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Cannabis at CBD para sa Sakit

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What the evidence does and doesn't show for cannabis and CBD in musculoskeletal pain, and practical and safety considerations.

Updated Jul 2026
Isang dahon ng cannabis.
Ang cannabis at CBD ay palaging tinatanong para sa sakit sa muskuloskeletal; ang ebidensya at regulasyon ay patuloy na nagbabago. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Maaaring nagtatanong ka kung ang cannabis o CBD ay makakatulong sa pamamahala ng iyong sakit. Maraming pasyente sa iyong sitwasyon ang nagtatanong ng parehong tanong. Ilang tao sa may sakit sa likod ay nagtatantiya na ang medikal na cannabis ay maaaring gamutin ang higit sa kalahati ng kanilang mga sintomas. Sa katunayan, isa sa tatlong pasyente sa may sakit sa likod ay gumagamit na ng medikal na cannabis.

Para sa mga may osteoarthritis ng basal joint ng hinlalaki, marami ang interesado subukan ang oral o topical na medikal na cannabis. Karamihan sa mga pasyente na nagpapakonsulta sa doktor para sa mga reklamo sa kamay at itaas na ekstremitas ay isasalang-alang ang paggamit ng medikal na cannabis. Tinitingnan nila ito bilang isang ligtas na opsyon sa paggamot para sa karaniwang mga kondisyon sa orthopedics. Gayunpaman, ang gastos ay isang pangunahing hadlang sa paggamit para sa marami.

Kung ikaw ay may naging arthroscopic rotator cuff repair, ang CBD ay maaaring bahagi ng iyong plano sa pamamahala ng sakit. Ipinakita nito na walang mga kakulangan sa mga resulta na ulit-ulitin ng pasyente kumpara sa placebo sa 1-taong pagsubaybay. Walang mga functional na kakulangan sa 1-taong pagsubaybay din. Maaari mong isaalang-alang ang CBD sa iyong pamamahala ng sakit pagkatapos ng operasyon nang walang mga mapanganib na epekto sa resulta o pangmatagalang mapanganib na epekto.

Ang mga gamot na batay sa cannabis ay angkop din para sa paggamot ng peripheral neuropathy. Ang kasalukuyang ebidensya ay nagpapakita ng epektibidad at kaligtasan para sa kronikong musculoskeletal at neuropathic na sakit gamit ang medikal na cannabis. Para sa mga pasyente na dumadaan sa primary total knee arthroplasty, isang sintetikong anyo ng cannabinoid (THC) ay tila hindi nagbabawal sa pag-inom ng opioid.

Mag-ingat na ang regular na paggamit ng cannabis ay maaaring magkaugnay sa pagtaas ng paggamit ng opioid sa konteksto ng total joint arthroplasty. Dahil sa ugnayang ito, walang tiyak na gabay sa paggamit ng cannabis sa pamamahala ng sakit sa perioperative na yugto ang maaaring mungkahi batay sa ugnayang iyon.

Karamihan sa mga sumagot sa survey sa komunidad ng orthopaedic sports medicine ay naniniwala na may papel ang CBD sa pamamahala ng sakit pagkatapos ng operasyon at kronikong sakit. Dagdag pa rito, 79% ng mga pasyente sa may sakit sa likod ay naniniwala na ang cannabis ay maaaring bawasan ang paggamit ng opioid. Habang ang mga tiyak na konklusyon tungkol sa epektibidad ng medikal na cannabis sa mga kondisyon sa kamay at itaas na ekstremitas ay nangangailangan ng patuloy na imbestigasyon, marami ang nakikita ito na kapaki-pakinabang.

Ano ang nangyayari talaga

Ginagamit ng iyong katawan ang isang kumplikadong sistema ng mga receptor upang pamahalaan ang sakit at pamamaga. Ang cannabidiol, na karaniwang tinatawag na CBD, ay nakikipag-ugnayan sa sistemang ito. Kapag ginamit ito pagkatapos ng operasyon, tulad ng arthroscopic rotator cuff repair, hindi ito nagdudulot ng mga kakulangan sa iyong mga patient-reported outcomes. Ibig sabihin, ang iyong kasiyahan sa mga resulta ay nananatiling pareho kung ikaw ay kumuha ng placebo.

Sa isang-taong follow-up, walang functional deficits ang paggamit ng CBD. Maaari mong ituring itong bahagi ng isang postoperative pain management plan nang walang alalahanin tungkol sa mga pangmatagalang nakakasamang epekto sa iyong paggaling. Para sa marami, tumutulong ito sa pamamahala ng hindi komportableng pakiramdam nang hindi hadlang ang kakayahan mong gumalaw o gamitin ang iyong balikat nang normal.

Ang mga gamot na batay sa cannabis ay aplikable din sa paggamot ng peripheral neuropathy, na sakit ng nerbiyos. Ang kasalukuyang ebidensya ay nagpapakita ng epektibidad at kaligtasan para sa chronic musculoskeletal at neuropathic pain gamit ang medical cannabis. Gayunpaman, ang regular na paggamit ng cannabis ay maaaring magkaugnay ng pagtaas ng paggamit ng opioid sa konteksto ng total joint arthroplasty, o joint replacement. Dahil sa ugnayang ito, walang tiyak na gabay sa paggamit ng cannabis sa perioperative pain management ang maaaring maitala batay sa ugnayang iyon.

Madalas na umaasa ang mga pasyente sa medical cannabis para sa ginhawa. Ang mga pasyente na may sakit sa likod ay nagtataya na ang medical cannabis ay maaaring gamutin ang higit sa kalahati ng kanilang sakit sa likod. Isa sa tatlong pasyente na may sakit sa likod ay gumagamit na ng medical cannabis. Pitumpu’t siyam na porsyento ng mga pasyente na may sakit sa likod ay naniniwala na ang cannabis ay maaaring bawasan ang paggamit ng opioid.

Mataas din ang interes sa hand care. Malaking bilang ng mga pasyente na may osteoarthritis ng thumb basal joint ay interesado na subukan ang oral o topical formulations ng medical cannabis para sa paggamot ng kanilang sakit sa thumb basal joint. Karamihan sa mga pasyente na dumating para sa mga reklamo sa kamay at upper-extremity ay aakalang gumamit ng medical cannabis, sa 80.9%. Ang mga pasyente ay nakikita ang medical cannabis bilang isang ligtas na opsyon sa paggamot para sa karaniwang orthopedic conditions.

Isang synthetic na anyo ng cannabinoid (THC) ay tila hindi limitahan ang pag-inom ng opioid pagkatapos ng primary total knee arthroplasty. Karamihan sa mga sumagot sa survey sa komunidad ng orthopaedic sports medicine ay naniniwala na may papel ang CBD sa postoperative at chronic pain management. Gayunpaman, ang mga definitive na konklusyon tungkol sa epektibidad ng medical cannabis sa mga kondisyon sa kamay at upper extremity ay nangangailangan ng patuloy na imbestigasyon. Ang gastos ay nakikilala bilang isang pangunahing hadlang sa paggamit ng medical cannabis sa mga pasyente na dumating para sa mga reklamo sa kamay at upper-extremity.

Ano ang inaasahan

Maaaring magtanong kung makakatulong ang cannabis o CBD sa pamamahala ng iyong sakit. Ang kasalukuyang ebidensya ay nagpapahiwatig na maaaring bahagi ng iyong plano sa pamamahala ng sakit ang CBD nang hindi nakakasama sa iyong paggaling. Halimbawa, pagkatapos ng arthroscopic rotator cuff repair, ang paggamit ng CBD ay hindi nagdulot ng mas masamang mga resulta na ulit-ulit ng pasyente o mga functional deficit sa isang-taong follow-up kumpara sa placebo. Ibig sabihin, maaari mong isaalang-alang ito bilang bahagi ng isang multimodal na regimen sa pamamahala ng sakit nang hindi nag-aalala tungkol sa pangmatagalang nakakasamang epekto sa iyong resulta.

Maraming pasyente ang interesado sa mga tratamientong ito. Karamihan sa mga sumagot sa survey sa komunidad ng orthopaedic sports medicine ay naniniwala na may papel ang CBD sa pamamahala ng postoperative at chronic na sakit. Malaking bilang ng mga pasyente na may osteoarthritis ng thumb basal joint ang interesado subukan ang oral o topical na medical cannabis. Sa katunayan, karamihan sa mga pasyente na dumadating para sa mga reklamo sa kamay at upper-extremity ay isaalang-alang ang paggamit ng medical cannabis, na may 80.9% na itinuturing itong ligtas na opsyon sa paggamot.

Gayunpaman, hindi pa definitibo ang ebidensya para sa lahat ng kondisyon. Ang mga definitibong konklusyon tungkol sa epektibidad ng medical cannabis sa mga kondisyon ng kamay at upper extremity ay nangangailangan ng patuloy na pagsisiyasat. Dapat mo ring maging mapanuri na ang regular na paggamit ng cannabis ay maaaring magkaugnay sa pagtaas ng paggamit ng opioid sa konteksto ng total joint arthroplasty. Sa kabila nito, maraming pasyente na may sakit sa likod ang naniniwala na maaaring bawasan ng cannabis ang paggamit ng opioid; 79% sa kanila ang may pananaw na ito. Ilang pasyente na may sakit sa likod ang nagtatantiya na maaaring gamutin ng medical cannabis ang higit sa kalahati ng kanilang sakit sa likod, at isa sa tatlo ay gumagamit na nito.

Ang gastos ay isang pangunahing hadlang sa paggamit ng medical cannabis sa mga pasyente na dumadating para sa mga reklamo sa kamay at upper-extremity. Habang ang kasalukuyang ebidensya ay nagpapakita ng epektibidad at kaligtasan para sa chronic musculoskeletal at neuropathic na sakit, dapat mong talakayin ang mga opsyong ito sa iyong surgeon. Matutulungan ka nito na bigyang-katwiran ang mga potensyal na benepisyo laban sa mga gastos at indibidwal na panganib, tulad ng ugnayan sa pagtaas ng paggamit ng opioid sa surgery ng joint replacement.

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on patient-reported outcomes versus placebo at 1-year follow-up after arthroscopic rotator cuff repair [1].
  • Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without long-term functional deficits at 1-year follow-up after arthroscopic rotator cuff repair [2].
  • Cannabis-based medicines are applicable for the treatment of peripheral neuropathy [3].
  • Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty [4].
  • No specific guidance in the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage in total joint arthroplasty [4].
  • Patients estimated medical cannabis could treat more than half of their spine pain [5].
  • One in three patients with spine pain already uses medical cannabis [5].
  • 79% of patients with spine pain believe cannabis could reduce opioid usage [5].
  • Most survey respondents in the orthopaedic sports medicine community believed that CBD has a role in postoperative and chronic pain management [6].
  • Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain [7].
  • Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) [8].
  • Patients presenting for hand and upper-extremity complaints perceive medical cannabis as a safe treatment option for common orthopedic conditions [8].
  • Cost is identified as a major barrier to medical cannabis use in patients presenting for hand and upper-extremity complaints [8].
  • A synthetic form of cannabinoid (THC) does not appear to limit opioid intake after primary total knee arthroplasty [9].
  • Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain regarding medical cannabis in hand surgery [17].
  • Definitive conclusions regarding the efficacy of medical cannabis in hand and upper extremity conditions require continued investigation [17].

How It Works

  • Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on patient-reported outcomes at 1-year follow-up after arthroscopic rotator cuff repair [1].
  • Buccally absorbed cannabidiol (CBD) demonstrates an acceptable safety profile and shows significant promise in reducing pain in the immediate peri-operative period following arthroscopic rotator cuff repair compared to control [14].
  • Patients estimated that medical cannabis could treat more than half of their spine pain [5].
  • One in three patients with spine pain were already using medical cannabis [5].
  • 79% of patients with spine pain believe that cannabis could reduce opioid usage [5].
  • Most survey respondents in the orthopaedic sports medicine community believed that cannabidiol (CBD) has a role in postoperative and chronic pain management [6].
  • Cost is identified as a major barrier to the use of medical cannabis among patients presenting for hand and upper-extremity complaints [8].
  • A majority of sports medicine surgeons believe that cannabidiol (CBD) has a role in post-operative and chronic pain management [10].
  • Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after total hip arthroplasty to help guide orthopaedic surgeons in counseling patients [11].
  • Cannabis-based medicine did not provide clinical improvement in pain compared with a placebo in patients with traumatic brachial plexus injuries [12].
  • Patients with documented cannabis dependence demonstrated higher odds of developing wound complications following hand and wrist soft-tissue surgical procedures [15].

What the Evidence Shows

  • Cannabidiol (CBD) use after arthroscopic rotator cuff repair demonstrates no deficits in patient-reported outcomes versus placebo at 1-year follow-up [1].
  • Cannabidiol (CBD) use after arthroscopic rotator cuff repair demonstrates no functional deficits at 1-year follow-up [2].
  • Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on outcome [1].
  • Cannabidiol (CBD) can be considered in a post-operative multimodal pain management regimen without long-term detrimental effects [2].
  • Buccally absorbed cannabidiol (CBD) demonstrates an acceptable safety profile following arthroscopic rotator cuff repair [14].
  • Buccally absorbed cannabidiol (CBD) shows significant promise in reduction of pain in the immediate peri-operative period following arthroscopic rotator cuff repair compared to control [14].
  • One in three patients with spine pain already use medical cannabis [5].
  • Most survey respondents in the orthopaedic sports medicine community believe that CBD has a role in postoperative and chronic pain management [6].
  • Cost is identified as a major barrier to medical cannabis use among patients presenting for hand and upper-extremity complaints [8].
  • A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management [10].
  • Cannabis use does not affect outcomes after total hip arthroplasty [11].
  • Cannabis-based medicine did not provide clinically important benefit as an adjuvant to standard multimodal drug therapy for neuropathic pain in traumatic brachial plexus injuries [16].
  • Higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing total joint arthroplasty [13].

Practical Considerations

  • Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without long-term detrimental effects after arthroscopic rotator cuff repair [2].
  • Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their pain [7].

Key Evidence

  • [L2] These findings suggest that CBD can be considered in a postoperative multimodal pain management regimen without detrimental effects on outcome. [1] (10.1177/23259671231222265)
  • [L2] These findings suggest that CBD can be considered in a post-operative multimodal pain management regimen without long-term detrimental effects. [2] (10.1177/2325967123s00172)
  • [L2] These findings suggest the applicability of cannabis-based medicines for peripheral neuropathy. [3] (10.1016/j.jhsa.2024.09.015)
  • [Paper] Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty, and no specific guidance in the use of cannabis in perioperative pain management can be suggested based on this discovery. [4] (10.1097/corr.0000000000003472)
  • [L4] Patients estimated medical cannabis could treat more than half of their spine pain, with one in three patients already using medical cannabis, and 79% of patients believe cannabis could reduce opioid usage. [5] (10.1186/s13018-024-04558-6)
  • [L4] Most survey respondents believed that CBD has a role in postoperative and chronic pain management. [6] (10.1177/23259671231191766)
  • [L4] Large numbers of these patients would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain. [7] (10.1016/j.jhsa.2021.10.018)
  • [L3] Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) and perceive it as a safe treatment option for common orthopedic conditions, with cost identified as a major barrier to use. [8] (10.1016/j.jhsg.2022.02.009)
  • [L1] Despite enthusiasm for cannabis after orthopaedic surgical procedures, this THC does not appear to limit opioid intake after primary TKA. [9] (10.1016/j.arth.2026.02.047)
  • [L4] A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management. [10] (10.1177/2325967123s00336)
  • [L3] Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after THA to help guide orthopaedic surgeons in counseling patients. [11] (10.1016/j.arth.2023.03.040)
  • [L1] Cannabis-based medicine did not provide clinical improvement in pain compared with a placebo in patients with traumatic brachial plexus injuries. [12] (10.1097/corr.0000000000003221)
  • [L1] Higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing TJA. [13] (10.1016/j.arth.2023.07.008)
  • [L1] Buccally absorbed CBD demonstrates an acceptable safety profile and shows significant promise in reduction of pain in the immediate peri-operative period following ARCR compared to the control. [14] (10.1016/j.jse.2023.02.032)
  • [L2] Patients with documented cannabis dependence demonstrated higher odds of developing wound complications following hand and wrist soft-tissue surgical procedures. [15] (10.1016/j.jhsg.2026.100948)
  • [Paper] This is a commentary on a randomized controlled trial by Kittithamvongs et al., which found no clinically important benefit to cannabis-based treatment as an adjuvant to standard multimodal drug therapy for neuropathic pain in traumatic brachial plexus injuries. [16] (10.1097/corr.0000000000003265)
  • [L4] Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain, but definitive conclusions regarding efficacy in hand and upper extremity conditions require continued investigation. [17] (10.1016/j.jhsa.2022.11.008)

References

[1] Cannabidiol for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair Demonstrates No Deficits in Patient-Reported Outcomes Versus Placebo: 1-Year Follow-up of a Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/23259671231222265

[2] Poster 186: Cannabidiol for Post-Operative Pain Control after Arthroscopic Rotator Cuff Repair Demonstrates No Functional Deficits at 1-Year. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00172

[3] The Use of Cannabinoids in the Treatment of Peripheral Neuropathy and Neuropathic Pain: A Systematic Review. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.09.015

[4] CORR Insights®: Do Medical and Recreational Marijuana State Laws Impact Trends in Postoperative Opioid Prescriptions Among Patients Who Have Undergone TJA?. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003472

[5] Perceptions in orthopedic surgery on the use of cannabis in treating pain: a survey of patients with spine pain (POSIT Spine). Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-04558-6

[6] Perceptions and Opinions on Cannabidiol in the Orthopaedic Sports Medicine Community. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/23259671231191766

[7] Assessment of Medical Cannabis in Patients With Osteoarthritis of the Thumb Basal Joint. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2021.10.018

[8] Hand Surgery Patient Perspectives on Medical Cannabis: A Survey of Over 600 Patients. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2022.02.009

[9] A Synthetic Form of Cannabinoid Does Not Decrease Opioid Use After Total Knee Arthroplasty: A Prospective, Randomized, Triple-Blind, Placebo-Controlled Study. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.02.047

[10] Poster 373: Perceptions & Opinions on Cannabidiol Among Sports Medicine Orthopaedic Surgeons. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00336

[11] Cannabis Use Does Not Affect Outcomes After Total Hip Arthroplasty. The Journal of Arthroplasty. 2023. DOI: 10.1016/j.arth.2023.03.040

[12] Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. Clinical Orthopaedics & Related Research. 2024. DOI: 10.1097/corr.0000000000003221

[13] Cannabis Use Following Total Joint Arthroplasty is Associated With Increased Risks? A Meta-Analysis. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.07.008

[14] Effects Of Cannabidiol On Post-Operative Pain Following Arthroscopic Rotator Cuff Repair. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.02.032

[15] Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.100948

[16] CORR Insights®: Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. Clinical Orthopaedics & Related Research. 2024. DOI: 10.1097/corr.0000000000003265

[17] Medical Cannabis in Hand Surgery: A Review of the Current Evidence. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.11.008

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1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.