Spinal cord diseases are spinal cord pathologies that develop by causes other than trauma. Studies have shown marijuana improves pain, sleep, spasms and other symptoms related to spinal cord diseases.
Overview of Spinal Cord Disease
Spinal cord disease is a type of pathology of the spinal cord that is unrelated to a trauma. There are many types of spinal cord diseases, some of which include multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), spina bifida, spinal stenosis, syringomyelia, transverse myelitis, hydromyelia, and Tarlov cysts.
The cause behind each of the spinal cord disease varies, however all result in the damage of the spinal cord and nerves. In MS, the myelin coating surrounding the nerves and the nerves themselves are damaged, permanently disrupting nerve signals. ALS is a rapidly progressive neurodegenerative disease that attacks the spinal cord nerve cells responsible for controlling voluntary muscles. In spina bifida, a birth defect creates an incomplete closing of the neural tube surrounding the spinal cord, causing deformities. Spinal stenosis is the narrowing of the spinal canal, which puts pressure on the cord and its roots. Transverse myelitis involves inflammation of the spinal cord, which destroys the cord’s insulation and ultimately damages the nerves. Hydromyelia is an abnormal widening of the central canal of the spinal cord that allows cerebrospinal fluid to accumulate and put pressure on the spinal cord. Syringomyelia and Tarlov cysts are characterized by accumulating sacs of cerebrospinal fluid, within the spinal cord and at the base of the spine, respectively, which damages the nearby nerves.
Depending on the specific spinal cord disease and its severity, symptoms can include severe pain, muscle twitching and spasms, sleeping problems, headaches, muscle weakening and atrophy, and motor control problems.
Most spinal cord diseases have no cure, so the focus of treatment is on limiting the disease’s progression with medications, surgery and physical therapy, while simultaneously managing its associated symptoms.
Findings: Effects of Cannabis on Spinal Cord Disease
Cannabis helps patients of spinal cord diseases manage their symptoms. Studies have shown that medical cannabis can improve pain, sleeping problems, bladder control, spasticity, muscle twitching and depression commonly associated with spinal cord diseases (Amtmann, et al., 2004) (Carter, Abood, Aggarwal & Weiss, 2010).
Research has solidified cannabis’ ability to reduce muscle spasms in patients with spinal cord diseases (Lakhan & Rowland, 2009) (Syed, McKeage & Scott, 2014). In one study, patients with a spinal cord disease experienced pain relief and an improvement in bladder control and muscle spasms and spasticity after two weeks of cannabis treatment (Wade, et al., 2003). In another, rats with spinal cord injuries saw improvements in locomotor functional recovery and the researchers concluded that the findings suggested cannabis to be potentially useful in the treatment of spinal cord lesions (Kwiatkoski, Guimaraes & Del-Bel, 2012).
In addition, multiple animal trials have demonstrated that the administration of cannabis can prolong the survival of neurons and slow the progression of spinal cord disease’s like ALS (Bilsland, et al., 2006) (Carter, Abood, Aggarwal & Weiss, 2010) (Raman, et al., 2004).
States That Have Approved Medical Marijuana for Spinal Cord Disease
Currently, Illinois, New Hampshire and Ohio have approved medical marijuana specifically for the treatment of spinal cord disease and New Mexico, New York and West Virginia have approved medical cannabis for the treatment of spinal cord damage. In addition, Illinois includes the specific spinal cord diseases, Tarlov cysts, hydromyelia and syringomyelia, as approved conditions for marijuana treatment.
A number of other states will consider allowing medical marijuana to be used for the treatment of spinal cord diseases with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
In addition, several states have approved medical marijuana specifically to treat “chronic pain.” These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont and West Virginia. The states of Nevada, New Hampshire, North Dakota, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington and West Virginia have approved cannabis for the treatment of “intractable pain.”
Fifteen states have approved medical marijuana for the treatment of spasms. These states include: Arizona, Arkansas, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maryland, Michigan, Minnesota, Montana, Nevada, New Hampshire, Oregon, Rhode Island and Washington.
Recent Studies on Cannabis’ Effect on Spinal Cord Disease
Adhikary, S., Li, H., Heller, J., Skarica, M., Zhang, M., Ganea, D., and Tuma, R.F. (2011). Modulation of Inflammatory Responses by a Cannabinoid-2–Selective Agonist after Spinal Cord Injury. Journal of Neurotrauma, 28(12), 2417–2427. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3235339/.
Amtmann, D., Weydt, P., Johnson, K.L., Jensen, M.P., and Carter, G.T. (2004). Survey of cannabis use in patients with amyotrophic lateral sclerosis. The American Journal of Hospice and Palliative Care, 21(2), 94-104. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/104990910402100206.
Baty, D.E., Zhang, M., Li, H., Erb, C.J., Adler, M.W., Ganea, D., Loftus, C.M., Jallo, J.I., and Tuma, R.F. (2008). Cannabinoid CB2 receptor activation attenuates motor and autonomic function deficits in a mouse model of spinal cord injury. Clinical Neurosurgery, 55, 172-7. Retrieved from http://journals.lww.com/neurosurgery/Citation/2007/07000/Cannabinoid_CB2_Receptor_Activation_Attenuates.192.aspx.
Bilsland, L.G., Dick, J.R., Pryce, G., Petrosino, S., Di Marzo, V., Baker, D. and Greensmith, L. (2006). Increasing cannabinoid levels by pharmacological and genetic manipulation delay disease progression in SOD1 mice. The FASEB Journal, 20(7), 1003-1005. Retrieved from http://www.fasebj.org/content/20/7/1003.long.
Carter, G.T., Abood, M.E., Aggarwal, S.K and Weiss, M.D. (2010). Cannabis and amyotrophic lateral sclerosis: hypothetical and practical applications, and a call for clinical trials. American Journal of Hospice & Palliative Medicine, 27(5), 347-356. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/1049909110369531.
Kwiatkoski, M., Guimaraes, F.S., Del-Bel, E. (2012, April). Cannabidiol-treated rats exhibited higher motor score after cryogenic spinal cord injury. Neurotoxicity Research, 21(3), 271-80. Retrieved from http://link.springer.com/article/10.1007%2Fs12640-011-9273-8.
Lahkahn, S.E., and Rowland, M. (2009, December 4). Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review. BMC Neurology, 9, 59. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2793241/.
Raman, C., McAllister, S.D., Rizvi, G., Patel, S.G., Moore, D.H., and Abood, M.E. (2004). Amyotrophic lateral sclerosis: delayed disease progression in mice by treatment with a cannabinoid. Amyotrophic Lateral Sclerosis & Other Motor Neuron Disorders, 5(1), 33-30. Retrieved from http://www.tandfonline.com/doi/abs/10.1080/14660820310016813
Spinal Cord Disease. (n.d.). Paralyzed Veterans of America. Retrieved from http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6348315/k.FC88/Spinal_Cord_Disease.htm.
Spinal Cord Diseases (2014, July 15). MedlinePlus. Retrieved from https://www.nlm.nih.gov/medlineplus/spinalcorddiseases.html.
Syed, Y.Y., McKeage, K., and Scott, L.J. (2014, April). Delta-9-tetrahydrocannabinol/cannabidiol (Sativex): a review of its use in patients with moderate to severe spasticity due to multiple sclerosis. Drugs, 4(5), 563-78. Retrieved from http://link.springer.com/article/10.1007%2Fs40265-014-0197-5.
Tripp, D.A., Nickel, J.C., Katz, L., Krsmanovic, A., Ware, M.A., and Santor, D. (2014). A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome. Canadian Urological Association Journal, 8(11-12), E901–E905. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277530/.
Wade, D.T., Robson, P., House, H., Makela, P., and Aram, J. (2003, February). A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical Rehabilitation, 17(1), 21-9. Retrieved from http://journals.sagepub.com/doi/pdf/10.1191/0269215503cr581oa.
Wilsey, B., Marcotte, T.D., Deutsch, R., Zhao, H., Prasad, H., and Phan, A. (2016) An Exploratory Human Laboratory Experiment Evaluating Vaporized Cannabis in the Treatment of Neuropathic Pain from Spinal Cord Injury and Disease. Journal of Pain, doi: 10.1016/j.pain.2016.05.010. Retrieved from http://www.jpain.org/article/S1526-5900(16)30072-4/fulltext.
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