Cannabis for Pain and Headaches: What Physicians Need to Know | Research

The takeaway

Cannabis compounds including phytocannabinoids, terpenes, and flavonoids show analgesic and anti-inflammatory potential, with dronabinol and nabilone already FDA-approved for other conditions.

Read this if you want an overview of the different cannabis compounds that may help with pain and headaches.

Dronabinol and nabilone are already FDA-approved; nabiximols is approved in Canada and the UK

What the researchers found

This primer reviewed the landscape of cannabis-based pain treatment for physicians, covering three main categories of active compounds.

Synthetic cannabinoids like dronabinol and nabilone have already received FDA approval for chemotherapy-related nausea and HIV wasting, providing a regulatory pathway for cannabinoid medicines. Nabiximols (Sativex), a cannabis extract, is approved in Canada and the UK for spasticity and intractable pain.

Beyond THC and CBD, phytocannabinoids have been identified as key compounds with analgesic and anti-inflammatory properties. The review also highlighted other cannabis compounds, including flavonoids and terpenes, that are being investigated for their individual effects and potential synergistic interactions (the "entourage effect").

The authors emphasized the endocannabinoid system as the biological foundation for these effects, noting that the identification of this intrinsic system has opened doors for further research into cannabis-based pain therapies.

Why it matters

This review serves as a practical primer for physicians who are increasingly asked about cannabis for pain. By organizing the evidence around specific compounds and approved medications, it provides a framework for evidence-based clinical conversations.

The numbers in context

Dronabinol and nabilone are FDA-approved. Nabiximols is approved in Canada and the UK. Clinical trials for seizure disorders were ongoing at publication.

How the study worked

Narrative review of medical literature on cannabis and cannabinoid pharmaceuticals, with emphasis on pain and headache conditions. Covers synthetic cannabinoids, phytocannabinoids, and other cannabis-derived compounds.

What this study cannot tell us

Narrative review without systematic methodology or quality assessment. Does not present original data. The headache-specific evidence is particularly sparse. Published before major developments in CBD regulation.

How to read the evidence

Narrative review aimed at clinical education. Moderate because it synthesizes existing evidence but does not conduct systematic analysis.

When this study was published

Published in 2017.

The bigger picture

The review reflects a shift from viewing cannabis as a single substance to understanding it as a complex plant with multiple potentially therapeutic compounds. This more nuanced pharmacological perspective moves the conversation beyond "does cannabis help pain" toward "which cannabis compounds, at what doses, for which types of pain."

Questions still open

Could specific terpene-cannabinoid combinations be optimized for different pain types? Does the entourage effect hold up under rigorous clinical testing? Are there headache-specific cannabinoid formulations worth developing?

Common questions

Are there FDA-approved cannabis medications for pain?

As of this review, dronabinol and nabilone are FDA-approved for nausea and HIV wasting, not directly for pain. Nabiximols (a cannabis extract) is approved for pain and spasticity in Canada and the UK but not the US.

Can cannabis help with headaches?

The review covers cannabis for pain including headaches, but notes that the headache-specific evidence is limited. The analgesic and anti-inflammatory properties of cannabinoids suggest potential, but clinical trials for headaches are needed.

Read the original research

Cannabis for Pain and Headaches: Primer.

Current pain and headache reports, 21(4), 19

View on PubMed ↗Publisher’s paper ↗

Citation

Kim, Philip S; Fishman, Michael A. (2017). Cannabis for Pain and Headaches: Primer.. Current pain and headache reports, 21(4), 19. https://doi.org/10.1007/s11916-017-0619-7