Pain: research and patient questions

A group of adults with long-lasting lower back pain that has a nerve-related component took part in a study. They were given a daily supplement made from a natural body fat molecule, packaged in a form designed to be absorbed better, or a dummy pill, for eight weeks alongside their usual care.

This study followed 241 adults with long-standing lower back pain that had not improved with usual treatments such as prescription painkillers, nerve medicines, antidepressants, anti-inflammatory tablets and physiotherapy. Each person started a medical cannabis treatment that was mostly smoked, and their progress was tracked once a year for five years.

This study followed 192 adults in the United Kingdom who had long-lasting pain from arthritis and were given medicinal cannabis by a private clinic. Each person filled in questionnaires about pain, mood, sleep and daily life over two years. The researchers looked at how these answers changed over time.

Researchers reviewed the best available medical studies that tested cannabis-based medicines in people with a long-lasting condition that causes widespread body pain, poor sleep and tiredness. They looked at a few different versions of these medicines and compared them with dummy pills or standard painkillers.

While current systemic and oral cannabinoid formulations lack robust evidence for managing acute orofacial and post-operative dental pain, topical transdermal CBD demonstrates potential for localized myofascial temporomandibular disorder pain. Integrative clinicians should prioritize conventional first-line agents like NSAIDs for acute dental pain while awaiting higher-quality trials on localized topical cannabinoid therapies.

In this double-blind laboratory study, low-dose oral cannabidiol (50 mg) enhanced the acute analgesic properties of 4 mg hydromorphone without increasing negative subjective effects or adverse events, whereas higher CBD doses (200 mg) increased adverse effects. CBD also successfully mitigated the psychomotor impairment caused by the opioid alone. These findings suggest that lower-dose CBD may hold clinical potential as an opioid-sparing adjunct for acute pain management.

This systematic review and meta-analysis demonstrates that standard personality traits do not reliably predict placebo responsiveness, challenging the clinical assumption of a 'placebo personality'. Clinicians and researchers should look to situational, contextual, learning-based, or neurobiological factors rather than baseline personality when assessing variability in patient response to inert treatments or therapies.