Cannabis for Spinal Cord Injuries

Severe pain and/or persistent muscle spasms from a spinal cord injury are approved Health Canada Category 1 MMAR condition

Medical Marijuana is NOT for everyone and is often a last resort for people that have tried a variety of pharmaceutical medications with little relief or too many side effects. Strong anecdotal evidence exists for the support of medical marijuana in treating symptoms associated with a spinal cord injury. We strongly suggest you discuss the potential benefit of medical marijuana with your doctor or specialist.

Condition Description

A spinal cord injury is damage that occurs to the spinal cord that results in a loss of function. Spinal cord injuries usually occur when vertebrae are dislocated or fractured [1]. The damage to the spinal cord begins at the moment of the injury when displaced bone fragments, disc material, or ligaments from the dislocation or fracture bruise or tear into spinal cord tissue [3]. Most injuries don’t sever your spinal cord. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy axons. Axons are extensions of nerve cells that carry signals up and down the spinal cord that allows the brain to communicate with the rest of the body [3].

Frequent causes of spinal cord injury are trauma such as car accident, gunshot wound or a bad fall. A spinal cord injury is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves. A person can have a severe back injury and not sustain a spinal cord injury.

There are two types of spinal cord injuries, complete and incomplete. In a complete spinal cord injury, both sides of the body are equally affected [2], and the spinal cord cannot relay messages below the level of the injury. This results in being paralyzed below the level of injury. In an incomplete injury, there is some movement and sensation below the level of injury. An incomplete injury does not affect both sides of the body equally, as a person may be able to move one limb more than another, have more functioning on one side of the body than the other, or be able to feel parts of the body that cannot be moved[4].

Symptoms

Besides a loss of sensation or motor functioning, individuals with a spinal cord injury can also experience other symptoms. From a sample population of individuals with chronic spinal cord injuries, 65%–78% had symptoms of spasticity [5]. Spasticity often negatively influences quality of life for spinal cord injury sufferers by restricting activities of daily living. These restrictions include but are not limited to effecting walking and self-care, causing pain and fatigue, disturbing sleep, and compromising safety [6]. Other symptoms related to spinal cord injuries are loss of bowel and bladder control, sexual dysfunction, blood clots, depression and anxiety, pressure ulcers and muscle contractions.

Traditional Treatments

In general, no one treatment option will successfully manage the symptoms related to spinal cord injuries in all individuals [6]. After the initial injury stabilizes, doctors focus on preventing secondary problems from arising [8].

Many patients who are long term sufferers of a Spinal Cord Injury have secondary complications from prescription drugs. They can suffer with ulcers, nausea, intestinal tract complications, lack of appetite, internal or external hemorrhaging and depression. Many SCI patients can dramatically reduce their prescription drug intake by including Medical Marijuana. Most prefer ingesting through either a cannabis tea or an edible for a longer lasting calming affect.

Rehabilitation

During rehabilitation, emphasis of often put on maintenance and strengthening of existing muscle function, redeveloping fine motor skills and learning adaptive techniques to accomplish day-to-day tasks.

Medications

Medications may be used to manage some of the effects of spinal cord injury. These include medications to control pain and muscle spasticity, as well as medications that can improve bladder control, bowel control and sexual functioning.

New technologies

Independence and mobility levels of people with spinal cord injuries can be greatly helped though medical devices. Some devices may also restore function. These include:

Modern wheelchairs
Computer adaptations
Electronic aids to daily living
Electrical stimulation devices

Benefits of Medical Marijuana

Some benefits of medical marijuana that many patients with spinal cord injuries have reported include improvements in:

Spasticity
Pain
Sleeping problems
Bladder control
Depression

Spasticity

Cannabinoids found in medical marijuana have been shown to be effective in reducing spasticity and are currently being studied. [7] Anecdotal reports by individuals with spinal cord injuries have revealed a beneficial effect of marijuana on the management of spasticity. The relaxing effect of marijuana on muscles in patients with spinal cord injury related spasticity is due to an anti-spastic effect rather than simply due to a general relaxation response.[6]

Pain

Medical marijuana has been shown to help control pain levels in patients with spinal cord injuries. Basic research conducted over the past 20 years has allowed researchers to identify the cannabinoid receptor system, which is the most widespread receptor system in the human body.

The CB1 receptors are found primarily in the brain, spinal cord and periphery. Endocannabinoids are produced by the body and interact with CB1 receptors. Numerous studies have now established that cannabinoids found in marijuana help lessen pain [9].

Sleeping Problems

Drowsiness is a known common side effect of marijuana. Many patients with spinal cord injuries have a hard time sleeping due to pain. A small dose of marijuana before bed often helps patients with spinal cord injuries get a good nights sleep.

Bladder Control

Many patients who suffer loss of bladder control find that medical marijuana helps control this symptom.

Depression

In small doses, marijuana increases serotonin, similar to SSRI antidepressants. Marijuana’s antidepressant effects are because of its chemical similarity to natural substances in the brain known as endo-cannabinoids.[10] These endo- cannabinoids are released under conditions of high stress or pain. These receptors have a direct effect on the cells producing serotonin, which is a neurotransmitter that regulates the mood.[10]