People with neuropathy are often desperate for relief. The causes of this nerve pain may vary, from drug side effects to the aftermath of an infection. Sometimes too little or too much of a common vitamin can trigger constant pain or numbness and tingling. Diabetes also frequently causes neuropathy. Doctors may prescribe medications such as gabapentin (Neurontin) or pregabalin (Lyrica), and sometimes these are helpful. However, many readers are curious about the potential for cannabis cream to alleviate nerve pain. A few share their experience below.
Managing Neuropathy:
Q. I have experienced neuropathy in my feet for many years. For almost as long, I have taken gabapentin, benfotiamine, vitamin B12 and alpha-lipoic acid daily.
I’ve quit drinking completely, and my A1c is around 6.7. I still have problems with burning or tingling in my feet when I go to sleep or wake up.
Capsaicin cream has helped, but here’s what really works: creams that are 1:1 THC:CBD. No, you do not get high.
A. Thank you for sharing your experience. High-dose topical capsaicin (8 percent) appears to be well-tolerated and helpful for easing diabetic neuropathy symptoms (Expert Review of Neurotherapeutics, March 2021).
Scientists have not run many good clinical trials on the cannabis-containing creams you describe. We found one small study in which CBD (cannabidiol) oil applied topically eased pain due to peripheral neuropathy (Current Pharmaceutical Biotechnology, 2020).
Controlling blood sugar and HbA1c (a measure of blood sugar control over several weeks) are the first steps in preventing diabetic neuropathy. Giving up alcohol consumption is also likely to help.
Will Cannabis Cream Help?
Q. Have there been any studies on the use of cannabis cream to relieve the burning and tingling of neuropathy in one’s feet? I have a jar of cream that contains cannabis (along with several other herbal ingredients) but I am somewhat hesitant to use it. I live in a state where marijuana is legal, so that is not the problem.
Limited Research on Cannabis Cream:
A. There is limited evidence to support topical cannabis for neuropathy (Hauser et al, Deutsches Arzteblatt, Sept. 22, 2017). However, several studies suggest that inhaled marijuana may offer relief for some people with this painful condition (Journal of Pain, Dec. 2015 and June 2016).
A recent overview of research concludes that long-term risks of such treatment have not been well studied (Mucke et al, Cochrane Database of Systematic Reviews, March 7, 2018). The scientists point out that some people who start using cannabis cream or other forms of marijuana medicinally may later turn to abusing this drug. They are not sure that the benefits outweigh the potential harms. On the other hand, they might say the same about medications approved to treat neuropathy.
A Cochrane review of gabapentin for this purpose concludes:
“Over half of those treated with gabapentin will not have worthwhile pain relief but may experience adverse events.”
(Wiffen et al, Cochrane Database of Systematic Reviews, June 9, 2017).
Cannabis for Diabetic Neuropathy:
One complication of diabetes is diabetic neuropathy, severe pain due to nerve damage. People often find it difficult to alleviate the pain of neuropathy. Consequently, we were interested to learn of this reader’s experience easing the agony with a low dose of medical marijuana.
How Can Diabetic Neuropathy Be Soothed?
Q. I have severe diabetic neuropathy. The pain is intense, but it lasts only a short time and can occur anywhere: on the left big toe one time, right little finger the next, left testicle, right earlobe etc.
None of the drugs my doctor prescribed worked very well, and they all took weeks or months to do anything. Even then, they had to keep increasing the dosage, and I suffered worse side effects each time.
Someone suggested I try something that never occurred to me: marijuana. I took two puffs, waited about twenty seconds and the pain was gone–for three days! That was the fastest and longest relief I have ever gotten. I am excited about this possibility.
Will Marijuana Help Diabetic Neuropathy?
A. There has not been much research on the use of medical marijuana for diabetic neuropathy, but we found one study that is of interest. Sixteen people with painful diabetic neuropathy that had not responded well to other treatments participated in a placebo-controlled trial of inhaled marijuana at various doses (Wallace et al, Journal of Pain, July, 2015). In this small study, several doses significantly reduced neuropathy pain.
In another study, 42 people with neuropathy due to spinal cord injury experienced pain relief when they inhaled cannabis vapor (Wilsey et al, Journal of Pain, Sep. 2016). We agree that more research will be very helpful. People interested in learning about research that has already been done on medical marijuana may wish to listen to our hour-long interview with David Casarett, MD, author of Stoned: A Doctor’s Case for Medical Marijuana.
