Have you ever experienced a searing pain running down your lower back, through your buttocks, all the way down to your left leg, making you feel agonizing pain, impairing your focus, and keeping you from your normal life activities?
That’s probably sciatica – as you may know, and have already been to the doctor for that.
Sciatica is a painful condition of the sciatic nerve, caused by a herniated spinal cord disk or an abnormal growth in the spinal bone pressing against the sciatic nerve, making it inflamed.
Apart from pain and inflammation, sciatica is often accompanied by numbness in the surrounding area, as this nerve is mainly responsible for regulating the sensation in the feet. In some severe cases, sciatica may lead to significant weakness in the legs and even affect bowel or bladder movement.
If you’ve been diagnosed with this sort of nerve pain, you’re probably already on some over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen, or naproxen.
When such pain-suppressants fail, a doctor may prescribe a stronger medication, such as a muscle-relaxant or an anti-seizure drug to lower the intensity of pain. In more severe cases, antidepressants (amitriptyline), opioid analgesics (tramadol or oxycodone), steroid injections, or even surgery (to fix the compressed nerve) may become necessary.
Although, initially, quite useful, long-term use of any such medication can have some very adverse effects on the health. Whether they are anti-inflammatories or NSAIDs, muscle relaxants, anti-seizure drugs, steroids, antidepressants, or opioid analgesics, each has its share of drawbacks.
While surgery is still an option, it’s not always desirable. Some may hate the idea of going under the scalpel, others may be worried about the risks and costs involved.
With the legalization of hemp farming and hemp-derived Cannabidiol (CBD), yet another, promising option for alternative therapy, with fewer side effects, has opened up.
Thanks to modern research techniques and the legalization of hemp, the scientific fraternity has found strong evidence to suggest CBD has potentially strong analgesic properties, without any intoxicating or severe side effects.
Many studies have even gone as far as indicating that this cannabis-derived compound could safely and effectively replace traditional prescription drugs in the coming future.
So, what about sciatica? Does CBD have an impact on its symptoms?
Sciatica Pain & CBD: What The Science Says
CBD, CBN, CBG (and of course, THC – the psychoactive compound that gives you the “marijuana high”) are all cannabinoids found in cannabis plants – hence called external or extraneous cannabinoids. Cannabinoids found inside our bodies (yes, there are those too, like anandamide) are known as endogenous cannabinoids or endocannabinoids.
All these cannabinoids interact with a network of receptors that are controlled by the endocannabinoid system (ECS) of our body. This system is like any other network of organs responsible for a variety of bodily functions. The ECS works in tandem with the nervous system to ensure homeostasis (i.e. chemical and physiological balance within our body) is regulated and maintained at all times.
Some such functions are pain sensations, moods, and immune responses.
Studies indicate that CBD interacts indirectly with some ECS receptors and directly with some non-ECS receptors in our body to trigger responses from the body’s naturally occurring cannabinoid –anandamide (or N-arachidonoylethanolamine, AEA) – to inhibit pain, discomfort, and inflammation (an immune system function).
CBD has complex pharmacokinetics, i.e. it follows several pathways to achieve certain effects and activities.
In case of pain, inflammation, and stress, comm sciatica symptoms, they are as follows:
- CBD indirectly interacts with the endocannabinoid receptor CB2 to boost immunity, even while reducing inflammation signaling, thus indirectly reducing pain sensation.
- CBD inhibits and blocks the enzyme FAAH (fatty acid amide hydrolase), preventing it from breaking down anandamide, thus maintaining its concentration in the bloodstream. FAAH’s importance in the body is to prepare the body to release cortisol, the body’s stress hormone, to trigger a fight or flight mechanism. This helps sciatica patients feel less pain, with comparatively fewer side effects.
- CBD also interacts with some other non-endocannabinoid receptors, like GPCRs (5-HT subtypes, like 5-HT1A) to induce production and release of anandamide, thus promoting pain relief.
- CBD “significantly suppresses chronic inflammatory and neuropathic pain, without causing apparent analgesic tolerance”, by targeting the α3 glycine receptors, which are specifically located in the spinal pain sensory neurons.
- There are also other pathways and atypical targets that CBD activates, like ion channels (TRPV1, TRPA1, and TPRM8) and PPAR, to alleviate pain.
Besides, sciatica patients also suffer from other issues that CBD can help with, such as improve sleep and reduce stress.
These studies indicate CBD could be highly effective in aiding sciatica treatment.
But is it safe?
Unlike marijuana-derived CBD, legal CBD doesn’t give you a “high”.
It’s derived from industrial/agricultural hemp, which also belongs to the cannabis family. But it doesn’t contain high enough levels of THC to induce any intoxicating effects when applied locally, consumed orally, vaped, or administered sublingually (below the tongue). The THC-content in this kind of cannabis plant is below 0.3% by dry weight – an amount so nominal that you won’t experience any psychedelic effects.
So, how effective is CBD for nerve pain?
Let’s find out what researchers have discovered so far…
Scientific Evidence Supporting CBD For Nerve Pain
- A randomized controlled trial on topical CBD oil’s effects on peripheral neuropathy of the lower extremities was recently conducted. The paper, which was published in the journal Current Pharmaceutical Biotechnology, in 2020, indicated that “transdermal (topical) application of CBD oil can achieve significant improvement in pain and other disturbing sensations in patients with peripheral neuropathy”. The treatment was well-tolerated by all 29 test subjects, recruited by the scientists.
- A 2018 review, published in the Frontiers of Pharmacology, studied some of the recent findings of clinical trials to assess the efficacy of cannabinoids “to treat diseases or improve symptoms”. The researchers also pointed to cannabidiol’s “significant analgesic, anti-inflammatory, anticonvulsant, and anxiolytic activities, without the psychoactive effect of THC”. The study added that compared to oral cannabinoids, the effect of inhaled cannabis is more rapid, predictable, and can be titrated.
- According to a 2007 study on the efficacy of oral cannabidiol in the animal model of chronic inflammatory and neuropathic pain, researchers found evidence of CBD being an effective therapeutic agent. While this study, which was published in the European Journal of Pharmacology, mentioned that this substance can’t heal sciatic nerve injury, it can, however, help alleviate the pain.
- Another 2009 study, published in Neurotherapeutics, indicated that neuropathic pain patients may derive benefits from cannabinoid treatment. This study involved the use of different cannabinoids (including THC) in different proportions.
- In another study by Ethan B Russo that dates back to 2008, the scientist talks about how cannabinoids can help in the management of difficult to treat pain. The paper, which was published in the Therapeutics and Clinical Risk Management mentioned: “Numerous randomized clinical trials have demonstrated safety and efficacy for Sativex® in central and peripheral neuropathic pain, rheumatoid arthritis, and cancer pain.” Sativex® (in the EU; nabiximols in the US) is an oromucosal spray, containing equal parts of THC and CBD, besides certain minor cannabinoids and non-cannabinoid components.
From these findings, one may deduce that CBD can play an important role in helping patients with sciatica. However, some of the studies indicated that CBD may be a more effective analgesic and an anti-inflammatory agent when combined with THC.
So, it’s safe to say that more studies are needed to establish a direct link between sciatic nerve issues.
Final Thoughts: Conventional Treatments vs. Cannabidiol
Out of all the non-invasive therapies available, your doctor may or may not have told you about CBD, since FDA hasn’t approved its use as a drug. Nevertheless, CBD has been found to have several benefits for sciatica patients as well as a comparatively safer profile than most traditional medications that often come with severe side-effects.
Owing to the recent advancements in research and the increasing number of anecdotal evidence, accumulated from users, a lot more people are benefiting from this therapeutic agent today.
Taking stock of what people around the world are saying about CBD on online forums gave us a glimpse into their lives and struggles with sciatica. Most of them had something great to say about this cannabinoid. They felt it was safe, effective, and quite potent. Even people who underwent surgeries for other issues, but were suffering from sciatica as a result of those surgeries, have found relief from CBD use.
Even though research on CBD has picked up pace since its legalization in the US and Canada, they are yet to fully comprehend how it reacts with the human body.
Still, the World Health Organisation (WHO) says CBD is generally well-tolerated with a good safety profile. “Reported adverse effects may be as a result of drug-drug interactions between CBD and patients’ existing medications…To date, there is no evidence of recreational use of CBD or any public health-related problems associated with the use of pure CBD.”
Nonetheless, it’s best to consult your doctor before making CBD a part of your daily regimen. While it has many benefits, you need to be aware of the dosage considerations and its (though rare) side-effects too. Only your doctor can advise you correctly and guide you on the right path.