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Thread: Effective Pain Management & Cannabis

  1. #1
    Join Date
    Feb 2016
    Posts
    15

    Effective Pain Management & Cannabis

    I recently got approved to post on this forum and I wanted to start a thread on pain management. More than 40 years ago, I had a spinal fusion for scoliosis with Harrington rod instrumentation. I did very well up until about 4 years ago when I started to get significant pain down my right leg. I belong to a HMO and my perception is that the [over-worked] doctors I saw about this pain believed that I was just another chronic, back pain patient . Thanks to this forum [and in particular, to Linda Racine, to whom I think we ALL owe a debt of gratitude] I came to understand that my problem could be a bit more complicated. One of the things that makes my situation different from most people who post on this forum is that the spinal tumor I have could account for a lot [but not all] of my pain. I live in California and have since seen and talked with some excellent specialists at Stanford Medical Center and UCSF.

    In an effort to get out of pain, I considered “revision” surgery but have decided that I will try a conservative route for as long as I can. For me this means: pain management meds, exercises to build my core strength and work to improve my posture. I would like to describe what I now do for pain management. First, using main stream medicine, I work with a pain specialist at my HMO. Considering her workload, I have appreciated her ability to try to help me. I think that most of my pain is neuropathic pain. I currently take Gabapentin and Diclofenac [NSAID]. We have tried other drugs with varying levels of success.

    My higher levels of pain “motivated” me to start searching for other effective pain control. I was primarily on Gabapentin to treat my neuropathic pain. This drug was effective in helping with my pain but Gabapentin could not really offer an adequate pain control. I was in sufficient pain that I started researching cannabis [marijuana] based medication. I live in California which allows the use of cannabis based products for medical conditions. I consulted with a nurse [who has a business advising chronic pain patients in the use of cannabis in the East Bay in Northern California] and got some idea of what to purchase and how to use it. This is a complex topic and it really requires a great deal of research and/or expert guidance. But here is my bottom line: I was amazed at the amount of relief I obtained through a couple of different cannabis products. One of these products was concentrated cannabis oil that is “vaped” and one is a tincture that is administered under the tongue. I was NOT interested in getting “high” and I found out that it is entirely possible to use cannabis products for pain relief WITHOUT ANY psychoactive results. The key thing is the type of cannabinoids you are using and their ratio to one another. I use a product that contains both CBD and THC in roughly a 1:1 ratio. Obviously another key thing is the amount of cannabinoids that you ingest. In general, you always want to start with a LOW dose and evaluate what happens when you gradually increase that amount. People have a very wide range in how they respond to these products so you need to monitor this process [e.g. track your response] and hopefully discuss it with a knowledgeable person.

    I need to state that I was very reluctant to try anything that is listed as a “Schedule 1 Drug” under Federal guidelines. However, it is now clear to me that cannabis based products ARE very effective for neuropathic pain. It has often been claimed that there is not enough medical evidence to justify the use of cannabis based products but our Federal Government makes it very difficult to do any large scale research into this area of pain relief. There are, however, plenty of research studies done out of this country that demonstrate how effective cannabis based medicine can be. Do your own research and you will find these studies. It is truly unfortunate that the USA has taken such a backwards stand on this important plant. It is also important to decide if the type of pain that you have will be amenable to treatment by cannabis products. I know that cannabis is effective for neuropathic pain but I don’t know if it is equally effective for muscular pain.
    I think effective pain management is a very important topic. It can positively change the quality of your life. Terry
    1973 Diagnosed with scoliosis [left thoracic curve 75* and right lumbar curve of 72*]
    Spinal fusion surgery with Harrington Rod instrumentation
    Left thoracic curve corrected to 55* and right lumbar curve corrected to 45*
    2013 Significant pain down right, upper leg
    2015 MRI of lumbar spine detects "multilevel degenerative disc disease with disc bulges and facet hypertrophy" AND
    the presence of a "possible nerve sheath tumor" at L2-L3

  2. #2
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,557
    Terry,

    Welcome to the forum!

    Now that several more states have legalized marijuana, I suppose there will be more people chiming in on this topic. It would be nice to have more testimonials as I think that most of us usually end up with some sort of arsenal of meds in our medicine cabinet, and having one more or a few more items would be a good thing.....

    There ARE and will be people that will benefit from getting stoned....There are people that are getting habitually stoned that shouldn’t be, and people that never tried that could benefit greatly....This being a statement for the head only, not the rest of it. (Sounds very Bob Dylan, I know) My dad passed from ALS, and wanted me to find some, but he passed before I could do anything. So, I don’t have a testimonial for this application. It also would have been hard to judge while he was on liquid morphine and fentanyl. I actually needed product of some sort before the later stages of that disease.

    My state is one that legalized but its going to take more time for the dispensaries to get set up....So, still more waiting time. When they open up, I will go down and see what they have to offer and read through the literature. I will probably buy some product of some sort, but I’m not sure what to buy? You say the oil under the tongue works well? I am not into vaping or smoking....

    I never used weed for my recovery, didn’t think it would be strong enough so never tried. The hospital told me I was on the strongest regiment they had, the orals I found in general were weak, and ended up using hot water soaks (106 deg F) for most of my relief. For medications, I found that the NSAID group in general to be the most beneficial....Celebrex many years ago, and Diclofenac.

    I dodged surgery in the 70’s and capitulated in 2008 due to multiple herniation’s in a 70 degree lumbar curve. Degeneration took a foothold.

    I hope you can manage your pain, what you have going on is very painful.

    I currently don’t take anything but I am very open minded.

    Thanks for posting!

    Ed
    49 yr old male, now 59, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  3. #3
    Join Date
    Feb 2016
    Posts
    15

    Effective Pain Management & Cannabis

    Thanks, Ed, for your warm welcome. I have appreciated your posts to this forum. I agree that medical marijuana can be abused [just as any other powerful drug can be abused] but I don’t think you will find too many deaths that can be associated with ingesting medical marijuana. You gave me an opportunity to provide some more information.

    Twenty-eight [28 ]states have made medical marijuana legal. I am lucky enough to live in one of them. To obtain medical marijuana, you need a letter from your doctor specifying that you have a condition that may be amenable to treatment with medical marijuana [e.g. chronic pain]. This allows you to go to a “dispensary” and obtain medical marijuana. However, here it gets tricky: the people at the dispensary vary in their ability to advise you on what marijuana product may be appropriate for your needs. You better be educated enough to help in the selection of an appropriate product. You will probably NOT get advice from your regular doctor.

    What about the side effects of medical marijuana? Probably the worst side effect happens when you take too much and have an unwanted “psycho active” experience. Like any other powerful drug, you need to be careful as to how much you take and WHEN you take it. If I am trying a medical marijuana product for the first time, I do it in the evening [I don’t have to drive or perform any complicated task] and start with a low dose. Unfortunately, most of the products you buy tend not to have quantitative information on the concentration CBD or THC. This will likely change in the future.

    So what does the scientific literature say about what conditions medical marijuana treats and whether or not it is effective for these conditions? Here is a link that does a nice job of summarizing this information: http://medicalmarijuana.procon.org/v...ourceID=000884

    Lastly, there are a few products that are manufactured by large pharmaceutical companies that are derived from medical marijuana. Here is a link to the FDA’s review of “Sativex” in the US: http://nationalpainreport.com/mariju...a-8823763.html I don’t know if any such product is available in the US.

    In summary you can probably get a feeling that this area of pain relief is a little like the “wild, wild west”: there is a lot of benefit to be gained BUT you are on your own to make decisions about what you will use, how much you will use and how you will ingest it. I would advise finding someone with a medical background who can advise you. These people exist if you look for them. Although it is possible to try to navigate this on your own, it is probably going to take you longer to find the best product to take and the best method to take it. Terry
    1973 Diagnosed with scoliosis [left thoracic curve 75* and right lumbar curve of 72*]
    Spinal fusion surgery with Harrington Rod instrumentation
    Left thoracic curve corrected to 55* and right lumbar curve corrected to 45*
    2013 Significant pain down right, upper leg
    2015 MRI of lumbar spine detects "multilevel degenerative disc disease with disc bulges and facet hypertrophy" AND
    the presence of a "possible nerve sheath tumor" at L2-L3

  4. #4
    Join Date
    Mar 2008
    Location
    Chicago-"land"
    Posts
    157
    Medical Marijuana has been suggested to me as well, and I'm going to give it a try. Since Obama has appointed his new drug Czar, Dr. Robert Califf, who has effectively frightened both pain management doctors and pharmacists with loss of license, I cannot get good pain relief (or relief at all). He has effectively made opioids and opiates so difficult to obtain, it's insane for chronic pain patients.

    I'll let you know my results - a 'friend' from California is sending me something and I'm willing to try anything at this point. Will post later!
    Susan
    XLIF/Posterior Surgery 6/16/08. Fused T10-L5 in CA by Dr. Michael Kropf (don't go there unless it's simple, I hear he's at Cedar's now). Very deformed, had revision w/5 PSO's, rods from T-3 to sacrum including iliac screws, all posterior, 5/23/16 with Dr. Purnendu Gupta of Chicago.


    Owner of Chachi the Chihuahua, So Cal born and bred, now a resident of 'Chicagoland' Illinois. Uh, dislike it here....thank God there was ONE excellent spine surgeon in this area.

  5. #5
    Join Date
    Feb 2016
    Posts
    15

    Link to Washington Post article on medical cannabis

    Here is a link describing "high CBD marijuana" as a game changer:

    https://www.washingtonpost.com/natio...=.2fce398e8ce2

    A lot of the literature I have read suggests the it is not just one of the cannabinoids [e.g. like CBD] that is effective in treating medical conditions but what the cannabis researchers call the "entourage" effect. This means, for example, that to treat pain you not only want the CBD cannabinoid but you also want other cannabinoids [like THC] and other cannabis plant molecules. This is one reason why selecting the correct strain of cannabis is so important to treating the the specific medical condition you are targeting. There is even some data to suggest that the CBD cannabinoid counteracts the psychoactive effect of the THC.
    Last edited by TerrySpear; 01-01-2017 at 12:22 PM.
    1973 Diagnosed with scoliosis [left thoracic curve 75* and right lumbar curve of 72*]
    Spinal fusion surgery with Harrington Rod instrumentation
    Left thoracic curve corrected to 55* and right lumbar curve corrected to 45*
    2013 Significant pain down right, upper leg
    2015 MRI of lumbar spine detects "multilevel degenerative disc disease with disc bulges and facet hypertrophy" AND
    the presence of a "possible nerve sheath tumor" at L2-L3

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