Chronic pain is a complex condition that can be caused by any number of factors. Because of the powerful mind-body link present in those suffering chronic pain, it’s important for patients to treat both the physical and psychological components of this often debilitating condition. Moreover, because the causes of chronic pain are often multi-factorial, patients generally find better success when they simultaneously treat the underlying factors or co-occurring conditions.
Given the heterogeneity of the disorder, treatment needs to be highly personalized. What works for some, may not work for you. Consequently, most patients who find success with cannabis after a bit of trial-and-error until they find the ideal strain (and preferred intake method, dosing, etc.).
To find the strain that’s best for you, identify what symptoms you’d like to address first. For example, pain or insomnia. And, work back from there. Likewise, consider when you’ll be medicating. What you use for daytime will likely be different than nighttime.
Finally, given the variable consistency among strains and patient accessibility to medicine, rather than recommend specific strains, we suggest focusing on products with a chemical composition profile best suited for your situation.
Also, keep in mind that because some well-intentioned professionals or peers may have a bias towards either CBD (the most prominent non-psychoactive cannabinoid) or THC, they may suggest one or the other. However, it’s not an either-or proposition. Many patients tend to find the best relief with products or strains rich in both cannabinoids, or with other cannabinoids and terpenes (thanks to the “entourage” or synergistic effect that occurs when compounds work together better together rather than independently).
Other cannabinoids that seem to be effective for chronic pain include cannabigerol (CBG), cannabichromene (CBC), and cannabinol (CBN). Likewise, terpenes such as myrcene and β-caryophyllene may also provide relief.
A few popular strains include Cannatonic, CBD Critical Care, AC/DC, Blackberry Kush, Harlequin, Blueberry, and Redwood Kush.
For daytime relief, most patients desire minimal psychoactivity (i.e. the euphoric effects of cannabis), so they will use strains or products that are high in CBD, with little to no THC.
For nighttime relief, patients report positive results with both high CBD and high THC strains. Likewise, strains that are rich in the terpene Myrcene (between .5% and 3%) -- which is thought to have sedative properties and work synergistically with THC -- seem to work best.
Some patients report they find it beneficial to combine an oral form (edibles, tinctures, etc.) with a small amount of cannabis consumed with a vaporizer. Vaporization provides rapid relief (and is easy to self-titrate), while orally consumed medication lasts longer through the night (which is ideal if you easily wake during the night).
Teri Robnett, a fibromyalgia patient who uses cannabis to treat her fibromyalgia reports cannabis took a bit of trial-and-error, but once she got the hang of it, she found it helped much better than pharmaceuticals. “From season to season, even day to day, the severity of symptoms can change because of the weather, stress, or hormones,” Robnett said. “Cannabis allows me to self-titrate. By being able to vary how I consume and types of strains, I can more effectively treat the symptoms.”
Robnett medicates with an edible and vaporizer at night. Because edibles take longer to kick in, she starts by vaporizing with a THC-dominant strain that’s also rich in myrcene. Vaporizing allows the active ingredients to quickly enter the bloodstream and provide immediate relief. Edibles, on the other hand, provide relief that lasts through the night. “The edible takes much longer to affect me than vaporizing, but lasts much longer, and I can sleep through the night,” she said. “Getting a good night’s sleep helps keep my symptoms under control the next day.”
Again, it’s important to consider that every patient is unique, so finding the ideal strain may take a little time. Beyond experimenting with different strains, also consider different forms of administration such as such as topicals, edibles, capsules, or tinctures.