# Patient Perspectives on Non-Traumatic Painful Upper-Extremity Conditions and Substance Use > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/non-traumatic-painful-upper-extremity-conditions-patient-perspectives/ > **Published:** 2026-04-23T14:05:33-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T10:14:15-04:00 > **Clinical Summary:** Explore patient perspectives on non traumatic painful upper extremity conditions and co-occurring risky substance use with integrated mind-body interventions. --- CED Clinical Relevance  #70Notable Clinical Interest  Emerging findings or policy developments worth monitoring closely. 🔬 Evidence Watch  |  CED Clinic PainCannabisSubstance UsePatient Education[Chronic Pain](https://cedclinic.com/cannabinoids-pain-management-opioid-alternative/) Journal [Pain management](https://cedclinic.com/cbd-cbg-topicals-for-eczema/) Study Type Clinical Study Population Human participants Why This Matters This study illuminates the complex interplay between [chronic pain](https://cedclinic.com/cannabinoids-pain-management-opioid-alternative/) and substance use behaviors, particularly relevant given cannabis’s dual role as both a therapeutic agent and potential substance of concern. Understanding patient perspectives on this relationship is crucial for developing effective treatment approaches that address both conditions simultaneously. Clinical Summary This qualitative study interviewed 19 adults with non-traumatic painful upper-extremity conditions and concurrent risky substance use, exploring their experiences and perspectives on an integrated web-based mind-body intervention. Four key themes emerged: challenges managing pain leading to functional and emotional deterioration, motivations for using alcohol, cannabis, and tobacco for symptom management, limited patient awareness of the bidirectional relationship between pain and substance use, and generally positive reception of integrated treatment approaches. The study highlights how patients often turn to substances including [cannabis for pain](https://cedclinic.com/cannabis-veterans-substance-use-disorder-study/), stress, and sleep management without fully understanding how substance use may perpetuate their pain cycle. Dr. Caplan’s Take “This reinforces what I observe clinically – patients frequently use cannabis and other substances to manage pain without recognizing how this can complicate their overall treatment trajectory. The finding that patients have limited awareness of the pain-substance use relationship underscores the need for better patient education about these interactions.” Clinical Perspective 🧠 Clinicians should routinely screen for substance use in chronic pain patients and provide education about the bidirectional relationship between pain and substance use. When cannabis is being used for [pain management](https://cedclinic.com/cbd-cbg-topicals-for-eczema/), this creates an opportunity for therapeutic discussion about optimizing [cannabinoid therapy](https://cedclinic.com/unknown-cannabinoid-receptor-brain-damage-relief/) while addressing any problematic use patterns through integrated treatment approaches. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/forum/cannabis-industry/) Have thoughts on this? Share it: [𝕏 Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Patient%20perspectives%20on%20non%E2%80%91traumatic%20painful%20upper%E2%80%91extremity%20conditions%2C%20co-occ...%20%40drcaplan&url=https%3A//pubmed.ncbi.nlm.nih.gov/42023723/)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A//pubmed.ncbi.nlm.nih.gov/42023723/)[🦥 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Patient%20perspectives%20on%20non%E2%80%91traumatic%20painful%20upper%E2%80%91extremity%20conditions%2C%20co-occ...%20--%20via%20%40drcaplan.bsky.social%20https%3A//pubmed.ncbi.nlm.nih.gov/42023723/)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan/)[📝 Read more on Substack](https://substack.com/@doctorapproved)[🔔 Subscribe via RSS](https://cedclinic.com/category/cannabis-news/feed/) 📰 Source: [https://pubmed.ncbi.nlm.nih.gov/42023723/](https://pubmed.ncbi.nlm.nih.gov/42023723/) Table of Contents - [FAQ](#FAQ)[How common is substance use among patients with upper extremity pain conditions?](#How_common_is_substance_use_among_patients_with_upper_extremity_pain_conditions) - [Do patients understand the relationship between their pain and substance use?](#Do_patients_understand_the_relationship_between_their_pain_and_substance_use) - [What motivates patients to use cannabis and other substances for upper extremity pain?](#What_motivates_patients_to_use_cannabis_and_other_substances_for_upper_extremity_pain) - [Are web-based interventions acceptable to patients with co-occurring pain and substance use?](#Are_web-based_interventions_acceptable_to_patients_with_co-occurring_pain_and_substance_use) - [How should clinicians approach patients with upper extremity pain who may be using substances?](#How_should_clinicians_approach_patients_with_upper_extremity_pain_who_may_be_using_substances) - [Related](#Related) ## FAQ #### How common is substance use among patients with upper extremity pain conditions? This study found that patients with non-traumatic painful upper-extremity conditions commonly use alcohol, cannabis, and tobacco to manage their pain, stress, and sleep difficulties. The research highlights a significant overlap between chronic pain conditions and risky substance use behaviors that clinicians should routinely assess. #### Do patients understand the relationship between their pain and substance use? The study revealed that participants had limited awareness of the reciprocal relationship between pain and substance use. Most patients did not recognize how their substance use might be affecting their pain levels or how pain might be driving their substance use patterns. #### What motivates patients to use cannabis and other substances for upper extremity pain? Patients reported using substances primarily as maladaptive coping strategies when experiencing functional deterioration, emotional distress, and frustration with limited symptom relief from conventional treatments. However, the study found that patients expressed low motivation to change these substance use patterns. #### Are web-based interventions acceptable to patients with co-occurring pain and substance use? The study assessed patient perspectives on Web-TIRELESS, an integrated web-based mind-body intervention targeting both conditions simultaneously. While specific acceptability metrics aren’t detailed in this summary, the research suggests patients are open to digital therapeutic approaches that address both pain and substance use concurrently. #### How should clinicians approach patients with upper extremity pain who may be using substances? Clinicians should routinely screen for substance use in patients with chronic upper extremity pain and provide education about the bidirectional relationship between pain and substance use. The findings suggest that integrated interventions addressing both conditions simultaneously may be more effective than treating each condition separately. [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. Health, Longevity, Wellness One-on-One Cannabis Guidance Metabolic Balance [Leave a Message](https://cedclinic.com/contact/) [Metabolic Care](https://cedclinic.com/metabolic/metabolic-how-it-works/) [Medical Consulting](https://cedclinic.com/book/) [Cannabis Care](https://cedclinic.com/book/) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) RELATED READING AT CED CLINIC Continue exploring the evidence [Patient perspectives on non‑traumatic painful upper‑extremity conditions, co-occurring risky substance use, and an integrated web-based mind-body intervention addressing both conditions.](https://cedclinic.com/upper-extremity-pain-substance-use-management-research/) In-depth research on patient experiences with upper-extremity pain and substance use, highlighting integrated treatment approaches. [Read More](https://cedclinic.com/upper-extremity-pain-substance-use-management-research/) [Cannabis use patterns and perception of acute pain during brief abstinence: sex-dependent associations with circulating cannabinoid levels.](https://cedclinic.com/acute-pain-cannabinoid-withdrawal-sex-dependent-cannabis-study/) Study exploring how [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) affects acute pain perception and its biological correlates. [Explore Study](https://cedclinic.com/acute-pain-cannabinoid-withdrawal-sex-dependent-cannabis-study/) [High-Risk Behavior? What Your Patients Should Know About Cannabis and Diabetes](https://cedclinic.com/cannabis-and-diabetes-management-patient-safety-guide/) Important insights on [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) risks for patients with diabetes and implications for clinical care. [Learn More](https://cedclinic.com/cannabis-and-diabetes-management-patient-safety-guide/) ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).