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Cannabidiol (CBD) as a treatment of acute and chronic back pain: A case series and literature review

Jonathan P. Eskander, MD, MBA, Junaid Spall, BS, Awais Spall, BA, Rinoo V. Shah, MD, MBA, Alan D. Kaye, MD, PhD

Abstract


Objective: Two patient case reports are presented describing the use of cannabidiol (CBD) for the symptomatic relief of a lumbar compression fracture and in the mitigation of thoracic discomfort and dysesthesia secondary to a surgically resected meningioma.

Discussion: CBD appears to have antisnociceptive and anti-inflammatory effects on opioid-naive patients with neuropathic and radicular pain. Of note, the patients in this case series used the same CBD cream: Baskin Essentials Body Wellness Cream (400 mg CBD per two oz.)

Conclusion: Hemp-derived CBD in a transdermal cream provided significant symptom and pain relief for the patients described in this case series. Based on these results, we believe further investigation is warranted to see if CBD-containing products should have a more prominent role in the treatment of acute and chronic pain.

 


Keywords


cannabidiol, CBD, compression fracture, low back pain, chronic pain, neuropathic, radicular, pain, marijuana, THC, tetrahydrocannabinol, CB1, CB2, receptors, meningioma, dysesthesia, paresthesia, thoracic back pain

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References


Boggs DL, Nguyen JD, Morgenson D, et al.: Clinical and preclinical evidence for functional interactions of cannabidiol and Δ9-tetrahydrocannabinol. Neuropsychopharmacology. 2017; 43(1): 142-154.

Vadivelu N, Kai AM, Kodumudi G, et al.: Medical Marijuana: Current concepts, pharmacological actions of cannabinoid receptor mediated activation, and societal implications. Curr Pain Headache Rep. 2018; 22(1): 3.

US Food and Drug Administration: FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. Silver Spring: US Food and Drug Administration, 2018.

Beaulieu P, Boulanger A, Desroches J, et al.: Medical cannabis: Considerations for the anesthesiologist and pain physician. J Canadien D'anesthesie. 2016; 63(5): 608-624.

Schrot RJ, Hubbard JR: Cannabinoids: Medical implications. Ann Med. 2016; 48(3):128-141.

Devane WA, Dysarz FR, Johnson MR, et al.: Determination and characterization of a cannabinoid receptor in rat brain. Mol Pharmacol. 1988; 34(5): 605-613.

Munro S, Thomas KL, Abu-Shaar M: Molecular characterization of a peripheral receptor for cannabinoids. Nature. 1993; 365(6441): 61.

Wolf J, Urits I, Orhurhu, V, et al.: The role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain. Curr Pain Headaches (In Press).

Eskander JP: A return to homeostasis: The pleiotropic effects of icosapent ethyl. BMJ case reports (resubmitted).

McDougle DR, Watson JE, Abdeen AA, et al.: Anti-inflammatory α-3 endocannabinoid epoxides. Proc Natl Acad Sci USA. 2017; 114(30): E6034-E6043.

Manzanares J, Julian MD, Carrascosa A: Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. Curr Neuropharmacol. 2006; 4(3): 239-257.

Glaser ST, Kaczocha M: Cyclooxygenase-2 mediates anandamide metabolism in the mouse brain. J Pharmacol Exp Ther. 2010; 335(2): 380-388.

Toth CC, Jedrzejewski NM, Ellis CL, et al.: Cannabinoid-mediated modulation of neuropathic pain and microglial accumulation in a model of murine type I diabetic peripheral neuropathic pain. Mol Pain. 2010; 6: 1744-8069.

Lowin T, Straub R: Cannabinoid-based drugs targeting CB1 and TRPV1, the sympathetic nervous system, and arthritis. Arthritis Res Therapy. 2015; 17(1): 226.

Pellati F, Borgonetti V, Brighenti V, et al.: Cannabis sativa L. and nonpsychoactive cannabinoids: Their chemistry and role against oxidative stress, inflammation, and cancer. BioMed Res Int. 2018: 2018; pp. 1-15.

Vennekens R, Owsianik G, Nilius B: Vanilloid transient receptor potential cation channels: An overview. Curr Pharm Des. 2008; 14(1): 18-31.

Tan KS, Nackley AG, Satterfield K, et al.: Beta2 adrenergic receptor activation stimulates pro-inflammatory cytokine production in macrophages via PKA- and NF-kappaB-independent mechanisms. Cell Signal. 2007; 19(2): 251-260.

Russell FA, Fernandes ES, Courade JP, et al.: Tumour necrosis factor alpha mediates transient receptor potential vanilloid 1-dependent bilateral thermal hyperalgesia with distinct peripheral roles of interleukin-1beta, protein kinase C and cyclooxygenase-2 signalling. Pain. 2009; 142: 264-274.

Boillat A, Alijevic O, Kellenberger S: Calcium entry via TRPV1 but not ASICs induces neuropeptide release from sensory neurons. Mol Cell Neurosci. 2014; 61: 13

Paudel KS, Hammell DC, Agu RU, et al.: Cannabidiol bioavailability after nasal and transdermal application: Effect of permeation enhancers. Drug Dev Ind Pharm. 2010; 36: 1088-1097.

Lodzki M, Godin B, Rakou L, et al.: Cannabidiol-transdermal delivery and anti-inflammatory effect in a murine model. J Control Release. 2003; 93: 377-387.

Coetzee C, Levendal RA, van de Venter M, et al.: Anticoagulant effects of a Cannabis extract in an obese rat model. Phytomedicine. 2007; 14(5): 333-337.




DOI: https://doi.org/10.5055/jom.2020.0570

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