pain

Posted on Pain Management

Cannabis pain relief without the ‘high’ Canadian researchers pinpoint the mechanism of cannabidiol for safe pain relief without side effects

 

In the wake of cannabis legalization, Dr. Gabriella Gobbi (right) and a team of scientists at the Research Institute of the McGill University Health Centre (MUHC) and McGill University have delivered encouraging news for chronic pain sufferers by pinpointing the effective dose of marijuana plant extract cannabidiol (CBD) for safe pain relief without the typical 'high' or euphoria produced by the THC. The findings of their study have been published in the journal PAIN (The Journal of the International Association for the Study of Pain).
Paul Logothetis/MUHC

 

In the wake of cannabis legalization, a team of scientists at the Research Institute of the McGill University Health Centre (MUHC) and McGill University have delivered encouraging news for chronic pain sufferers by pinpointing the effective dose of marijuana plant extract cannabidiol (CBD) for safe pain relief without the typical “high” or euphoria produced by the THC. The findings of their study have been published in the journal PAIN (The Journal of the International Association for the Study of Pain).

Cannabis indica and sativa are the two main cannabis strains that produce the pharmacological principles known as tetrahydrocannabinol (THC) and cannabidiol (CBD). Dr. Gabriella Gobbi’s team demonstrated that CBD does not act on the CB1 cannabinoid receptors like THC but through the mechanism that binds specific receptors involved in anxiety (serotonin 5-HT1A) and pain (vanilloid TRPV1). Researchers were able to extrapolate the exact dosage of CBD displaying analgesic and antianxiety properties without the risk of addiction and euphoria classically produced by the THC.

“We found in animal models of chronic pain that low doses of CBD administered for seven days alleviate both pain and anxiety, two symptoms often associated in neuropathic or chronic pain,” says first author of the study Danilo De Gregorio, a post-doctoral fellow at McGill University in Dr. Gobbi’s laboratory.

Lead author Dr. Gobbi, a researcher in the Brain Repair and Integrative Neuroscience (BRaIN) Program of the RI-MUHC, sees this as advancement for the evidence-based application of cannabis in medicine with CBD offering a safe alternative to THC and opioids for chronic pain, such as back pain, sciatica, diabetic, cancer and post-trauma pain.

“Our findings elucidate the mechanism of action of CBD and show that it can be used as medicine without the dangerous side effects of the THC,” says Dr. Gobbi, who is also Professor of Psychiatry at the Faculty of Medicine at McGill University and staff psychiatrist at the MUHC. “This research is a new advancement for an evidence-based application of cannabis in medicine.”

Despite widespread public usage, little clinical studies exist on CBD, which became legal in Canada on October 17, 2018, following the passage of Canada’s Cannabis Act.

“There is some data showing that CBD provides pain relief for humans but more robust clinical trials are needed ,” says Dr. Gobbi, a recent grant recipient for her study of the pharmalogical effects of CBD.

Posted on Fibromyalgia

“My body is like red hot lava!” – Fibromyalgia – living with chronic pain

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Fibromyalgia is a common, little-understood condition that is seven times more likely to affect women than men. It is characterised by widespread pain and fatigue and can be difficult to diagnose. This week, Kirsty Young announced she is taking time off Desert Islands Discs because of the condition. Journalist Lucy Hancock, who also has it, attends a gentle movement class for sufferers to hear about what it’s like to live in chronic pain with such an unpredictable illness.

Posted on Multiple Sclerosis

Managing Pain and Sleep Issues in MS: Part 1- Pain in Multiple Sclerosis

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Pain and sleep disorders often cause confusion and frustration for people with MS, their loved ones, and healthcare providers. Learn from scientists and clinicians about strategies for symptom management, available treatment options, and ongoing research to identify the cause of pain and sleep disorders in MS.

Posted on Fibromyalgia, Pain Management

Studies provide new insights into the role of sleep in chronic pain Sleeping problems shown to predict the onset of chronic pain in a 20-year prospective study and linked to chronic pain in adolescents in Swedish study

Sleep Deprivation in Elderly - The Common Causes, Effects, and Solutions

Sleep Deprivation in Elderly – The Common Causes, Effects, and Solutions

The results of two studies presented today at the Annual European Congress of Rheumatology (EULAR 2018) provide insight into the role of sleep in chronic pain. The first study demonstrates a predictive role of sleep problems for chronic pain and the second provides insight into chronic pain and sleep in adolescents.

“The relationship between pain and sleep is complex, as the consequences of sleep problems can affect perception to pain and, in turn, pain can interfere with sleep quality,” said Professor Robert Landewé, Chairperson of the Scientific Programme Committee, EULAR. “This is why these studies are important as they help elucidate the role of sleep in chronic pain and highlight it as a potentially important modifiable risk factor for alleviating the distress in these patients.”

Sleep problems predict the onset of chronic widespread pain (CWP) in 20-year prospective study1

Within the study all four parameters relating to sleep – difficulties initiating sleep, maintaining sleep, early morning waking and non-restorative sleep – as well as one related to fatigue, were found to predict the onset of CWP after five years in a model adjusted for age, gender, socio-economy and mental health. In addition, all parameters except ‘problems with early awakening’ predicted the onset of CWP at 18 years.

“Our results demonstrate that sleep problems are an important predictor for chronic pain prognosis and highlight the importance of the assessment of sleep quality in the clinics,” said Katarina Aili, PhD, Spenshult Research and Development Center, Halmstad, Sweden.

Additional analysis showed that reporting all four sleeping problems at baseline versus no sleep problems was significantly associated with CWP at both time points using a number of models adjusted for age, gender, socio-economy as well as mental health, number of pain regions or pain severity.

Individuals included in the study had not reported CWP* at baseline or during the previous three years, 1249 entered the five-year and 791 entered the 18-year follow up analysis. Four parameters related to sleep (difficulties initiating sleep, maintaining sleep, early morning awakening and non-restorative sleep), and one parameter related to fatigue (SF-36 vitality scale) were investigated as predictors for CWP.

Sleeping problems and anxiety associated to chronic multisite musculoskeletal pain in adolescents2

One in ten students in the study was suffering with chronic multisite musculoskeletal pain (CMP). Analysis showed that, compared to other students, having CMP was associated with reporting severe sleeping problems as well as probable cases of anxiety.

“Although the relationship between sleep and pain is complex, our results clearly indicate a strong association which needs to be explored further,” said Julia S. Malmborg, PhD student at The Rydberg Laboratory for Applied Sciences, Halmstad University, Sweden. “As both problems affect the physiological and psychological well-being of sufferers we hope that these results will be used by school health professionals to promote student health.”

The study included 254 students from a Swedish school who completed questionnaires on chronic pain, sleeping problems, stress, anxiety and depression. The mean age of participants was 16.1 years (SD 0.6) and two thirds were girls. CMP† was identified in 9.8% of students with no difference between boys and girls. CMP was significantly associated with reporting severe sleeping problems‡ (OR 2.49, 95% CI 1.06-5.81, p=0.035) and also probable cases of anxiety§ (OR 3.06, 95% CI 1.09-8.61, p=0.034) but not possible cases of anxiety or probable/possible cases of depression.