The Challenge of Pain Management
As anyone who has experienced back problems like sciatica, slipped disc, or spinal stenosis can tell you, persistent pain is far and away the most difficult symptom. And a great deal of spine patients suffer chronically; according to the American Academy of Pain Medicine, “[m]ore than 26 million Americans between the ages of 20-64 experience frequent back pain.”  A big aspect of treatment and care for this population entails minimizing and managing it.
Lately, as an increasing number of states have allowed medical use of marijuana, there’s been increasing interest in assessing this substance as means to take on back pain. Research is growing—especially as this substance increasingly enters the mainstream market—but federal prohibition has certainly slowed progress.
Still, there is a body of work that indeed points to the potential for marijuana as a means to help with back pain.  Let’s take a closer look at how this works and the evidence for it.
The marijuana plant contains a number of different compounds, each with different effects on the body and mind. The compounds associated with the “high” experienced from the drug are in the tetrahydrocannabinol (THC) family, but it’s another compound, cannabidiol (CBD) that’s been most prominently linked with therapeutic effects. 
CBD is not psychoactive, so when it’s isolated from the other compounds, you don’t get the psychological effects and intoxication associated with marijuana use. This makes it much less controversial. Not only are strains marijuana being cultivated that contain virtually no THC, but extracts of just CBD, usually in the form of oil, are available in states where medical marijuana is offered.
CBD & The Body
What is it about CBD that makes it potentially effective in taking on spine pain? This compound stimulates a part of the brain called the cannabinoid system. This stimulation helps reduce the intensity of pain and aids in the reduction of inflammation in the body. It also provides an alternate path for pain management. Where typical pain killing drugs tend to be opioids are effective but both habit-forming and associated with numerous side-effects, with CBD, researchers are finding reduced central nervous effects. 
It’s promising, then, that this compound has been observed to help mitigate acute and chronic pain problems. Here’s a quick breakdown of a some of the findings in the literature:
Chronic & Acute Pain Management: A review of the literature published in the journal, Current Neuropharmocology, outlined the pathways by which the cannabinoid system aids in chronic and acute pain management. It noted that results are promising, and the use of CBD or cannabis-based treatments may offer pain relief and “suggest new therapeutic approaches to avoid central nervous system side effects.”  The researches also noted its anti-inflammatory action as beneficial.
Significant Effects: In a more recent review of the existing literature, Dr. Kevin P. Hill and his team assessed the state of research surrounding CBD and cannabis. They hold that, though more research is needed, there is a distinct pain managing effect with this approach. In addition, as with the above study, much of the promise with this approach resides in its ability to reduce potentially harmful opioids to minimize pain conditions. 
Degenerative Disc Disease: A recent study of mice with degenerative disc disease found outcomes much improved with high doses of CBD. Though the exact pathway is not yet known, researchers found reduced damage to spine areas in their experimental population. 
Certainly, as CBD and the other compounds are researched more, and as applications for pain management further tested, a consensus about healthy use, advantages, and disadvantages will emerge. Still, it does seem that evidence is mounting in favor this potential use.
” American Academy Of Pain Medicine – Get The Facts On Pain “. 2018. Org. Accessed March 12 2018. http://www.painmed.org/patientcenter/facts_on_
“What Is Cannabidiol? | Project CBD”. 2018. Org. Accessed March 12 2018. https://www.projectcbd.org/about/what-cbd.
Manzanares J, et al. 2018. “Role Of The Cannabinoid System In Pain Control And Therapeutic Implications For The Management Of Acute And Chronic Pain Episodes. – Pubmed – NCBI “. Nlm.Nih.Gov. Accessed March 12 2018. https://www.ncbi.nlm.nih.gov/pubmed/?term=Role+of+the+cannabinoid+system+in+p
Hill, Kevin P., Matthew D. Palastro, Brian Johnson, and Joseph W. Ditre. 2017. “Cannabis And Pain: A Clinical Review”. Cannabis And Cannabinoid Research2 (1): 96-104. Mary Ann Liebert Inc. doi:10.1089/can.2017.0017.
“Cannabis For Back Pain And Degenerative Disc Disease”. 2018. Net. Accessed March 12 2018. https://cannabis.net/blog/medical/cannabis-for-back-pain-and-degenerative-disc-disease.
“How CBD Oil Helped My Back Pain – CBD School”. 2017. CBD School. Accessed March 12 2018. https://cbdschool.com/how-cbd-oil-helped-my-back-pain/.