Neuropathic Pain and Medical Cannabis

Neuropathic Pain Causes

Diabetes is the leading cause of neuropathic pain. However, there are multiple other causes of neuropathic pain including:

Conditions such as:

• Alcoholism, diabetes, facial nerve issues, HIV or AIDS infection, disorders of the central nervous system (Parkinson’s disease, multiple sclerosis, stroke for example)

Surgical procedures or trauma such:

• Amputation surgery, spinal nerve compression/inflammation, trauma such as from a car accident or sporting injury, damage caused during a surgical procedure, nerve compression from tumours

Treatment for other diseases or illnesses such as:

• Chemotherapy drugs, radiotherapy

Additionally, one may experience neuropathic pain due to:

Neuralgia

Neuralgia is when a nerve misfires and causes pain, but no actual injury or known damage has occurred.

Radiculopathy

Radiculopathy is the medical term for a pinched nerve in the spinal column which causes symptoms including, but not necessarily limited to, pain, weakness, numbness, and tingling. The most common cause of this is sciatica, which is a painful condition which affects the sciatic nerve which runs along the back of the leg.

Symptoms of Neuropathic Pain

The pain sensations may be shooting, burning, stabbing or electric shock-like pain. People may also experience other sensations, including tingling, numbness or pins and needles.

Neuropathic pain can be spontaneous and occur without warning or reason (this is called idiopathic neuropathy).

Allodynia

Allodynia is when one experiences pain because of stimuli that would not ordinarily cause discomfort, such as cold air or something touching the skin, even gently (a feather, for example).

Hyperalgesia

Hyperalgesia is over-sensitivity to painful stimuli, such that the intensity of pain that is felt is out of proportion to a typical response.

Diagnosing Neuropathic Pain

A GP will complete a thorough assessment to determine whether the symptoms experienced are neuropathic pain. During the assessment, they will ask about medical history including any underlying health conditions, previous injuries, or surgeries, and will complete a physical examination.

They will then seek to find the underlying cause of the neuropathic pain to come up with a treatment and care plan. This may require the input of one or more specialists as well as diagnostic imaging, depending on the cause.

Neuropathic Pain Treatment

The underlying cause of the neuropathic pain will determine the recommended treatment.

Lifestyle changes can help reduce the likelihood of symptoms becoming worse in certain cases (such as for those with diabetic neuropathy) and surgical procedures can help in instances where a herniated spinal disc is pressing on a nerve.

Often, treatment will be multi-faceted and include a mixture of medication and physical/psychological therapy. However, some people may be able to cope without additional medications depending on the severity of symptoms.

Whilst there isn’t a specific neuropathic pain medication, possible medical treatments include:

• Anti-depressant/anti-seizure drugs
• Strong pain medication
• Topical treatments such as capsaicin patches, creams, or ointments applied to the affected area.

Medical Cannabis for Neuropathic Pain

Managing neuropathic pain involves addressing its underlying cause, often through a combination of therapies and medications. For those struggling to find relief from first-line treatments or experiencing unwanted side-effects, medicinal cannabis may be an appropriate next step.