Medical Marijuana to Treat Back Pain

The popularity of medical marijuana is on the rise. More than ever before, marijuana is being used as an alternative treatment for a host of medical conditions—both physical and emotional. When it comes to chronic pain, osteoarthritis, back pain, medical marijuana is now being recommended by some physicians and healthcare providers, as well as independently sought out by those living with chronic back pain.

However, the stigma (or echoes of past stigma) attached to marijuana still hold true. Since marijuana was an illegal substance for most of our adult lives (and did not have the marketing push and distribution of popular prescription pain medications) there simply isn't a ton of information about "marijuana as a treatment for back pain". Those seeking pain treatment alternatives for prescription pain medication have a lot of unanswered questions about medical marijuana and how to use it for pain management.

Common questions about medical marijuana: Is medical marijuana safe? Does marijuana always get you "high"? Can marijuana really help with back pain? Can I use it alongside prescription pain medication? Is it legal?

Read on as we break down facts about marijuana and back pain, discuss how medical marijuana can reduce back pain and symptoms, share the different types of marijuana and administration methods, and explain the legality of marijuana by US state.

Curious about what causes lower back pain and how to treat it? Read this before we get into medical marijuana as a solution.

First things first:

What Exactly is Marijuana?

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Marijuana itself refers to the dried cannabis flowers (buds) and the leaves. Marijuana has many natural chemical compounds called cannabinoids. These compounds (like THC or CBD) have medicinal properties and treat a host of symptoms. The human body has natural cannabinoid receptors that react with the cannabinoids in marijuana and interact with the body to potentially reduce pain, cut down inflammation, aid with anxiety and depression, improve mobility (feeling more flexible and able to function), aid with nausea and more.

Hot Tip: In marijuana, THC is the psychoactive compound that gets you "riding high". If you don't want to feel high (side effects can include shifts in mood, anxiety, losing track of time etc.) look for a strain of marijuana that has low THC (average is about 25%). Your marijuana dispensary will be able to guide you.

Why Medical Marijuana for Back Pain?

There's way more to marijuana than the classic "stoner high". Marijuana has several medicinal properties that can aid in treating back pain, tightness, inflammation, nausea (caused by other medication), as well as emotional side effects that come with chronic pain like depression, anxiety, and insomnia.

Cannabis has approximately 100+ different types of cannabinoids, with THC being the most well-known. The compounds CBC, CBD, CBN, and THC have all been linked to relieving pain, arthritis, inflammation, fibromyalgia, depression, anxiety etc. Some of these cannabinoid compounds interact with the body and leave you feeling "high", however, not all of these compound have the psychoactive elements (THC) that will leave you feeling stoned.  In other words, if you want the pain relief without "flying high", there are strains of medical marijuana for you!

Benefits of Marijuana vs. Prescription Pain Medication

Is your physician withholding pain medication or drastically cutting down your dose? Here's why.

Healthcare providers and governing health care bodies (like CDC, Medicare etc.) are cracking down on opioid and narcotic prescription pain medication for patients. Physicians are lowering doses of narcotic pain medication, drastically cutting down pill counts, and in some cases refusing to prescribe opioids or turning away chronic pain patients. The situation, like the opioid crisis, is very complicated. For someone with back pain who may be tapering off prescription pain medication (or wants to avoid altogether), marijuana may be a great alternative or supplementary "medication" to use with pain medication.

Note: Before mixing prescription or over-the-counter medication with marijuana, always speak with your physician or healthcare provider.

Some Key Benefits to Marijuana vs. Prescription Pain Medication

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  • Can Lower Effective Opioid Doses. According to a study in Clinical Pharmocology and Therapeutics, using marijuana with opioids may significantly decrease pain. The study states that, when it comes to marijuana and opioids "the combination may allow for opioid treatment at lower doses with fewer side effects.

  • 100% Natural. Marijuana is a natural plant that is unprocessed. Prescription opioid pain medication is synthetic, and can have numerous negative side-effects that with long-term use, can be harmful to your body.

  • Fewer Side Effects. Marijuana has much fewer, less harmful side-effects than opioid pain medication or other synthetic meds (like NSAIDs, tylenol etc.). Pain medication is linked to heart attacks, seizures, constipation nausea etc. Marijuana side effects are limited to: anxiety, increased heart rate, dry mouth, possible increased risk of stroke etc.

  • Less Addictive. With the current opioid epidemic, it's clear that opioids are very addictive and can have a powerful hold over patients and other users. Marijuana, although arguably addictive, is less addictive than opioids. Chronic marijuana users can develop a dependency, cravings and experience withdrawal symptoms. However, marijuana addiction is much more infrequent, with much milder symptoms.

  • Less Dangerous. Prescription pain medication can be highly addictive, is tolerance-building, and comes with withdrawal symptoms for long-term patients. Although it's argued that marijuana may also be addictive, tolerance-building, and has withdrawal side-effects, it's not to the same degree as opioid pain medication. In addition, you cannot die of an accidental marijuana overdose.

Taking Marijuana for Back Pain

Marijuana has various strains and administration methods. Most commonly, people think of marijuana as being smoked. Medical marijuana can also be consumed through vaporizing, edibles, as a tincture/ spray, or as a topical lotion. Depending on your level of back pain and preference, you may lean towards one ingestion method or another and decide whether THC (the compound that gets you "high") is beneficial or not.

Hot Tip: Always start with a low dose. You can always ingest more, but you can't "uningest" once you've consumed marijuana. According OrganiGram, medical literature suggests that most people use between "1-3 grams of dried cannabis per day". It takes a few minutes up to an hour for marijuana to kick in.

Here's a rundown of the ingestion methods:
  • Smoking: Easy to administer, and you can control how much you are taking. Smoking small amounts at a time helps you to not over do it. After smoking, the effects can be felt almost immediately (peaking at 9 minutes after consumption).

  • Vaporizing "Vaping": Is like the fancy version of plain old smoking. You are still smoking the medical marijuana, however it's less harsh and smother with a vaporizer.  Also using dried cannabis flower that is smoked for instant relief, a vaporizer is less harsh than smoking. Vaporizers can be pricey to purchase, but may be a good option for more regular users.

  • Edibles: Edibles are popular for those that do not like the idea of smoke or typical marijuana use. The effects and relief tend to last longer, are more of a "body high" and take longer to set in. After an edible, it may take 30-60 minutes before you peak.

  • Tinctures/ Sprays. Generally, sprays come in a lower dose. This is a great option for those who do no wish to smoke, but are also intimidating about getting an edible dose right. Generally, sprays are low in dose, and take less time to kick-in than standard edibles.

  • Topical. Marijuana topicals are great for inflammation, swelling, and localized back pain. Applying marijuana topicals onto your back can offer immediate relief. Marijuana topicals have no psychoactive elements whatsoever, so you will not get high, but can receive the medical benefits and pain relief. Plus, topicals are mixed with beeswax, shea butter etc., so you're getting that moisture in too! Win-win!

The Legal Stuff: How Do I Get Medical Marijuana?

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Depending on which state (or country) you live in, marijuana laws will vary. In states like Alaska, Massachusetts, California, Colorado, Maine, Washington and Nevada, all uses of marijuana (recreational or medical) have been legalized.

In other states, recreational marijuana is illegal (or just decriminalized) but medical use is permitted. These states include: Arizona, Arkansas, Florida, Hawaii, Louisiana, and Michigan.

In five states (Georgia, Iowa, South Carolina, Tennessee, and Virginia) the THC level of medical marijuana is capped and controlled. Anything over the level of THC outlined by the state is not permitted. South Carolina and Tennessee have most limited THC content permitted, stating that cannabis oil must contain less than 0.9% THC.

As of this writing, only 4 states deem marijuana illegal for medical use. Currently, medical marijuana is still illegal in:

  • South Dakota

  • Nebraska

  • Kansas

  • Idaho

Note: Here's an updated list with the legality of marijuana across the USA (things are changing fast!).

The rest of the states allow some form of legal medical marijuana use. However, costs and difficulty associated with obtaining a license or prescription vary. In addition, marijuana is largely not covered by insurance as it is not directly prescribed by providers. A lot of patients independently go to dispensaries to get their medical marijuana (an out of pocket expense) and not entirely government-controlled.

District of Columbia has the most expensive price per ounce of high-quality marijuana. Per ounce, it costs nearly three times the average price on Oregon!

Here are the states where medical marijuana is broadly legalized (either outright legal or legal for some form of medical use):

  • Alabama

  • Alaska

  • Arizona

  • Arkansas

  • California

  • Colorado

  • Connecticut

  • Delaware

  • Florida

  • Georgia

  • Hawaii

  • Illinois

  • Indiana

  • Iowa

  • Kentucky

  • Louisiana

  • Maine

  • Maryland

  • Massachusetts

  • Michigan

  • Minnesota

  • Mississippi

  • Missouri

  • Montana

  • Nebraska

  • Nevada

  • New Hampshire

  • New Jersey

  • New Mexico

  • New York

  • North Carolina

  • North Dakota

  • Ohio

  • Oklahoma

  • Oregon

  • Pennsylvania

  • Rhode Island

  • South Carolina

  • Tennessee

  • Texas

  • Utah

  • Vermont

  • Virginia

  • Washington

  • West Virginia

  • Wisconsin

  • Wyoming


Are you suffering from back pain? Have a musculoskeletal condition? Sign-up for PeerWell. We have a free daily smartphone programs that can improve your symptoms.

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Hi, I'm Grace. I write and research about hip and knee replacements, PreHab before orthopedic surgery & ReHab. Content advised or co-authored with physicians (MD) and orthopedic surgeons (OS).

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