zhu, Meng
Bhandari, Mohit
author_facet Johal, Herman
Vannabouathong, Christopher
Chang, Yaping
Zhu, Meng
Bhandari, Mohit
author_sort Johal, Herman
collection PubMed
description The treatment of chronic, non-cancer musculoskeletal pain has become a topic growing interest as it is believed to be one of the reasons for the current opioid epidemic. The medicinal use of cannabis has a long history as a number of active compounds in cannabis have been shown to interact with the body’s endocannabinoid system to reduce pain. This position paper provides a history on the evolution of cannabis, the science behind its therapeutic effects, and review of the evidence and current guideline recommendations on its use as a treatment for patients with chronic, non-cancer musculoskeletal pain. Results from systematic reviews have demonstrated a statistically significant reduction in chronic pain conditions with cannabinoids, compared with placebo, although the effects might be considered small and did not reach the minimally important difference. More adverse events were reported in the cannabinoid group than in the placebo group with longer than 2 weeks of treatment. There is a lack of evidence on dependence. With changes to policies, patients’ perception has changed to be more positive toward the use of medical cannabis. Current recommendations from North America, Latin America, Europe, Australia and Iran support the use of medical cannabis for chronic, non-cancer pain. Based on the current evidence, it is our position that cannabinoids may be considered as an adjunctive therapy after recommended first- and second-line therapies have failed to provide sufficient efficacy or tolerability. Patients should consider the balance between the desirable and undesirable effects of taking cannabis for chronic pain, and comprehensively consider their own values and preferences, as well as cost-effectiveness factors, based on the information provided by their physician.
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spelling pubmed-73334822020-07-10 Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use? Johal, Herman Vannabouathong, Christopher Chang, Yaping Zhu, Meng Bhandari, Mohit Ther Adv Musculoskelet Dis Review The treatment of chronic, non-cancer musculoskeletal pain has become a topic growing interest as it is believed to be one of the reasons for the current opioid epidemic. The medicinal use of cannabis has a long history as a number of active compounds in cannabis have been shown to interact with the body’s endocannabinoid system to reduce pain. This position paper provides a history on the evolution of cannabis, the science behind its therapeutic effects, and review of the evidence and current guideline recommendations on its use as a treatment for patients with chronic, non-cancer musculoskeletal pain. Results from systematic reviews have demonstrated a statistically significant reduction in chronic pain conditions with cannabinoids, compared with placebo, although the effects might be considered small and did not reach the minimally important difference. More adverse events were reported in the cannabinoid group than in the placebo group with longer than 2 weeks of treatment. There is a lack of evidence on dependence. With changes to policies, patients’ perception has changed to be more positive toward the use of medical cannabis. Current recommendations from North America, Latin America, Europe, Australia and Iran support the use of medical cannabis for chronic, non-cancer pain. Based on the current evidence, it is our position that cannabinoids may be considered as an adjunctive therapy after recommended first- and second-line therapies have failed to provide sufficient efficacy or tolerability. Patients should consider the balance between the desirable and undesirable effects of taking cannabis for chronic pain, and comprehensively consider their own values and preferences, as well as cost-effectiveness factors, based on the information provided by their physician. SAGE Publications 2020-07-02 /pmc/articles/PMC7333482/ /pubmed/32655704 http://dx.doi.org/10.1177/1759720X20937968 Text en © The Author(s), 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Johal, Herman
Vannabouathong, Christopher
Chang, Yaping
Zhu, Meng
Bhandari, Mohit
Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?
title Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?
title_full Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?
title_fullStr Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?
title_full_unstemmed Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?
title_short Medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?
title_sort medical cannabis for orthopaedic patients with chronic musculoskeletal pain: does evidence support its use?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333482/
https://www.ncbi.nlm.nih.gov/pubmed/32655704
http://dx.doi.org/10.1177/1759720X20937968
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