RSD is a chronic pain condition that typically follows soft tissue injury or surgical procedures.   The pain is often severe, chronic and described as stabbing or burning.   Patients report that light touch creates a severe pain that is out of proportion to event.   For example, brushing up against a person who has RSD may cause a pain that causes them to “shoot through the roof.”

(AMAZINGLY: IN THE MIDDLE OF WRITING THIS BLOG A NEW PATIENT CAME IN WITH THE DIAGNOSIS OF RSD!.  THAT IS 2 IN ONE DAY AFTER HAVING ONLY 3 IN 4 YEARS OF PRACICE).

This new patient was a 24 year old US Marines who fractured his wrist while deployed in Iraq and had surgery to repair it.   He then had to have corrective surgery for hardware failure.   It was after this second surgery that he developed RSD.   He described the pain as burning and severe.   Like my first patient, light touch  causes severe pain.   He has been using medical marijuana for the past 2 years after trying lyrica, effexor, gabapentin (neurontin), oxycontin, vicodin and percocet.   He was able to stop all of them and just use medical marijuana.

OK back to RSD.   The pain is caused by an overactivity of the nerves to the affected area.    It is very often misdiagnosed, incorrectly treated and patients suffer greatly.   Loss of work (only 1 in 5 can go back to their normal work routine prior to being diagnoses), depression, insomnia and suicidal ideations often follow the symptoms.    My Marine patient said he was “blown off” by doctors for 2 years after he starting having the symptoms.   I would guess that is because they did not consider the diagnosis.

Treatment of RSD is very difficult.   Typically patients try a many different medications:  everything from NSAIDS (motrin, celebrex) to oral steroids (prednisone) to anti-depressants, anti-convulsants, anti-oxidants (the list goes on).      I have found very little research of using marijuana to treat RSD but the stories of my three patients is certainly promising.

Medical Marijuana is an NMDA Receptor Antagonist

Although we do not know the exact mechanism of how medical marijuana reduces pain in RSD, I personally believe that its central affects on the NMDA receptor (NMDA receptor is the main receptor for the excitatory neurotransmitter Glutamate) have something to do with it.    I recently went to a lecture by a world renowned neurologist who is studying the effects of cannabis on the NMDA receptor.

Regardless of the mechanism, the one thing that I do know is that in some patients (all 3 of mine), it works!   They have all been able to use significantly less traditional pain medication and it has improved their day to day lives tremendously.

I recently reached out to the national headquarters for RSD research and asked them if they have seen results in other RSD patients using cannabis and am waiting for their answer. Certainly this is exciting news and if any patient reading this suffers from RSD/CRPS please feel free to contact me to see if medical marijuana can be of some benefit to you.

Be blessed,

Many treatment options for neuropathic pain range from medications to nerve blocks to TENS (transcutaneous electrical nerve stimulation).  Because patients with neuropathic pain typically do not respond well to opiates (Percocet, Vicodin, Hydrocodone) there are other classes of drugs that are typically used.   Anticonvulsants such a gabapentin (neurontin), anti-depressants such as amitriptyline and corticosteroids such as prednisone are just three of many different drugs that patients typically try.  Most patients experience limited relief with this approach.  It is extremely important that the psychological effects of chronic pain are also addressed.

Many patients are unaware of the clinical research supporting the use of cannabis (marijuana) to treat neuropathic pain.  The Center for Medicinal Cannabis Research at the UCSD has completed three clinical research studies demonstrating the efficacy of cannabis in treating neuropathic pain.  In the first study by Dr. Donald Abrams (Cannabis for treatment of HIV associated peripheral neuropathy) demonstrated that cannabis reduced daily pain by 34% vs 17% with placebo.  52% of patients using cannabis experienced a 30% reduction in pain compared to 24% in the placebo group.   For more clinical trials please visit the CMCR website at www.cmcr.ucsd.edu

In addition to cannabis’s analgesic (pain reduction) properties it also can improve patients mood from its euphoric properties.   This is an extremely important component in the overall care of pain patients.  Cannabis also has a safety profile which is unprecedented when compared to other treatment modalities.   It is a fact that there has never been one documented overdose from using cannabis.  In addition it does not cause a physical addiction like many other pharmaceuticals.  It will improve a patients appetite, assist with falling and staying asleep and eliminate the nausea often caused by opiate analgesics.   Once patients are educated on the safety and efficacy of marijuana (cannabis) they will be more likely to give it a try.  In the majority of cases the benefits of trying it clearly outweigh the risks.

Lastly, patients do not have to smoke to get the immediate benefits of cannabis.  Vaporization is way to inhale cannabis without producing any smoke.  It is essentially smoke free.

For more information on how to determine if you may benefit from the medicinal use of cannabis please visit our website at www.mcsocal.com and pre-qualify for free online.  To schedule an appointment to meet with Dr. Breen simply call 877-721-0047.  We have three convenient office locations in Southern California (Long Beach, Irvine and Encinitas)

Western medicine has found many challenges in treating this type of pain and often patients with neuropathic pain have given up on ever living a pain free life.   They typically have concominant depression as a result of the daily pain that they suffer from.