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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.

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 ito

Ang cannabidiol (CBD) ay isang hindi psychoactive na compound na matatagpuan sa cannabis. Madalas itong ginagamit bilang bahagi ng multimodal na plano sa pamamahala ng sakit pagkatapos ng operasyon. Halimbawa, ang mga pag-aaral tungkol sa arthroscopic rotator cuff repair ay nagpapakita na ang paggamit ng CBD ay hindi nagdudulot ng mga kakulangan sa mga resulta na iniulat ng pasyente o sa functional recovery sa isang-taong follow-up kumpara sa placebo. Ang buccally absorbed na CBD ay nagpapakita ng pangako din sa pagbabawas ng sakit sa agwat na panahon pagkatapos ng ganitong uri ng operasyon.

Maaari mong isaalang-alang ang medical cannabis para sa chronic musculoskeletal o neuropathic na sakit. Ang peripheral neuropathy ay pinsala sa mga nerbiyos na nagdudulot ng sakit, pamamanhid, o pangangati. Ang mga gamot na batay sa cannabis ay angkop para sa paggamot sa kondisyong ito. Ang mga pasyente na may sakit sa likod ay nagtatantya na ang medical cannabis ay maaaring gamutin ang higit sa kalahati ng kanilang sakit. Isa sa tatlong pasyente na may sakit sa likod ay gumagamit na ng medical cannabis. Bukod dito, 79% ng mga pasyenteng ito ay naniniwala na ang cannabis ay maaaring bawasan ang paggamit ng opioid.

Ang interes sa medical cannabis ay mataas din sa mga pasyente na may mga reklamo sa kamay at upper extremity. Karamihan sa mga pasyente sa grupong ito ay handang isaalang-alang ang paggamit ng medical cannabis (80.9%). Tinatanggap nila ito bilang isang ligtas na opsyon sa paggamot para sa karaniwang mga kondisyon sa orthopedics. Malaking bilang ng mga pasyente na may osteoarthritis ng thumb basal joint ay interesado sa pagsubok ng oral o topical na mga formulasyon. Gayunpaman, ang gastos ay itinuturing na pangunahing hadlang sa paggamit para sa maraming pasyente.

Habang 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, ang mga definitive na konklusyon para sa mga kondisyon sa kamay at upper extremity ay nangangailangan ng patuloy na imbestigasyon. Ang regular na paggamit ng cannabis ay maaaring magkaroon ng kinalaman sa pagtaas ng paggamit ng opioid sa total joint arthroplasty. Ang mga pasyente na may dokumentadong cannabis dependence ay nagpakita ng mas mataas na odds ng pag-unlad ng mga komplikasyon sa sugat pagkatapos ng mga surgical procedures sa malambot na tisyu ng kamay at pulso. Ang iyong doktor ay makakatulong sa iyo na bigyang-kahulugan ang mga salik na ito.

Gumagana ba ito?

Ang sagot ay nakadepende sa iyong partikular na kondisyon at sa uri ng operasyon na gagawin mo. Para sa ilang mga prosedura, ipinapakita ng mga produkto ng cannabis na may pangako. Para sa iba, hindi ito nag-aalok ng malinaw na benepisyo o maaari pa ring magdulot ng mga problema.

Kung ikaw ay gagawa ng arthroscopic rotator cuff repair, ang kamakailang ebidensya ay nagpapahiwatig na ligtas ang paggamit ng cannabidiol (CBD). Hindi ito nagdudulot ng anumang kakulangan sa iyong mga resulta na ulit-ulitin ng pasyente o sa functional recovery sa 1-taong follow-up kumpara sa placebo. Sa katunayan, ipinapakita ng buccally absorbed CBD ang malaking pangako sa pagbawas ng sakit sa agarang peri-operative na panahon pagkatapos ng operasyong ito. Maaaring isaalang-alang ng iyong doktor ang pagdaragdag nito sa iyong postoperative na multimodal na regimen ng pamamahala ng sakit nang walang pangmatagalang nakakasamang epekto.

Gayunpaman, halong-halo ang ebidensya para sa ibang mga kondisyon. Para sa mga pasyente na may traumatic brachial plexus injuries, hindi nagbigay ng klinikal na pagpapabuti sa sakit o kalidad ng tulog ang gamot na batay sa cannabis kumpara sa placebo. Walang klinikal na mahalagang benepisyo sa paggamit nito bilang karagdagan sa pamantayang gamot na terapiya para sa uri ng pinsala sa nerbiyos na ito.

Maaari ring maging realistiko ang iyong mga inaasahan tungkol sa joint replacements. Ang regular na paggamit ng cannabis ay maaaring magkaugnay sa pagtaas ng paggamit ng opioid sa konteksto ng total joint arthroplasty. Ang paggamit ng cannabis pagkatapos ng total joint arthroplasty ay may kaugnayan sa pagtaas ng mga panganib. Habang tila hindi limitahan ng isang sintetikong anyo ng cannabinoid (THC) ang pag-inom ng opioid pagkatapos ng primary total knee arthroplasty, kailangan ng mga mas mataas na antas na pag-aaral upang lubos na maunawaan ang epekto. Walang partikular na gabay na maaaring mungkahi sa kasalukuyan batay sa mga ugnayang ito.

Maraming pasyente ang naniniwala sa potensyal nito. Inaangkin ng mga pasyente na maaaring gamutin ng medical cannabis 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 maaaring bawasan ng cannabis ang paggamit ng opioid. Sa pag-aalaga sa kamay at itaas na ekstremitas, karamihan sa mga pasyente ay handang isaalang-alang ang paggamit ng medical cannabis, at maraming bilang ng mga pasyente na may osteoarthritis ng thumb basal joint ay interesado na subukan ito.

Sa kabila ng interes na ito, ang gastos ay nakikilala bilang isang pangunahing hadlang sa paggamit ng medical cannabis sa mga pasyente na dumadating para sa mga reklamo sa kamay at itaas na ekstremitas. Dapat mong bukas na talakayin ang mga halong-halong resulta na ito sa iyong doktor upang matukoy kung ito ay ligtas at angkop na bahagi ng iyong plano ng paggaling.

Tama ba ito para sa iyo?

Maraming pasyente ang nakakakita ng tulong mula sa cannabis para sa mga partikular na uri ng sakit. Maaari itong maging magandang opsyon kung mayroon kang nerve pain sa iyong mga limb o wear-and-tear arthritis sa thumb joint. Karamihan sa mga may spine pain ay naniniwala na maaari itong makatulong, at marami na sa kanila ang gumagamit nito. Sa totoo lang, 79% ng mga pasyente na may spine pain ay naniniwala na maaari nitong bawasan ang pangangailangan nila para sa opioid painkillers. Kung mayroon kang hand o upper-arm issues, 80.9% ng mga pasyente tulad mo ay mag-iisip na subukan ang medical cannabis. Karamihan sa kanila ay nakikita ito bilang isang ligtas na pagpipilian para sa mga karaniwang problema na ito.

Para sa joint replacements, ang larawan ay halo-halo. Ang paggamit ng cannabis pagkatapos ng hip o knee replacement ay tila hindi nagbabago ng iyong mga final results. Gayunpaman, ang regular na paggamit ay maaaring magresulta sa pagkuha ng mas maraming opioids pagkatapos ng mga operasyong ito. Ito ang dahilan kung bakit hindi maaaring magbigay ng simpleng payo ang iyong doktor tungkol sa paggamit nito sa paligid ng panahon ng malaking joint surgery. Kailangan pa ng mas maraming research upang makagawa ng malinaw na rekomendasyon para sa mga prosedurang ito.

Ang gastos ay isang pangunahing hadlang para sa maraming pasyente na nag-iisip ng paggamot na ito. Ang availability ay nag-iiba depende sa lokasyon at batas. Dahil patuloy pa ring lumalago ang ebidensya, lalo na para sa joint replacements, ito ay dapat na isang shared decision kasama ang iyong doktor. Matutulungan ka nilang bigyang-kahulugan ang mga posibleng benepisyo laban sa mga panganib at gastos. Para sa mga minor surgeries tulad ng rotator cuff repair, ang cannabidiol (CBD) ay tila ligtas at hindi nakakasama sa iyong recovery sa isang taon. Laging kausapin ang iyong care team bago magsimula ng anumang bagong paggamot.

Ang pangunahing aral

Maaari mong isaalang-alang ang cannabidiol (CBD) bilang bahagi ng iyong plano sa pagpapagaan ng sakit pagkatapos ng rotator cuff repair. Walang nakikitang pangmatagalang pinsala ito at maaari itong makatulong sa agad na sakit. Para sa sakit sa likod o kamay, maraming pasyente ang gumagamit nito upang pamahalaan ang mga sintomas o bawasan ang paggamit ng opioids. Gayunpaman, ang regular na paggamit ng cannabis ay maaaring magpalaki ng pangangailangan sa opioids pagkatapos ng joint replacement. Ang iyong doktor ang magbibigay-direksyon sa iyo tungkol sa kaligtasan, gastusin, at kung angkop ba ito sa iyong partikular na operasyon.


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