Shah Dhruvil, Murhekar Siddhartha, Ward Michael, Sagane Shrikant, Pahwani Ashvin
Trauma and Orthopaedics, King's College Hospital, London, GBR.
Trauma and Orthopaedics, Medway NHS Foundation Trust, Gillingham, GBR.
Cureus. 2025 Jul 3;17(7):e87208. doi: 10.7759/cureus.87208. eCollection 2025 Jul.
This systematic review examines the efficacy of medical cannabis in pain management within orthopaedic domains, including arthritis pain, postsurgical pain, back pain, and post-trauma pain. Given the challenges and risks associated with traditional pain medications, particularly opioids, this review aims to assess the efficacy and safety of medical cannabis for orthopaedic pain management. A literature search was conducted on databases such as PubMed and Cochrane to find primary research papers on the efficacy and safety of cannabis. A comprehensive analysis was conducted on available literature, focusing on studies that evaluated the efficacy and safety profile of medical cannabis in various orthopaedic pain conditions. Only randomised controlled trials (RCTs) were included to keep the evidence of high quality. The quality of the studies was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool, and the risk of bias was assessed using the Cochrane Risk of Bias tool. The review particularly assessed the effectiveness of medical cannabis compared to no treatment, placebo, and active comparators. Additionally, the review examined the optimal dosing, methods of administration, and the safety profile of medical cannabis. The review reveals minimal high-quality evidence supporting the efficacy of medical cannabis in the targeted orthopaedic areas. Most evidence suggests effectiveness only when compared with no treatment or placebo, with limited data against active comparators. The review also highlights the need for more research to determine optimal dosing and administration methods. The safety profile of medical cannabis, characterised by generally mild to moderate adverse effects, suggests its potential as a safer alternative or adjunct to opioid pain management. The findings indicate that while medical cannabis may hold promise as an alternative or adjunct therapy in orthopaedic pain management, there is a need for more robust and methodologically sound research. Future studies should focus on long-term efficacy and safety, standardisation of dosing and administration, and comprehensive reporting of adverse effects. This is essential for developing effective treatment protocols that balance pain relief with safety and understanding the role of medical cannabis in orthopaedic pain management.
本系统评价考察了医用大麻在骨科领域疼痛管理中的疗效，包括关节炎疼痛、术后疼痛、背痛和创伤后疼痛。鉴于传统止痛药物，尤其是阿片类药物存在的挑战和风险，本评价旨在评估医用大麻用于骨科疼痛管理的疗效和安全性。在PubMed和Cochrane等数据库上进行了文献检索，以查找关于大麻疗效和安全性的原始研究论文。对现有文献进行了全面分析，重点关注评估医用大麻在各种骨科疼痛状况下疗效和安全性的研究。仅纳入随机对照试验（RCT）以确保证据质量高。使用推荐分级评估、制定和评价（GRADE）工具评估研究质量，并使用Cochrane偏倚风险工具评估偏倚风险。该评价特别评估了与不治疗、安慰剂和活性对照相比，医用大麻的有效性。此外，该评价还考察了医用大麻的最佳剂量、给药方法和安全性。该评价显示，支持医用大麻在目标骨科领域疗效的高质量证据极少。大多数证据表明，仅在与不治疗或安慰剂相比时有效，与活性对照相比的数据有限。该评价还强调需要更多研究来确定最佳剂量和给药方法。医用大麻的安全性通常表现为轻度至中度不良反应，表明其作为阿片类药物疼痛管理更安全的替代或辅助药物的潜力。研究结果表明，虽然医用大麻在骨科疼痛管理中作为替代或辅助疗法可能有前景，但需要更有力且方法合理的研究。未来的研究应关注长期疗效和安全性、剂量和给药的标准化以及不良反应的全面报告。这对于制定平衡止痛与安全性的有效治疗方案以及理解医用大麻在骨科疼痛管理中的作用至关重要。
