Patients Report: Cannabis Improves Pain and Spasticity in MS

Christine Kielhorn PHD November 19, 2017 0 comments

THC and CBD, in combination, may improve symptoms of MS but there is not evidence that it changes the course of the disease.

Spasticity in Multiple Sclerosis (MS) refers to muscles contracting rapidly or tightening out of control. Destruction of nerves and the subsequent loss of communication between the nerves and the muscles characterizes MS. Spasticity is one of the most common symptoms of the disease and also one of the most troublesome because few medications work to help it.

Many MS patients have turned to cannabis to ease the symptoms of muscle spasticity. But, does cannabis treatment actually improve the muscle’s dysfunction as a result of the disease?

There have been many clinical studies on the use of cannabis and cannabinoid medications in MS. Most of these studies found that when patients were asked to report on a numerical scale the intensity of their spasticity symptoms, there was significant improvement after taking delta-9-tetrahydrocannabinol (THC) alone or a combination of THC and cannabidiol (CBD).

CBD helps to minimize the psychotropic effects of THC, therefore the side effects of the medication were better tolerated when THC and CBD were taken together. Some studies, though, showed no significant changes in the spasticity symptoms as reported by patients.

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ms medications represented by pain in wrist

Muscle Spasticity Responds to Cannabis

Some of these studies compared the subjective response to an objective measurement of muscle spasticity taken by a physician. There was no significant improvement in the objective measure of muscle spasticity as there was in the self-reported, subjected measure. It is not clear to researchers why some patients say spasticity improved while objective measures of muscle stiffness had not.

The author of one article reviewing the research stated it well, saying, “there might be a reduction in the manifestations of spasticity, rather than an effect on muscle stiffness per se” (Rog, 2010). Perhaps we need to develop a new method to measure muscle spasticity objectively.

The mechanism by which cannabinoids like THC improve spasticity is the activation of the cannabinoid receptor CB­1. In MS’ neuron damage means that there is a loss of communication between the muscles and the central nervous system. As a result, control of muscle movement also weakens.

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The CB1 receptor activity has been shown to be involved in many neurotransmitter pathways, and seems to help restore this communication ability. Improving neural communication would then be likely to reduce the spasticity of the muscles.

ms medications represented by image of neuronal synapses

The improvement of spasticity by activating the CB1 receptor may help to explain the variation in study responses to MS medications like cannabis. And also why some studies showed no significant improvement in spasticity resulting from cannabis treatment. Activating the CB1 receptor also causes the psychotropic effects of cannabis. Therefore doctors will have to keep the dosage at a moderate level to balance the side effects with therapeutic effects. Clinical studies have utilized a variety of dosages and dosage formulations of cannabis, likely resulting in the variable results. Overall, the use of cannabinoids seems to improve the symptoms of muscle spasticity. Whether they actually improve the course of the disease is still subject to active research.

Administering Cannabis for MS

For potential patients with a debilitating condition like MS, methods of administration can be a big concern. Essentially, methods of administration are how you take cannabis medicine. Smoking or vaping cannabis are two of the most common methods of administration. However, dealing with a lit joint, or a fragile vaporizer, may lead to issues for a patient who has difficulty holding or carrying objects. After all, one of the hallmarks of the disorder is muscle spasticity, and its accompanying difficulty holding or moving small, or breakable, objects. Thankfully, there are other methods of administration, which could present a welcome relief to a patient suffering from MS, in more ways than one.

Five Potential Methods of Administration include:

  • Edibles – This method involves chewing and swallowing food, and perhaps making it. This means that it will be more suitable for a patient earlier in the progression of the disease.
  • Oils – This method is effective and enjoyed by many patients. It’s best to take an edible with food, however, to help prevent lipoid pneumonia, which means it may also cause a slight complication for a consumer with difficulty swallowing.
  • Sprays – This method of administration can be taken at any time in MS’s progression, and is highly effective.
  • Inhalers – Again, suitable for any time, but is slightly less common than a cannabis spray.
  • Sublingual Strips – This medication again works well, and at any time, although it is a newer tech that is harder to find than the above.

As is typically the case with cannabis, further research is needed to match scientific proof to patient reports.