Should You Try CBD for Spine Issues?
Cannabidiol, also known as CBD, is a substance derived from the Cannabis plant that has recently exploded in popularity as a natural remedy for a variety of ailments. Patients frequently ask me about the safety and purported benefits of CBD for spine-related issues. Read on for a synopsis of what you should know prior to using CBD-containing products.
What is CBD?
Cannabis, a group of flower plants, has been grown and used by humans for thousands of years. It contains numerous naturally-occurring chemicals, called cannabinoids, each with unique properties. Delta 9-tetrahydrocannabinol (THC) is the main psychoactive component of Cannabis and produces the “high” associated with marijuana. CBD, on the other hand, does not cause these mind-altering effects but may have desirable properties. Strains of Cannabis with low THC content (less than 0.3%) are considered hemp, while varietals with higher amounts of THC are classified as marijuana.
How does it work?
The human body has a receptors for cannabinoids located in numerous tissues including the central and peripheral nervous systems, immune tissues, and bone. Scientists have not yet fully characterized the mechanism of action for CBD, but it seems to indirectly affect the cannabinoid system. It also binds to dopamine, opioid, and serotonin receptors and may therefore modulate pleasure, pain and mood.
Dr Peter Derman Talks about CBD Oil and the frequently asked question about the substance.
Is there good evidence that CBD is effective for treating spine-related issues?
Not presently. The majority of research to date has focused on THC, and the scientific community has not yet produced sufficient data on CBD. Currently available information on CBD for spine problems must be gleaned from the results of mouse and rat studies because rigorous scientific testing in people has not been performed. Given the recent surge in interest among the general public, the US government recently announced $3 million in research grants to focus on CBD studies.
Those animal studies demonstrate some promising results, however. CBD use has been shown to be protective against disc degeneration, spinal cord injury, arthritic pain, and post-surgical pain. It may promote bone healing after fractures and increase bone density. While these findings are intriguing, caution must be exercised when extrapolating these results to humans, and dedicated studies in people are necessary to truly establish the effectiveness of CBD.
Is it safe?
CBD use appears to be fairly safe in most instances. Studies show that it does not produce a “high,” alter physiologic parameters (e.g., blood pressure, body temperature, heart rate), or produce withdrawal symptoms. It is not believed to be addictive. However, it has been associated with sleepiness, diminished appetite, and diarrhea. Because CBD is processed through the liver, it may produce abnormal liver function tests and can affect the metabolism of medications. One such drug is the blood thinner warfarin, which can produce dangerous bleeding if levels are not kept within a safe range. It is therefore advisable to consult with your internist prior to trying CBD to ensure that there are no medication interactions or other medical reasons to avoid it.
Is it legal?
The short answer is: maybe. CBD falls into a regulatory gray zone. Hemp-derived CBD was removed from the list of federally controlled substances in 2018. While the use of CBD is not forbidden by the federal government, it cannot be marketed as a medication or dietary supplement except in the case of Epiodiolex, an anti-seizure medication that is the only CBD-based treatment currently approved by the United States Food and Drug Administration (FDA). The FDA has sent numerous warning letters to CBD retailors making unsubstantiated medical claims.
Some states have their own laws regarding CBD, and it is currently completely prohibited in South Dakota, Idaho, and Nebraska. To complicate things further, buying and selling CBD-containing products across state lines is forbidden, which may affect online purchasing.
Will it cause me to fail a drug test?
Use of CBD could result in a positive drug test because even hemp-derived CBD products may contain small amounts of THC (or even relatively high quantities if there has been contamination with THC from marijuana-derived products). The best way to minimize this risk is to purchase from reputable vendors and to only use products with a Certificate of Analysis confirming that the product contains no THC. For any current or aspiring professional athletes out there… CBD was recently removed from the World Anti-Doping Agency’s list of banned substances for international competition.
The bottom line
While encouraging early results have been observed in animal studies of CBD for spine-related problems, there is not currently enough data to advocate for human use in this setting. The chance of serious side effects from CBD seems relatively low. People who want to try it are therefore likely not putting themselves at significant risk but should discuss with their internists prior to starting CBD to ensure that it is safe to do so.
*Please note, communication or information on this site does not create a physician/patient relationship. Any tips or suggestions given on this page should be discussed with your physician before attempting.
Lumbar Disc Herniation. Can Physical Therapy Help?
Lumbar disc herniation is a devastating medical complication that may result in immense back pain. Physical Therapy with a back pain expert can reduce this pain and help optimize your overall health.
What is a Lumbar Disc Herniation?
Each of the bones that form the spine are cushioned from one another by sponge-like discs. These help absorb the shock from movements of the body. They also help in optimizing the flexibility of the spine.
In many instances, one or more of these discs experience damage.
When this occurs, the actual disc may start to bulge or may completely break open. While many may refer to this occurrence as a “slipped disc” or a “ruptured disc”, this is medically-termed a “herniated disc”.
There are three distinct locations of the spine.
The neck, which is referred to as the “cervical spine”, the upper back, which is referred to as the “thoracic spine”, and the lower back, which is referred to as the “lumbar spine”.
A lumbar disc herniation is a damaged disc in the lower back region.
“For all the happiness mankind can gain; is not in pleasure, but in rest from pain….” – John Dryden
What Causes a Lumbar Disc Herniation?
Many individuals experience a lumbar disc herniation because of the natural aging process.
As we grow older, the discs in our spine start to dry out.
This, in turn, results in a general lack of flexibility.
When we engage in certain movements, this dryness and lack of flexibility may cause one or more disc to bulge or rupture. Any type of spinal injury could cause a herniation in the disc to develop.
While the disc is covered in a hard, protective material, injuries could cause tears, which could result in the internal fluids of the disc to leak out.
What Happens When the Disc Gel Leaks Out?
When the gel of the inside of a lumbar disc herniation leaks out into the body, it immediately irritates the nerves that run to and from the spine.
The reaction is similar to that of a chemical-based irritation.
Pain immediately sets into the region because the nerves become inflamed in response to the irritation of the gel and the swelling that sets in because of the pressure that is placed on the area by the herniated disc.
Lumbar Disc Herniation Symptoms
In most instances, pain is the most pronounced symptom of a lumbar disc herniation. This is not always the case.
Pressure and inflammation irritate the nerves.
This causes most of the herniated disc symptoms that are experienced.
The following outlines some of the most commonly experienced symptoms that come with the development of a lumbar disc herniation:
- Many find that they suffer from pain in one or both of their legs when a disc in the lower back becomes herniated.
- Tingling sensations may occur as a result of the pressure placed on the nerves near the spine. In most instances, the tingling sensations occur within the legs.
- Muscle pain, discomfort, and weakness is common within the legs when a lumbar disc has herniated.
- In some instances, lumbar disc herniations may cause detrimental effects to the reflexes in one or both of the legs.
- Pain may develop in the back when a disc becomes herniated.
When Should I Get Medical Help?
There are a few different symptoms that may occur when a lumbar disc herniation occurs that indicates you need immediate medical help.
These include weakness or numbness in both legs, the loss of bladder control, and/or the loss of control over the bowels.
If any of these symptoms develop, it could indicate the development of an issue called “cauda equina syndrome”.
While this is a rare situation, it is quite serious and if you are experiencing the symptoms associated with it, you should seek medical attention right away.
What is Cauda Equina Syndrome?
This is a situation that results when the nerve roots located on the very end of the spinal cord are unnaturally squeezed together.
When this happens, bladder problems, bowel complications, lower pelvic issues, and serious leg problems – such as numbness and lack of functionality – may develop.
Treatments for Lumbar Disc Herniation
There are generally four types of treatments available for patients with lumbar disc herniation.
These include self-care treatments, medications, physical therapy, and surgery.
All treatments are generally considered to be effective for the reduction of symptoms.
Those that have experienced long-term relief claim that physical therapy is the most productive option for treatment.
How Does a Physical Therapist Help?
Ultimately, the overall goal of physical therapy is to assist patients in returning to their full capacity as quickly as possible, without experiencing additional injury.
A physical therapist does not encourage the long-term use of medications or surgery unless it is deemed absolutely necessary.
A physical therapist will perform the following in order to help individuals with a lumbar disc herniation:
- Teaching proper posture techniques
- Instruct on how to walk properly with the injury
- Educate on appropriate lifting strategies
- Encourage to engage in stretching exercises that will optimize the flexibility of both the spine and the legs
- Help to strengthen the stomach muscles
- Aid in making the back muscles stronger
- Engage in activities that help develop the leg muscles
- Provide exercises that are designed to optimize the strength of the spine
Popular Techniques Among Physical Therapists
Physical therapists aid in encouraging activities that offer pain relief and help the overall conditioning of the body so that further injuries do not occur.
There are two types of techniques used in physical therapy. One is referred to as “passive” and the other is referred to as “active”.
Passive Physical Therapy Treatments for Disc Herniation
Examples of passive treatments include massage of the deep tissues, hot therapy, cold therapy, water therapy, the use of a TENS machine, and traction.
Active Physical Therapy Techniques for a Herniated Disc in the Lower Back
The active treatments for a lower back disc herniation help to improve flexibility, optimize posture, build strength, improve the stability of the joints, and enhance the movements of the joints.
Examples of these treatments include core stability exercises, flexibility exercises, hydrotherapy, and exercises that strengthen the muscles.
How Do I Get Started with Physical Therapy?
If you’re interested in getting started with physical therapy to overcome the symptoms of your herniated disc search the internet or ask your physician for a referral. In many states, insurance will cover Physical Therapy First.