Peripheral Neuropathy: Can Cannabis & CBD Help?

Peripheral Neuropathy: Can Cannabis and CBD help with the tingling?

A large part of our practice deals exclusively with active duty and retired service members. Many come in complaining of tingling, numbness and shooting pain in their hands and feet. These types of symptoms can be attributable to a number of conditions like radiculopathy or sciatica. Unlike those conditions, peripheral neuropathy-  which is a condition affecting the peripheral nerves, disrupts the vital communication system between the brain, spinal cord, and the rest of the body. This interference leads to a spectrum of symptoms, from mild tingling to debilitating pain and muscle weakness. It can be debilitating at times, significantly impacting quality of life, employment ability and mental health. We’ve been able to help a number of the veterans who present to the clinic, so instead of keeping the juicy goodness all to ourselves- we’ve decided to share it with you 🤗

Let’s dive into the causes, symptoms, demographics, treatments, of peripheral neuropathy and how cannabis and CBD can offer promising relief.

What Is Peripheral Neuropathy?

Peripheral neuropathy is a condition where peripheral nerves—the network of nerves outside the brain and spinal cord- become damaged or dysfunctional. These nerves are responsible for transmitting sensory information and controlling muscle movements. When damaged, the signals become distorted or interrupted, causing pain, weakness, and sensory changes.

There are numerous causes of peripheral neuropathy. Diabetes stands out as the leading contributor, often associated with poorly controlled blood sugar levels damaging the nerves. Other causes include chronic alcohol use, vitamin deficiencies (particularly B12 and E), autoimmune diseases, infections like Lyme disease and shingles, and exposure to toxins. Chemotherapy drugs such as paclitaxel, vincristine, and cisplatin are also major culprits, with many cancer survivors reporting neuropathy as a lasting side effect of treatment.

Symptoms can include tingling, burning sensations, or numbness, typically starting in the hands and feet. Muscle weakness, difficulty with coordination, and heightened sensitivity to touch are also common. Over time, if left untreated, symptoms may worsen, significantly reducing mobility and quality of life.

Pearls

• Diabetes accounts for over half of all peripheral neuropathy cases worldwide.

• Chemotherapy-induced neuropathy affects up to 68% of patients during cancer treatment, often persisting for years.

Who Is Affected by Peripheral Neuropathy?

Peripheral neuropathy affects over 20 million Americans, though many cases remain undiagnosed. The condition predominantly impacts people over 50, as aging increases vulnerability to nerve damage.

Men have a slightly higher risk than women, likely due to lifestyle factors like higher rates of alcohol use and diabetes prevalence. While no significant racial disparities exist, socioeconomic factors play a critical role. Individuals in underserved communities may face delays in diagnosis and treatment due to limited healthcare access, exacerbating the condition’s progression and impact.

Pearls

• Aging is a significant risk factor, with nerve function naturally declining as we grow older.

• Undiagnosed cases of peripheral neuropathy are particularly common in underserved populations.

Diagnosing Peripheral Neuropathy

Diagnosing peripheral neuropathy starts with a detailed medical history and physical examination. Healthcare providers assess reflexes, muscle strength, and sensitivity to detect signs of nerve damage.

Further tests include:

• Blood Work: Identifies conditions like diabetes, thyroid dysfunction, or vitamin deficiencies.

• Electromyography (EMG) and Nerve Conduction Studies: Measure electrical signals in nerves to evaluate their speed and strength.

• Skin or Nerve Biopsy: Rarely performed, these tests can confirm complex cases where other diagnostics are inconclusive.

Early diagnosis is key to preventing further damage and managing symptoms effectively.

Pearls

• Nerve conduction studies are the gold standard for identifying peripheral nerve damage.

• Vitamin deficiencies, especially B12, are reversible causes of neuropathy if detected early.

Traditional Treatments for Peripheral Neuropathy

Treating peripheral neuropathy often requires a dual approach: addressing the underlying cause and managing symptoms.

Medications like gabapentin and pregabalin are commonly prescribed for nerve pain. These drugs work by calming overactive nerves but can cause side effects such as dizziness or fatigue. Antidepressants like duloxetine or amitriptyline are also effective in reducing nerve pain while addressing related mood disturbances.

Physical therapy plays a vital role, focusing on exercises to enhance coordination, strength, and balance. In some cases, treating underlying conditions like diabetes or improving nutrition can help prevent further nerve damage.

While medications provide relief, they are not without drawbacks. Opioids, though effective for severe pain, carry risks of dependency and should be used sparingly.

Pearls

• Gabapentin and pregabalin are first-line treatments for neuropathic pain, though they may cause sedation.

• Lifestyle changes, like blood sugar control, can slow or halt the progression of diabetic neuropathy.

Holistic Treatments for Peripheral Neuropathy

Holistic approaches to managing peripheral neuropathy focus on reducing pain and improving nerve health. Acupuncture has shown promise in reducing pain and inflammation by stimulating blood flow and releasing endorphins. Massage therapy and yoga can relieve tension and improve mobility, while dietary supplements like alpha-lipoic acid and vitamin B12 support nerve repair.

Holistic treatments are generally safe and can complement traditional therapies. However, their effectiveness varies, and consistent practice is often required to see benefits.

Pearls

• Alpha-lipoic acid is an antioxidant that has shown potential in reducing neuropathic pain and improving nerve function.

• Acupuncture may reduce pain perception and improve overall nerve health.

Cannabis and CBD for Peripheral Neuropathy

Cannabis and CBD have emerged as promising options for managing neuropathy symptoms. THC, the psychoactive component of cannabis, activates receptors in the brain and nervous system to reduce pain. CBD, on the other hand, offers anti-inflammatory and antioxidant effects, making it particularly effective for nerve protection.

Routes of Administration

• Topicals: CBD creams or balms provide localized relief for pain in specific areas like the hands or feet.

• Edibles/Tinctures: Offer systemic relief with long-lasting effects, ideal for chronic pain.

• Vaping/Smoking: Provides fast-acting relief for acute flare-ups but may not be suitable for all individuals.

Pearls

• CBD topicals are excellent for targeted nerve pain, while tinctures offer comprehensive symptom relief.

• The combination of THC and CBD can enhance therapeutic effects due to the entourage effect.

Rolling It Up

Peripheral neuropathy is a complex condition with a wide array of causes and symptoms. It can present like other conditions (radiculopathy) or overlap with them. Conditions like this usually aren't typically successfully managed with one modality, but rather with an “all of the above” approach. Whether through traditional treatments, holistic approaches, or cannabis and CBD, there are numerous ways to manage symptoms and improve quality of life. Early diagnosis and a comprehensive treatment plan tailored to your needs are essential for long-term relief.

Advice: Focus on addressing the root cause of neuropathy and explore alternative therapies like cannabis for enhanced symptom control. To learn more about holistic and personalized care options feel free to contact us. And as always, if you’re interested in CBD products, you can shop the products I created to help with a number of conditions here. 

Pearls

• Combining traditional and holistic treatments often yields the best results for managing peripheral neuropathy.

• Cannabis and CBD offer innovative relief options, with growing evidence supporting their use for neuropathic pain.