Division of Orthopedic Surgery, Department of Surgery, Victory 3, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
J Orthop Surg Res. 2024 Jan 30;19(1):97. doi: 10.1186/s13018-024-04558-6.
Back pain is the leading cause of disability worldwide. Despite guidelines discouraging opioids as first-line treatment, opioids remain the most prescribed drugs for back pain. There is renewed interest in exploring the potential medical applications of cannabis, and with the recent changes in national legislation there is a unique opportunity to investigate the analgesic properties of cannabis.
This was a multi-center survey-based study examining patient perceptions regarding cannabis for spine pain. We included patients presenting with back or neck pain to one of three Orthopedic clinics in Ontario. Our primary outcome was perceived effect of cannabis on back pain, while secondary outcomes were perceptions regarding potential applications and barriers to cannabis use.
259 patients participated in this study, 35.3% (90/255) stating they used cannabis medically. Average pain severity was 6.5/10 ± 0.3 (95% CI 6.2-6.8). Nearly three-quarters were prescribed opioids (73.6%, 148/201), with oxycodone/oxycontin (45.9% 68/148) being the most common, and almost half of (49.3%, 73/148) had used an opioid in the last week. Patients estimated cannabis could treat 54.3% ± 4.0 (95% CI 50.3-58.3%) of their spine pain and replace 46.2% ± 6. 6 (95% CI 39.6-52.8%) of their current analgesics. Age (β = - 0.3, CI - 0.6-0.0), higher pain severity (β = 0.4, CI 0.1-0.6) and previous cannabis use (β = 14.7, CI 5.1-24.4) were associated with a higher perceived effect of cannabis. Patients thought cannabis would be beneficial to treat pain (129/146, 88.4%), and reduce (116/146, 79.5%) or eliminate opioids (102/146, 69.9%). Not considering using cannabis for medical purposes (65/150, 43.3%) was the number one reported barrier.
Patients estimated medical cannabis could treat more than half of their spine pain, with one in three patients already using medical cannabis. 79% of patients also believe cannabis could reduce opioid usage. This data will help support more research into cannabis for musculoskeletal pain.
背痛是全球导致残疾的主要原因。尽管指南不鼓励将阿片类药物作为一线治疗药物，但阿片类药物仍然是治疗背痛最常用的药物。人们对大麻的潜在医学应用重新产生了兴趣，并且随着国家立法的最新变化，现在有机会研究大麻的镇痛特性。
这是一项基于多中心调查的研究，旨在研究患者对脊柱疼痛大麻治疗的看法。我们纳入了在安大略省三个骨科诊所就诊的背痛或颈痛患者。我们的主要结局是患者感知大麻对背痛的影响，次要结局是对大麻使用的潜在应用和障碍的看法。
本研究共纳入 259 名患者，35.3%（90/255）表示他们将大麻用于医疗用途。平均疼痛严重程度为 6.5/10 ± 0.3（95%CI 6.2-6.8）。近三分之二的患者开了阿片类药物（73.6%，148/201），其中最常见的是羟考酮/羟考酮（45.9%，68/148），几乎一半的患者（49.3%，73/148）在过去一周内使用过阿片类药物。患者估计大麻可以治疗 54.3%±4.0（95%CI 50.3-58.3%）的脊柱疼痛，替代 46.2%±6.6（95%CI 39.6-52.8%）的当前镇痛药物。年龄（β=-0.3，CI -0.6-0.0）、较高的疼痛严重程度（β=0.4，CI 0.1-0.6）和先前使用大麻（β=14.7，CI 5.1-24.4）与大麻的感知效果更高相关。患者认为大麻有益于治疗疼痛（129/146，88.4%），并减少（116/146，79.5%）或消除阿片类药物（102/146，69.9%）。有 65/150（43.3%）名患者不考虑将大麻用于医疗目的，这是报告的最大障碍。
患者估计医用大麻可以治疗一半以上的脊柱疼痛，每三名患者中就有一名已经使用医用大麻。79%的患者还认为大麻可以减少阿片类药物的使用。这些数据将有助于支持更多关于大麻治疗肌肉骨骼疼痛的研究。
Zotero 插件