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