Sciatica and Cannabis

---

About 40% of people will experience sciatica, or irritation of the sciatic nerve, at some point in their life. (2)

---

Sciatica is a form of radiculopathy, the pinching of a nerve root, caused by the compression of the sciatic nerve, the large nerve that travels through the buttocks and extends down the back of the leg. This compression causes shock-like or burning low back pain combined with pain through the buttocks and down one leg, occasionally reaching the foot. In the most extreme cases, when the nerve is pinched between the disc and the adjacent bone, the symptoms may involve not only pain, but numbness and muscle weakness in the leg because of interrupted nerve signaling. The condition may also be caused by a tumor or cyst that presses on the sciatic nerve or its roots. (1)

---

Learn how I treat my sciatica with Cannabis.

Self diagnosed Sciatica struck me for the first time in my mid-to-late twenties and still afflicts me to this day.

---

As a child, it was discovered that one of my legs was longer/shorter than the other. I was also prescribed orthotics to stabilize and correct my gate because my ankles wanted to roll in. The podiatrist told me that if I didn't wear them regularly, it would affect me as I got older; I stopped using them after a short while. It was out-of-site, out-of-mind until that fateful, excruciating day getting up from the couch. It was as though someone was stabbing me right at the base of the back.

---

I have attributed my sciatic nerve flare-ups to improper sitting or sitting in chairs or couches that are too soft with little lower back support; both of my sciatic nerves are susceptible to being pinched/inflamed. Stress also seems to play a part in the aching of my lower back and only exacerbates the symptoms when having a sciatica episode. There are potentially more serious causes to sciatica such as a herniated disc, tumor or cyst; consult a doctor or chiropractor at your discretion. After connecting the dots to the causation of my sciatica outbreaks, I have learned to be more careful on how and where I sit. Even after all these years, I still sit wrong at times. The most recent intense episode was caused by watching Netflix on the computer sitting up in bed, something my wife and I started to do on vacation the week before.

---

During a severe sciatica event, I can experience sharp shooting pain emanating from one or both nerves. When both are pinched, it feels as though I am broken in half when bending at the waist. At times, a tingling in the affected leg can be felt that ends at the back of the knee and this usually precedes an experience of muscle weakness/delayed nerve signalling when getting up from a seated position causing me to misstep. A couple of times, I couldn't make it to a standing position, ending up on one knee.

---

I can experience pain or soreness when my sciatic nerves are not pinched. They seem bruised leaving a low grade ache across the lower back. This feeling can be attributed to bad posture while sitting but also, stress. When stressed, my body tenses and the energy accumulates in the lower back and sciatic nerves.

---

I have never visited a doctor for sciatica pain. Why, knowing I would only accept a prescription for a higher strength non-steroidal anti-inflammatory (NSAIDs) such as 800 mg. Ibuprofen. Other oral medications could include muscle relaxers, antidepressants and narcotic pain medications, opioids. Steroid injections are another treatment option. I am not interested in the other options. Prior to entering the Medical Cannabis market, my self-prescribed treatment for sciatica was Ibuprofen (600 - 800 mgs. at a time), massage, hot-packing and smoking black market Cannabis. A sciatica episode with excruciating back pain could last at least a week to a month and was easy to re-aggravate.

---

Medical Cannabis for Sciatica and Back Pain

---

The Endocannabinoid System is involved in the actions of pain. The primary neuro-modulatory receptor, Cannabinoid Receptor 1 (CB1R), accounting for psychopharmacological effects of THC and most of its analgesic (pain relieving) effects are located in all major areas of our brain, neurons within the spinal cord and on primary afferent neurons (neurons on nerves fibers). (3-5) The CB2R receptor also plays a part on the effects of pain, both neuropathic and inflammatory and is present throughout the body. They are located in the Central Nervous System, in tissues of immune cells such as the spleen and thymus, and in the brain. Further Cannabinoid receptors, such as GPR55 otherwise referred to as the third Cannabinoid receptor, also plays a role in the modulation of pain and other functions in our body. (4-6, 7)

---

Why does Cannabis work well for inflammation and chronic pain relief? Cannabinoids, endo and phyto, participate in retrograde signaling. It serves as an inhibitory feedback mechanism that tells other neurotransmitters to cool it when they are firing too fast. When tickled by THC or its endogenous cousins, Cannabinoid receptors trigger a cascade of biochemical changes on a cellular level that puts the brakes on excessive physiological activity. Endocannabinoids are the only neurotransmitters that engage in “retrograde signaling,” a form of intracellular communication that inhibits immune response, reduces inflammation, relaxes musculature, lowers blood pressure, dilates bronchial passages, and normalizes overstimulated nerves. Retrograde signaling serves as an inhibitory feedback mechanism that tells other neurotransmitters to cool it when they are firing too fast. (5)

---

It is important to know Cannabis works well at reducing chronic pain and inflammation but not so much for acute pain. There are times when a stronger analgesic is required for lower back pain. In worst case scenarios, research shows Cannabis works in synergy with opioids. Michael Backes, author of Cannabis Pharmacy: The Practical Guide to Medical Marijuana says, “Cannabis is best described as being able to provide significant distraction from pain, rather than relief associated with opioids. Cannabis is also “opioid-sparing” meaning if you use it with conventional opioid pain medications, your doctor can typically reduce the opioid dose.”

---

Upon entering California's Medical Cannabis market in 2016, I quickly discovered a 2:1 CBD:THC topical transdermal ointment. The Cannariginals topical transdermal utilizes Emu oil to carry the Cannabinoids past all layers of the epidermis; a topical ointment may penetrate some but not all layers of the skin preventing the Cannabinoids from reaching the nerve endings deep in the back. (6) The use of Cannariginals with firm rubbing provides tremendous relief, almost instantaneously. For more severe cases, it could take a couple of days of application, two to three times daily to get the inflamed nerves back to a more normal state, not a week to a month with traditional treatment.

---

A patient with pain, such as sciatica, that is focused and acute will not get the relief they are looking for by smoking/vaping, eating or a oromucosal tincture; the Cannabinoids will be distributed throughout the body, not concentrated where nerve endings are located. I have never received acute sciatica pain relief by smoking Marijuana. Transdermal patches are available in legalized markets, though instructions are to apply on an area with thin skin such as the inside of the wrist, not an area with a lot of body fat like the lower back. Again, the Cannabinoids are too diluted for the acute sciatica pain.

---

Chronic back pain is defined as pain that persists for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain persists despite medical and surgical treatment. (1) For me, sciatica is not a chronic pain condition, though it felt like it before the use of the transdermal topical Cannariginals. Stress, unfortunately, can be a chronic condition that can present chronic pain such as a sore lower back. To fight symptoms of stress, I apply Cannariginals daily to my lower back when getting out of the shower.

---

Cannariginals is only available in California with plans for expansion to other legal Cannabis states. In the meantime, they do have a CBD only version, Theramu, that can be purchased online.

---

Smoking and Vaping Decarboxylated Cannabis for Pain Related Insomnia

---

Smoking Cannabis provides little relief for acute pain associated with my sciatica, but it does help with sleep.

---

Studies suggest that sleep disturbance may impair key processes that contribute to the development and maintenance of chronic pain, including endogenous pain inhibition and joint pain. (8) According to the Centers for Disease Control and Prevention, adults who sleep less than the recommended seven hours per night are more likely than solid sleepers to report one of 10 chronic health conditions — including arthritis, depression, and diabetes. (11)

---

Pain, insomnia, depression and chronic pain can be a self-feeding cycle for many people. Numerous studies indicate that disrupted sleep will exacerbate pain, making it worse. Further, chronic pain has been linked to anxiety (9) which in turn may cause stress chemicals such as adrenaline and cortisol to flood their systems. Over time, anxiety creates an overstimulation of the nervous system, which makes it difficult to sleep. Depression has also been linked to sleep issues and chronic pain.

---

Cannabis is a proven sleep aid. THC and CBD have both been shown to assist with sleep issues due to numerous causes such as sleep apnea and Post Traumatic Stress Disorder (PTSD). For patients that do not want or to limit the intoxicating side effects of THC, CBN is a Cannabinoid that has shown to be a powerful sedative leading to improved mental health. In legal markets, CBN can be found in different forms, such as tinctures and tablets.

---

Ardent Cannabis patients with PTSD and insomnia have reported relief of symptoms by smoking or vaping previously activated Marijuana. Smoking decarboxylated medicine produces more CBN creating powerful a sedative effect. Research suggests that CBN coupled with THC produces sedation. Ardent Cannabis patient @svenskasmokes smokes decarbed flower before bed for a restful sleep. Noting that she gets up at least once a night to use the restroom says, “I smoke a bowl before bed and as long as I am not up too long while using the restroom, I can fall back to sleep. If I was smoking raw flower, I would need to smoke each time I got up in the middle of the night to use the restroom.”

---

Of all the Cannabinoids, CBN appears to be the most sedative. Not only is it sedative, it takes very little to do the job. The consumption of 2.5mg to 5mg of CBN has the same level of sedation as a mild pharmaceutical sedative, with a relaxed body sensation similar to 5mg to 10mg of diazepam. CBN is synergistic with both CBD and D9THC for inducement of sleeping, and when mixed in the correct ratios, CBN becomes an effective sleep aid of 5-6 hours duration. As we do more research focused on CBN, we will no doubt discover more fascinating properties of this often misunderstood Cannabinoid. In the meantime, CBN appears to be a beneficial alternative to THC for treatment, and patients that require low (or no) adverse psychoactive effects. (10)

---

YOUR CANNABIS JOURNEY

---

Your Endocannabinoid System is unique to you and so will your Cannabis experience. Practice ‘start low, go slow, and stay low’, have a positive mental attitude and experiment to find what works best for you. If you feel a consultation with an expert is warranted, we recommend Green Health Solutions for over-the-phone consults.

---

Journaling your Cannabis journey will allow you to stay more connected and focused on your health. It also allows you to notice nuances, small changes in your behavior or demeanor, that you might not have otherwise noticed on a day-to-day basis. Everyone's Endocannabinoid System is unique and a journal helps pin-point what worked or is working or what is not doing the trick. Here is a journal template for you to download and use, Medical Cannabis Journal Template.

References
(1) Low Back Pain Fact Sheet — National Institute of Neurological Disorders and Stroke

---

(2) Sciatica Pain Relief — WebMD

---

(3) Jessica Freundt-Revilla, Kristel Kegler, Wolfgang Baumgärtner, Andrea Tipold: Spatial Distribution of Cannabinoid Receptor Type 1 (CB1) in Normal Canine Central and Peripheral Nervous System; PLOS One, Publishes July 10, 2017 — Study

---

(4) Jane E. Lauckner, Jill B. Jensen, Huei-Ying Chen, Hui-Chen Lu, Bertil Hille, and Ken Mackie; GPR55 is a Cannabinoid Receptor That increases Intracellular Calcium and Inhibits M Current; PNAS February 19, 2008 vol. 105, no. 7, 2699–2704 — Study

---

(5) Lee, Martin, A "The Discovery of the Endocannabinoid System" O’Shaughnessy’, 2012 — Link

---

(6) Michele N. Ross, PhD; Vitamin Weed: A 4-Step Plan to Prevent and Reverse Endocannabinoid Deficiency; Greenstone Books, 2018, p. 164,

---

(7) Raquel Guerrero-Alba, Paulino Barragán-Iglesias, Abimael González-Hernández, Eduardo E. Valdez-Moráles, Vinicio Granados-Soto, Miguel Condés-Lara, Martín G. Rodríguez1 and Bruno A. Marichal-Cancino; Some Prospective Alternatives for Treating Pain: The Endocannabinoid System and Its Putative Receptors GPR18 and GPR55; Front. Pharmacol. 9:1496. doi: 10.3389/fphar.2018.01496 — Link

---

(8) Finan, Patrick H et al. “The association of sleep and pain: an update and a path forward” journal of pain : official journal of the American Pain Society vol. 14,12 (2013): 1539-52. — Link

---

(9) University of Vermont. "Connection between chronic pain, anxiety disorders found by researchers." ScienceDaily. ScienceDaily, 31 August 2016. — Link

---

(10) Cannabinol (CBN): A Sleeping Synergy — Link

---

(11) Short Sleep Duration Among US Adults — Link