Research Library
Cannabinoids & chronic pain
Trials and reviews covering neuropathic, arthritic, and musculoskeletal pain.
Overview
Chronic pain is the most common reason people report using cannabinoid products, and the evidence base is correspondingly large — but also mixed.
Neuropathic pain has the strongest supporting data; inflammatory and mechanical pain results are more inconsistent.
What the evidence supports
- Multiple reviews find a modest but real reduction in neuropathic pain scores versus placebo.
- Combined THC:CBD preparations generally outperform CBD alone in trials of severe pain.
- Benefits often show up as improved sleep and function rather than large drops in raw pain scores.
Where the evidence is thin
- Placebo response in pain trials is unusually high, which complicates interpretation.
- Topical cannabinoid research is still mostly preclinical.
- Long-term functional outcomes are rarely measured beyond 6 months.
Selected studies
Systematic review · 2017
The health effects of cannabis and cannabinoids (pain chapter)
National Academies of Sciences, Engineering, and Medicine · NASEM Consensus Study Report
Concluded there is substantial evidence that cannabinoids treat chronic pain in adults.
Find this study on PubMed (opens in a new tab)Systematic review · 2018
Cannabis-based medicines for chronic neuropathic pain in adults
Mücke M, et al. · Cochrane Database of Systematic Reviews
Small benefits over placebo for pain relief and sleep, with more side effects.
Find this study on PubMed (opens in a new tab)Randomized trial · 2018
Transdermal cannabidiol for symptomatic knee osteoarthritis
Hunter D, et al. · Osteoarthritis and Cartilage
Did not separate from placebo on the primary pain endpoint.
Find this study on PubMed (opens in a new tab)