Photo by Jernej Graj

Cannabis Topicals: Pain-Relief Without the High

In 1998, I was in a severe accident that separated and dislocated my shoulder, and left my clavicle fractured in two places. I’d been an athlete all my life, experiencing an assortment of bumps, bruises, and breaks along the way, but this was by far the most severe, pervasive pain I had ever experienced. With time, the breaks, cracks, and tears healed, and I regained stability in my shoulder. The lingering effects of the tissue scarring, however, were an entirely different matter.

Tissue scarring might not sound like much, but the bone-deep pain it generated was debilitating. It compressed nerves, restricted my movement and prevented me from sleeping at night. For nearly two decades worth of countless doctors’ visits, the solution was a rainbow assortment of painkillers and muscle relaxants of increasing potencies. In addition to offering minimal improvement and axing my productivity, these meds also turned me into a drugged, lethargic and dizzy excuse of a person.

I had tried medical marijuana in the past, but couldn’t tolerate its psychoactive effects and had little hope that it would work for me. But pain demands attention, and I eventually tried a homemade cannabis-infused topical muscle rub. Within an hour, I experienced increased movement and I slept pain-free that night for the first time in nearly twenty years!

I awoke feeling ‘off’ the next morning. I was no longer in active pain and after two decades of painful nights, I had forgotten what it had felt like.

How Cannabis-Infused Topicals Work

“The skin possesses a robust capacity to synthesize and respond to cannabinoids,” states a dermatological paper from the American Chemical Society (ACS). Although many sources available today suggest that cannabinoids work on the skin by activating its endocannabinoid receptors, the truth is that we don’t know for certain.

The same paper from the ACS demonstrates that topical cannabis does work to regulate pain, inflammation, homeostasis, and balance. Yet, at this point in time, its authors can only hypothesize the processes involved in achieving these effects.

Why We Don’t Get High on Topicals

Again, the simplest answer here is that we are uncertain why most mammals do not get high from topically-applied cannabis, including topicals with high amounts of THC.

Some researchers believe that topicals do not produce cerebral effects because they primarily work on the skin’s CB2 receptors, the endocannabinoid receptors involved in immune regulation and inflammatory response. These receptors are not known for activating mental highs, like their cousins, CB1 receptors. (To learn more about CB1 and CB2 receptors, visit our primer on the endocannabinoid system.)

It’s worth noting that transdermal patches work differently, and are designed to deliver cannabinoids through the skin and into the bloodstream. For this reason, these patches can induce highs. However, at this time, transdermal patches are not legally available in Canada.

What Can Cannabis-Infused Topicals Treat?

Anecdotal evidence suggests that topicals can treat localized pain, muscle tension, inflammation, and itchy skin conditions — and what little research is available backs it up. One mouse study also showed that topically-applied THC decreased allergic skin reactions.

Although there is still much to learn about how and why topicals work, the results of another study suggest that they could be used in the future to treat pruritus, inflammatory skin diseases and skin cancer.

As for me, I’m sure I’m not alone in welcoming the day when science can explain exactly how and why topicals work to reduce my pain. But for now, I’m just grateful they do.