Cannabis and CBD for Focal Neuropathy
Cannabis can be an effective alternative or supplemental therapy for peripheral neuropathy, an often-debilitating condition for which conventional therapies still provide little relief. Many studies show moderately improved cannabis use pain due to inhalation, but adverse effects such as impaired cognition and breathing problems are common, especially at high doses. Long-term safety data are limited to cannabis care. Before risk-benefit profiles are better defined, it should be prescribed for peripheral neuropathy only after careful consideration by physicians in states where cannabis therapy is legal.
What is Focal Neuropathy
Focal neuropathies are conditions where you usually have nerve damage, most often in your hand, head, torso, or leg. It is less common for this form of nerve damage than peripheral or autonomic neuropathy. There are many common focal neuropathies that can affect people with diabetes. Polyneuropathy, in comparison, affects one nerve, which is based on neuropathy, and may also be called mononeuropathy. All types of diabetic neuropathy above — peripheral, self-reliant, and proximal — are examples of Polyneuropathy. Poly means that they affect many nerves.
Focal neuropathy, which occurs unexpectedly (also called mononeuropathy), most often affects the nerves in the head (especially those that go to the eyes). The chest and legs may also be affected.
It has different symptoms when focal neuropathy affects the legs than proximal neuropathy, which can also affect the legs. As you can read above, proximal neuropathy causes muscle weakness in the legs and can also cause pain in the legs.
Neuropathy is a condition that injures one or more nerves, leading to nervous system problems. Just a few nerves are damaged in focal neuropathy at most, confining the subsequent symptoms to a small area of the body. Focal neuropathies generally occur in the neck, head, abdomen, or leg, resulting in multiple location-based symptoms.
Symptoms of Focal Neuropathy
Specific symptoms of focal neuropathy depend primarily on the location and cause of neuropathy. For example, with carpal tunnel syndrome, where the median nerve is damaged by continuous compression, patients often experience pain and weakness in the affected hand. However, a patient may experience partial paralysis and numbness in focal neuropathies of the face.
The most common symptoms of focal neuropathy include the following.
- Loss of function: A loss of sensation or control in the affected area is the most common sign of focal neuropathy. This will generally manifest as numbness, weakness, tremor or loss of fine motor control.
- Pain: Feeling pain is another common symptom of focal neuropathy, which typically presents as a feeling of ache, tingling, scratching, creeping, or pins-and-needles. In extreme cases, pain may be acute enough to fail and may allow painkillers to be used.
- Sensitivity: Patients with focal neuropathy, particularly if the area contains bundles of nerve endings, may note an increase in sensitivity in the affected area.
If patients persist long enough, any of these symptoms can weaken patients. While focal neuropathies that do not involve trapped nerves may fade over time without treatment, those that often linger make the treatment necessary to lead a normal life for a patient.
Entrapments — focal neuropathies involving trapped nerves — causes symptoms that slowly begin and get worse over time. Examples are;
- Carpal tunnel syndrome that causes pain, numbness and tingling of the thumb, index finger, middle finger, and sometimes grip weakness.
- Ulnar entrapment, which causes pain, numbness, and tingling in your little and ring fingers
- Peroneal trapping that causes pain in your lower leg outside and weakness in your big toe
Focal neuropathies that do not include damaged nerves cause symptoms that arise spontaneously after a few weeks or months and improve. You may have pain and other signs in your nerve depending on which nerve is affected.
Cranial neuropathies—focal neuropathies that affect the nerves in the head—may cause symptoms such as
- aching behind one eye
- double vision
- paralysis on one side of your face, called Bell’s palsy
- problems focusing your eyes
The same medications used to treat peripheral neuropathy pain may be used by the doctor to treat focal neuropathy pain.
- Use a splint or brace to relieve the nerve pressure
- Medicines that reduce inflammation
- Surgery, if other treatments don’t work
Many people recover within a few weeks or months, even without medication, with focal neuropathies that do not require trapped nerves.
How Cannabis Can Help Relieve the Symptoms of Focal Neuropathy
Current standard treatment options include the following:
- Splints: Though a splint or brace may be sufficient to relieve minor cases of foyer neuropathy, patients can treat focal neuropathy that involves trapped nerves that relieve some of the pressure on the nerve. Physicians also recommend this treatment together with medicine.
- Surgery: Some cases may involve surgery to remove obstacles to the nerve, such as tumors or other anatomy. Operation is typically a final option if there are no other therapies.
- Antidepressants: Various forms of antidepressants function on the central nervous system in a way that has been found to help relieve neuropathic pain. In patients without depression, tricyclic and certain antidepressants of the SNRI may be particularly useful.
- Anticonvulsants: It has been found that anticonvulsants and antiepileptic medications have some positive effects in neuropathic pain management. These drugs block neuronal calcium channels, reducing pain sensitivity for patients.
- Opiate painkillers: Doctors usually recommend medicines for prescription drugs to help manage neuropathic pain. While these medications are powerful, the negative side effects have made doctors reluctant to prescribe opioids to patients, including the risk of dependency and extreme constipation.
- Topical anesthetic: Doctors recommend treatment with a topical anesthetic such as lidocaine or capsaicin for certain forms of neuropathy.
- Lifestyle changes: Lifestyle changes have been shown to be very helpful in treating neuropathic pain for some patients. Historically, yoga, meditation and dietary modifications designed specifically to activate the nervous system have been used to varying degrees of success, and some patients have even sought dietary supplements, medications and even specific types of massage to help ease their pain.
- Neuromodulators: Neuromodulators are implantable and non-implantable devices that activate the brain’s motor cortex with a method called deep brain stimulation, either electrical or chemical.
- Other options: Botulinum toxin type A, better known as Botox ®, and NMDA antagonists such as ketamine are additional solutions that have found some success.
With so many potential causes of focal neuropathy, patients usually end up using one or more of these different treatments for symptom management. For most people with long-term pain as a result of focal neuropathy, Opioid pain relievers have become the standard treatment choice as they are effective in rapidly reducing pain. Nonetheless, along with the current American opioid epidemic, dangers and side effects associated with opioid narcotic medications — like abuse — have prompted clinicians to try more long-term alternatives.
Medical Cannabis Treatment for Focal Neuropathy
Medical marijuana has many advantages for patients with focal neuropathy. Several studies have supported the idea that tetrahydrocannabinol (THC) and cannabidiol (CBD), the two primary compounds in medical cannabis, are beneficial for neuropathy treatment. CBD, in particular, is an effective pain reliever, and THC helps to manage pain and relaxation.