Research study · Biomedicines · 2026
Lower Pain Intensity Is Associated with the Use of Recreational Edible Cannabis Products Containing Delta-9-Tetrahydrocannabinol: A Secondary Analysis in Adults Self-Managing Their Chronic Low Back Pain
Verified on PubMed Clinical Evidence Analysis
A 2026 study in Biomedicines tested cannabis in pain. Products containing the main intoxicating compound from cannabis helped lower daily pain, while products focused primarily on the non-intoxicating compound did not make a difference. This suggests that for patients seeking relief from chronic back pain through edibles, products containing THC are more effective than those.
In plain language
Study overview
Researchers followed adults living with long-term lower back pain who chose to use edible cannabis products from legal stores over a two-week period. Participants filled out daily questionnaires about their pain levels, whether they consumed their cannabis product, how many times they used it, and the estimated amounts of plant compounds they took. The goal was to see how different mixtures of major cannabis plant compounds related to daily and short-term changes in pain.
Findings
Products containing the main intoxicating compound from cannabis helped lower daily pain, while products focused primarily on the non-intoxicating compound did not make a difference. People using a balanced mixture of both major compounds experienced steady pain relief over the course of the two weeks. Taking higher amounts of the main intoxicating compound was linked to less pain the following day, but consuming larger amounts of the non-intoxicating compound seemed to reduce this benefit.
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The deeper readScientific analysis
Current literature regarding the efficacy of cannabis to reduce chronic pain intensity is mixed. Despite growing accessibility throughout the U.S., it is still unclear if the naturalistic use of recreational cannabis edible products is associated with decreases in pain intensity on days of use or longitudinally, and if these associations are dependent on the doses of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) being consumed. Methods: The trial (NCT03522324) from which these data were pulled was pre-registered in April 2018. Participants (N = 243; 56% female; mean age = 46 ± 12 years) with self-reported chronic low-back pain selected a recreational edible cannabis product to use exclusively, ad libitum, for 14 days. Labeled THC and CBD potency were used to determine product group: CBD-dominant (n = 97), THC + CBD (n = 112), or THC-dominant (n = 34). Participants completed daily surveys indicating current pain intensity (PROMIS; 0–10 scale), use or non-use of their product, and cannabinoid dose (THC and CBD). Results: Linear mixed effects showed a significant use × group interaction (p = 0.002), indicating that pain intensity was significantly lower on days of use in THC-dominant (b = −0.66, 95% CI [−0.94, −0.37]) and THC + CBD (b = −0.41, 95% CI [−0.57, −0.25]) groups compared to days when cannabis was not used. A significant group × time interaction (p = 0.02) indicated that pain intensity significantly decreased from day 1 to day 14 in those using THC + CBD products (b = −0.05, 95% CI [−0.07, −0.03]), with 36.6% of participants in the THC + CBD group experiencing ≥30% reduction in pain intensity from day 1 to day 14. Increasing doses of THC (b = −0.02, 95% CI [−0.04, −0.01]), not CBD (b = 0.003, 95% CI [−0.03, 0.01]), were associated with significantly lower pain intensity on days following product use, with increasing doses of CBD diminishing the impact of THC dose (b = 0.02, 95% CI [0.01, 0.04]). Conclusions: These findings indicate a complex relationship between THC, CBD, and pain intensity associated with the naturalistic use of recreational cannabis edible products. Lower daily pain intensity was associated with the use of products containing delta-9-tetrahydrocannabinol; however, dose models indicate that this association may be attenuated at higher doses of cannabidiol. Additionally, only products containing relatively equal amounts of THC and CBD were associated with lower pain intensity after 14 days of observation.
The paper
Citation
Lisano JK, Rosa L, Skrzynski CJ, Bryan AD, Bidwell LC Lower Pain Intensity Is Associated with the Use of Recreational Edible Cannabis Products Containing Delta-9-Tetrahydrocannabinol: A Secondary Analysis in Adults Self-Managing Their Chronic Low Back Pain. Biomedicines (2026). PubMed 42512114 · DOI
Limitations the authors noted
Observational, naturalistic design lacking random assignment and a placebo control. Participants were not blinded to product cannabinoid content due to state labeling regulations. Short 14-day observation period. Sample was predominantly white and highly educated, limiting generalizability. Self-reported dosing is susceptible to recall bias and reporting errors.
In practice
Why this matters
This suggests that for patients seeking relief from chronic back pain through edibles, products containing THC are more effective than those relying solely on CBD, though a balanced ratio may offer better sustained benefit over time.
Frequently asked questions
Clinical Questions & Answers
What were the primary clinical findings regarding Cannabis and Low back pain?
Products containing the main intoxicating compound from cannabis helped lower daily pain, while products focused primarily on the non-intoxicating compound did not make a difference. People using a balanced mixture of both major compounds experienced steady pain relief over the course of the two weeks. Taking higher amounts of the main intoxicating compound was linked to less pain the following day, but consuming larger amounts of the non-intoxicating compound seemed to reduce this benefit.
What study limitations or clinical safeguards should patients keep in mind?
Observational, naturalistic design lacking random assignment and a placebo control. Participants were not blinded to product cannabinoid content due to state labeling regulations. Short 14-day observation period.
Browse related research
Condition: Low back pain Condition: Pain Topic: Cannabis Topic: CBD Topic: THC
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Reviewed by Dr. Caplan on October 29, 2026.
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