Back Pain, Chronic Pain, Nerve Pain & Cannabis - Mara Gordon, for Green Flower Media
Pain changes who you are. The chronic expectation of pain restricts thought, movement and actions.
Mara grew up in a house ruled by the pain of her arthritic mother and she came through that experience expressing many of the same genetic tendencies for pain, further complicated by injuries to her back. She’s lived in her own painful universe for about 30 years. She has first-hand experience in the comparisons between conventional chronic pain management and cannabis therapies.
Mara’s husband, a sober alcoholic, broke his back, and preparing for surgery he rebelled against the “life-sucking opioids” put forth as his only option for pain management. No member of the medical support team offered cannabis as an option, in California, where it was medically legal.
- A friend stepped forward. “Hey, I make brownies for my boyfriend.”
- Starting with brownies awakened the idea that there was more than meets the eye, and they dug further.
- What they found was credible relief and hope that there was a better way to treat debilitating pain.
80% of Americans will experience some sort of back pain in their lives.
When you add in the rest of the world the number falls to only 10% of the world population.
Sounds like we would be well advised to do some serious lifestyle changes, eh?
- Back pain is the most prevalent reason people seek medical help.
- Between 7-10% will develop chronic back pain.
- Only a small percentage are helped with traditional pharmaceutical or OTC solutions.
The difference between acute pain and chronic pain is that chronic pain is the disease.
- Pain is a signal to the body that something needs tending to.
- A person without a pain response is in serious threat of harm or death.
- With chronic pain there’s so much memory about the pain that the painful loop never really stops.
People are choosing multiple drugs, looking for relief, and few are finding it.
- NSAIDs
- OTC drugs: Tylenol, Ibuprofen, etc
- Opioids: Fentanyl, Oxytocin, Vicodin, Norco, etc
- Muscle relaxers: Soma, Flexarol, etc.
All of these choices come with a list of undesirable side effects like
When people tell Mara they don’t want euphoria she responds with, “Is it because you feel good that’s the problem? Because all these other choices are to some extent psychoactive, but in a depressing way.“
***Desk work is the leading cause of chronic back pain. ***
I’d bet my life it’s got a lot to do with the hump. I already knew it was a bad idea to train humans to be seated. It’s part of what led to my husband early death. Circulation and energy don’t like to be restricted.
- Kids spend their youth sitting at desks in schools and hunched over game consoles in free times instead of running around outdoors.
- Then they graduate to desk jobs.
- We’ve created the perfect storm for chronic, ongoing nerve pain.
- From an evolutionary standpoint we haven’t been bipedal all that long, and we certainly haven’t evolved quickly enough to adapt to sitting hunched over all day, with our arms in front of us on the desk all day, every day.
Glad I am that I set up a standing work station the other day. 
Make the option to stand to work, or to move around with regularity to counteract the hunching.
Women present 8% m chronic back pain than men.
- Interestingly, Men miss 50% more workdays for back pain than women do.
- Women push right through the pain. Anyone who’s given birth understands this power.
- $50 billion per year in direct costs, $100 billion per year for indirect costs.
You get into a loop:
- You get injured or develop pain.
- Pain increases to debilitating.
- You can’t work and sign up for disability.
- Pain, lack of feeling productive, and restricted income create an environment ripe for depression.
- Other complications arise, stemming from further injury, pain, or medical response to control pain.
Most people would rather be out there working. When you think your neighbor is lucky because he doesn’t have to go to work you’re wrong. “Lucky” and “back pain” aren’t compatible.
Chronic Pain serves no protective biological function.
If anything, back pain is self-perpetuating.
- Pain makes you less active. The myofacial tissue that isnt moved around turns to a felt-like consistency and the ECM crinkles, making it more challenging for cells to send and receive signals.
- Muscles break down and skeletal support begins to fail.
- You’re not supporting the inflamed and damaged nerves the way you would if you were moving freely and stronger physically.
- The last thing you want to do when you’re on opioids - which make you sleepy and loopy - is to get up and go for a walk.
The way our disability system is set up there’s a discouragement to heal.
- When you start to get better they take the income away.
- Theres an encouragement to perpetuate being sick to keep the roof over their head and food on the table.
- What people want os to get back to work in a healed manner, to become another productive member of their community.
My daughter deals with this fear, and her disability claim is for severe anxiety, the worst her diagnosing psychiatrist or the judge that ruled in her favor had ever confronted in an applicant for disability income. She worries all the time that they’ll strip her of her income and she’ll be destitute. She feels a need to continue to prove that she deserves the income, and worries now that it’s been over a year since she’s been able to find a replacement for the therapist that wasn’t doing much more than fall asleep while she talked, but was making those notations every month.
Yeah ..... the system has flaws.
How does chronic pain work? What do THC and CBD do in your body to bring relief from chronic pain? It’s not a masking of the pain. It’s a physiological change in response to the components found in the essential oils of cannabis.
There are five mechanisms of action involving THC and pain reduction. Reality: we use cannabis because your body is under so much stress that the ECS can’t keep up with demand for cannabinoid signaling
- THC retards the electrochemical charge at the peripheral pain receptor. (eCB1)
- THC also interrupts the pain signal at the dorsal root ganglia. (eCB1)
- THC interrupts the pain signal at the neuron. (eCB1)
- THC activates the CB2 receptors, enhancing immune response.
- The euphoric effect of THC offers the possibility of a break from the pain cycle, as it breaks the memory loop that keeps pain on the forefront of consciousness.
CBD is 30-50 times more potent as an anti-inflammatory than cortisone
without shutting down the adrenal system. When you take steroids it’s difficult to get away from them because your adrenals stop working on their own.
The U.S. federal government has a patent on CBD as a neuroprotector, despite the fact that they keep it at the top of Schedule One as the most dangerously addictive and toxic medicine known to man, with no medicinal value.
Go figure.
eCB1 activation doesn’t BLOCK the pain, it blocks the pain signal, so you don’t feel it as pain, so , in a sense, pain isn’t registering as pain.
eCB2 activation blocks inflammation, thusly controlling pain response.
- You’re causing a physiological change by positively reducing the inflammation around the nerve.
- You're also stopping the transmission of the pain signal.
All epithelial cells have nerve endings.
- Every cell with a nerve ending can have a pain response.
- Pain signals travel from the point of pain to the basal root ganglia.
- The signal travels up to the brain stem to the pain perception areas.
- eCB receptors are expressing themselves anywhe they’re needed on the surface of the cell
Note: The surface of a cell is a fluid thing, constantly changing as receptors express themselves as needed.
- When activated, the CB1 receptors stop the transmission of the pain signal.
- The pain signal is stopped at 1) the point of pain, 2) the basal root ganglia, and 3) the brain’s pain perception areas.
- Microglia impact the inflammation itself, slowing the inflammatory response and clearing out the clutter inflammation leaves behind.
Cannabis offers a complete pain reduction program, not just a masking of pain perception.
1. Reduced pain perception.
2. Reduced inflammation.
3. Euphoria.
4. Short term memory reduction.
With cannabis you reduce or possibly eliminate the pain you're experiencing.
The graphic speaks for itself.
In states with legal medical:
- People find relief from chronic pain.
- Sleep is restored.
- Depression incidents decrease. Pain is depressing. It robs you of your identity and your vigor.
Because fewer pharmaceuticals are consumed you also see a significant drop in secondary and tertiary conditions that typically arise as a result of the pharmaceuticals. Pain patients get caught in polypharmacy to deal with the many uncomfortable side effects of their single-molecule medicines.
- If you start with cannabis you don’t have to go through the mess of drugs and side effects.
- Cannabis saves the federal government lots of money in pharmaceutical and medical costs.
Which cannabinoid should I use? To be honest, you can’t go wrong.
Acid Cannabinoids:
- CBGa is found in the young cannabis plant, before the transformation of oil components has begun. Analgesic, anti-inflammatory
- If all you do is walk up to a cannabis plant and pick off a bud to eat it you’ll get medicinal benefit, albeit not too efficiently.
- Raw buds are difficult to dose, if you’re trying to maintain tight values, and they don’t taste as good as you might have thought they would.
- THCa
- Anti-inflammatory
- Anti-cancer
- Anti-spasmatic
- THCVa
- CBDa
- Anti-inflammatory
- Anti-cancer
- CBDVa
Decarboxylated cannabinoids:
- CBG
- Anti-cancer
- Analgesic
- Anti-bacterial
- Bone stimulant (with degenerative disks or bone disease, think CBG)
- Anti-depressant
- Anti-fungal
- THC
- Anti-cancer
- Anti-inflammatory
- Analgesic
- Anti-bacterial
- Anti-spasmatic
- Bronchodilator
- Neuroprotective
- THCv (diabetes, weight loss, and other conditions. Not really all that valuable for chronic pain) THCv is more about bone stimulation than inflammatory response of analgesia
- Anti-convulsive
- Appetite suppressant
- Bone stimulant
Although THCv stimulates the CB1 receptor, it doesn’t present as much euphoria as THC will.
- CBD
- Anti-cancer
- Anti-inflammatory
- Analgesic
- Anti-bacterial
- Anti-spasmatic
- Anti-anxiety
- Immunosuppresive
- Neuroprotective
- Anti-depressant
- Anti-convulsive
- Anti-psychotic
CBD expresses itself in three different ways in the patient population. There’s no way to predict which way you’ll feel it until you try.
- Patient gets really sleepy.
- Patient gets really energized.
- Patient feels no difference at all.
- CBDv
- Anti-convulsive
- Bone stimulant
Aged cannabinoids
- CBNa
- Delta-8 THC
- CBN used to be the way the dispensaries noted the age of cannabis. Now we know it’s a potent sleep aid and much more.
- Anti-inflammatory
- Analgesic
- Anti-convulsive
- Anti-insomnia
CBN activates the CB1 receptors, but with a much lower affinity for euphoria than THC.
If you go to Mara and say, “I’m in chronic pain” she’s gonna put you on
- CBD for inflammation
- THC for all the anti-inflammatory, analgesic, and neuroprotective properties benefits of euphoria.
- CBG for the great benefits, especially as an anti-depressive.
How much do I take?
Every patient is individual, and requires individual titration, but patterns and
guidelines do exist.
Weight isn’t a good determinant of cannabinoid need.
Start low. Go slow.
Pick healthy products. Don’t use medicine that’ll harm you.
Patient #1: Female
This is the magic formula of terpenes for chronic pain management.
- Beta-caryophyllene activates CB2 receptors, stimulating the immune response.
- Limonene is uplifting, restorative.
- Linalool is calming, soothing, relaxing.
- Myrcene increases availability of the components of the essential oils by helping them pass through the BBB more easily, and it’s also relaxing to the point of encouraging sleep.
- Pinene opens the airways and speeds uptake and effect of cannabis components.
Target dose was 30 mg THC/day, in two sublingual 15 mg doses, morning and evening, after a small dose of healthy fats. Cannabinoids are fat-soluable.
She also took 20mg of CBD once a day, in the afternoon, sublingually.
- This dose allowed her to be highly productive through the day without psychoactivity until later in the day.
Last, but in no way least, a topical was used. Topicals won’t touch deep pain, but they do offer benefits to the chronic pain patient.
- Nerve endings close to the surface are soothed.
- Tense muscles relax.
- No psychoactivity.
- No limitations on using topicals. Use as needed. You need to reinforce this fact in the senior community.
