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Cbd oil for phantom pain

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Can CBD Help Phantom Pain? [Fully Explained]

According to one 2018 study, the most common issue for which people use CBD is chronic pain. It is known for its anti-inflammatory and analgesic properties, but could CBD help the phantom pain that affects some amputees?

In this article, we explain the potential benefits of CBD for phantom limb pain and how to use it effectively.

What Is Phantom Pain?

Phantom pain, or phantom limb pain, is a condition that affects 60–80% of amputees. It results in the perception of pain in the body part that is no longer there. Patients often describe the pain as tingling, throbbing, sharp, or pins and needles.

The condition can occur after an amputation due to trauma, infection, vascular problems, cancer, or congenital limb defects. And although phantom pain is most common in the limbs, it can occur after surgical removal of any body part. It can begin immediately after amputation or develop after several months or years.

Phantom pain may eventually resolve itself without treatment. However, in some cases, it persists for many years, significantly impacting a person’s quality of life.

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Phantom Pain Causes

In the past, many doctors believed that phantom pain was a psychological problem. However, recent discoveries suggest that it occurs due to the way the nervous system reorganizes itself after amputation.

When nerves are severed by surgery, it causes massive disruption to the whole nervous system. There may be an accumulation of neurotransmitters in the area, leading to increased sensitivity and pain. Furthermore, an amputation can alter the way that local nerves communicate with the spinal cord and brain.

Because of this disturbance in the nervous system, doctors generally classify phantom pain as a type of neuropathic pain.

Although most experts now agree that there are physical causes of phantom pain, psychological factors could also play a role. For example, people who suffer from stress, anxiety, or depression may experience more severe phantom pain.

Conventional Treatments for Phantom Pain (Not CBD)

Unfortunately, treatments for phantom pain are limited. Some doctors prescribe opioid painkillers, although they are not always effective. They also carry a high risk of dangerous side effects and dependence.

Other options include antidepressant and anticonvulsant medications. Although these treatments are not specifically designed to relieve pain, they do help to regulate signals in the nervous system.

Some patients find adjunctive therapy, such as physical therapy, massage therapy, and biofeedback helpful. Another relatively new treatment that is showing some promise is called mirror therapy. The patient uses a mirror while moving the remaining limb to try and reprogram the nervous system.

Now that CBD is becoming more popular, some people may be wondering whether it can help phantom pain. Let’s take a look.

Does CBD Oil Help with Phantom Pain?

People have used cannabis and its derivatives to relieve pain for centuries. However, most of the research to date has focused on the cannabinoid THC. It is the chemical that gives cannabis many of its benefits and also its intoxicating effects.

A 2018 Cochrane Library review looked at the effects of several different cannabinoids on neuropathic pain. It assessed studies on whole-plant cannabis, THC/CBD oral spray, and two synthetic cannabinoids.

While the study found that many patients experienced reductions in pain, the risk of adverse reactions was high. This is where CBD could offer additional benefits.

Unlike THC, CBD has no intoxicating effects. A World Health Organization report states that it is “generally well tolerated with a good safety profile.” And while CBD could potentially cause minor side effects, they are nothing like those of THC or other powerful painkillers.

CBD also has the advantage of coming from industrial hemp plants as well as cannabis. This feature means that CBD is far more widely available, even in many places without medical marijuana programs.

The downside of using CBD for phantom pain is that there is currently no clinical research to confirm its effectiveness. However, various studies support its use as a general painkiller.

For example, a 2020 study for the journal Postgraduate Medicine had encouraging results. It followed 97 chronic pain patients for eight weeks while they added CBD to their existing drug regimens.

During that time, 53% of the patients reduced or stopped their use of opioid medication. Furthermore, 94% reported improvements in their quality of life. These improvements included better sleep and reduced pain intensity and interference.

How to Use CBD for Phantom Pain

There are many different CBD products available.

The most traditional way of taking the compound is as an oil tincture. Consumers place the oil under the tongue and hold it there for up to 90 seconds before swallowing. This method allows the CBD to enter the body via the blood vessels in the mouth.

Although this way of taking CBD is still popular, many companies have come up with alternative consumption methods. Capsules and edibles are both widely available and offer a more discreet and convenient way to take CBD. However, one drawback is that these products must pass through the digestive system. This means that a lot of their active ingredients get lost along the way.

Another way of using CBD, and one that may be especially useful for pain, is topical creams and ointments. It is possible to apply these products directly to an uncomfortable area, providing more targeted relief. The CBD enters the body through the top layer of skin, and many people report faster results in comparison to oral products.

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Finally, some people choose to vape their CBD. This method might be another good option for people with painful conditions as the CBD acts almost immediately through the lungs. It is also a convenient way to use small doses of CBD throughout the day.

However, it is essential to note that no form of CBD has been proven more effective than another for treating phantom pain. Therefore, it may be necessary to experiment to find the most suitable method. It is also important to consult a physician before using CBD oil for phantom pain to ensure it is appropriate and safe.

Choosing the Best CBD Oil for Phantom Pain

While CBD has many potential benefits, there are a few things to consider before using it for phantom pain.

Firstly, consumers must understand that the CBD market is currently unregulated. Therefore, many companies are selling substandard goods that offer little therapeutic value. It is possible to avoid this pitfall by looking for a brand that provides third-party lab reports. These will explain precisely how much CBD is in a product and prove that it is free from contaminants.

Another thing to consider is how the company has extracted its CBD. Most experts consider CO2 extraction the best. It yields a product that is pure and potent, without the risk of residual solvents. Furthermore, the CO2 extraction process is expensive. Therefore, if a company is willing to invest in this method, it shows a certain level of credibility.

One more essential factor is whether the CBD is full-spectrum or an isolate. The difference is that full-spectrum CBD contains a myriad of other beneficial cannabinoids and terpenes. Experts believe that these compounds work together synergistically, a phenomenon called the entourage effect.

Full-spectrum products include trace levels of THC, although not enough to get consumers high. In America, the maximum level of THC in CBD products should be 0.3%.

On the other hand, CBD isolates contain no additional chemicals. This may be an advantage for anyone who undergoes regular drug testing and is concerned about traces of THC. Fortunately, there is now also a compromise between full-spectrum and CBD isolate. Broad-spectrum products offer a range of cannabinoids and terpenes, minus the THC.

Can CBD Help Phantom Pain? Final Thoughts

Although there is no specific research on CBD for phantom pain, it may be worth a try. The compound has pain-relieving properties, is generally safe, and causes little in the way of side effects. However, there is a chance that CBD could interact with other drugs. For this reason, it is vital to consult a doctor before use.

It is also important to choose CBD products carefully and ensure they come from a reputable brand. Look for lab reports and read plenty of customer reviews before making a purchase. Taking this additional step will ensure the CBD is both safe and effective.

Have you ever used CBD for phantom pain? Our community would love to hear about your experience in the comments below.

Relieving Phantom Pain and Opioid Dependency with Medicinal Marijuana

In January 2006, when I was 29, I lost my left leg below the knee in a car accident. After months in a coma, I awoke to my brain fixating on the last signal from the now-missing limb: being crushed. Twelve years later, I still experience phantom pain – with very specific manifestations. I’ve wakened my husband more than once because my third metatarsal has shooting pain, or my heel is on fire, or my big toe is being crushed. But none of them are there. It’s disorienting and tormenting.

Phantom pain results from psychogenic and physiological (mental and physical) activity and post-amputation changes in the residual limb and the brain. The prevalence of phantom pain in the first two years post-amputation is 65-80 percent; however, severe, chronic phantom pain past the second or third year affects only 5-10 percent of amputees.

A Foot No Longer There, a Pain That Never Leaves

Pain disabled me for 18 months. The agony of feeling my left foot crushed, all day, every day, and the associated depression and despair left me unable to function. A neurologist managed my pain for years with high-dose, long-acting opiates supplemented by short-acting opiates for so-called “breakthrough pain,” which broke through far too often. I used to joke that I had enough fentanyl on my person to kill a city block.

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The narcotics enabled me to return to full-time work but with high costs. I was chronically nauseated and constipated and had to take additional medications for side effects. I built a tolerance to opioids and had to constantly change dosages and formulations. The medicines became less effective. I worried about not having enough medication – and worried even more that I was taking too much medicine for little relief. I had yet another diagnosis: opioid dependency. (Note: This is not addiction but the body adjusting to needing the opiates to function normally. Don’t call me an addict. I’ve heard that enough from robotic but well-meaning ER docs when the phantom pain wouldn’t respond to even the most massive opiate intervention I could safely take.)

There are several treatment options for phantom pain, including gabapentin (what I call the “workhorse” of my pain regimen), Lyrica, mirror therapy, cognitive-behavioral therapy, NSAIDs, biofeedback, hypnotism, acupuncture, surgery, and even ketamine infusions, but they all failed, adding to my despair.

An Ancient Cure: A Modern Option?

Cannabis is now medically or recreationally legal in 29 states and the District of Columbia. Ninety-one percent of Americans support legalizing medical marijuana, and 58 percent support legalizing recreational cannabis nationwide, even though cannabis remains federally illegal.

In January 2016, days after medical marijuana became legal in the District of Columbia, my primary care physician advised me that he was enrolling me in the program, because he was tired of seeing me suffer. “The worst that’ll happen is you’ll get the munchies,” he laughed. “There’s anecdotal evidence that this can help. You’ve failed everything else, and cannabis can’t hurt; no one’s ever died from a cannabis overdose. It’s medicine, Meredith. Use it.”

So, Do I Get High All Day?

Medical cannabis use is not like recreational consumption. Yes, I medicate with cannabis all day, every day. But I am rarely “high.” I take small amounts every few hours for pain control. Two years in, I take 70 percent fewer opiates than in 2016. I may never fully get off narcotics, but such a dramatic decrease has reduced their side effects.

Now, in 2018, cannabis patients have easier access and more choices. I don’t have to light a joint every couple of hours, which is conspicuous and inconvenient. I can use a vape pen, add tincture to my tea, or have a medicated candy, all portable (but always within state lines!) and discreet options. If I don’t smoke flower (also called buds) but instead use concentrates (or “dabs”), I must use a “live” extract of the whole plant containing the critical terpenes (essential oils found in plants) needed for the combined, therapeutic “entourage effect.” Emerging data suggests that THC and CBD, the two main cannabinoids in marijuana, are most therapeutic when combined with other trace cannabinoids – psychoactive and non‑psychoactive compounds specific to the cannabis plant – and terpenes.

It’s all been an educated guess at trying various strains and modes of consumption, taking detailed notes about my sensations before and after trying them and finding my own regimen. It’s been worthwhile, because I’ve been able to reduce my opioid intake and have better pain control. In 2016, there were more than 44,000 deaths attributable to opioids in the U.S. No cannabis‑related deaths have ever been recorded.

I’m so grateful to cannabis and to the forward-thinking physician who saw potential in it for giving me greater freedom over my pain management and for reducing my opioid need. Because cannabis is federally illegal, there is virtually no research allowed in the U.S. So it’s up to individual patients to discover what strains and delivery methods work best for them and share their knowledge with others to build a community understanding of the medication and its effects. Medical marijuana should be considered a viable treatment option for phantom pain sufferers, and as regulations evolve nationwide, one that will surely be more widely available.

©2018 Amputee Coalition LLC | Amputee-coalition.org | 888.267.5669
Published in inMotion, Volume 28, Issue 2 | March/April 2018, Page 38