In 150 patients, medical cannabis did not improve physical functioning, but CBD-only products helped spasticity patients with sleep, fatigue, and pain, while THC-containing products helped spasm patients similarly.
Neurologists, rehabilitation specialists, medical cannabis prescribers, patients with spasticity
Improvements in sleep, fatigue, pain but zero improvement in physical functioning
What the researchers found
No physical functioning improvements for any group or product type. Spasticity patients using CBD-only products improved in sleep disturbance, fatigue, pain interference, and pain intensity. Spasm patients using balanced, CBD-dominant, or THC-dominant products improved in those same four outcomes. Common adverse events: dry mouth, drowsiness, fatigue, dizziness, nausea.
Why it matters
Conventional spasticity treatments have poor effectiveness or tolerability. Medical cannabis may help manage secondary symptoms even when it does not address the underlying physical impairment.
The numbers in context
150 patients (adverse events), 78 (outcomes). CBD-only improved 4 outcomes for spasticity. Balanced/CBD-dominant/THC-dominant improved 4 outcomes for spasms. Zero physical functioning improvement.
How the study worked
Longitudinal study with patient surveys, clinic records, and PROMIS-29 scores. 150 patients reported adverse events, 78 reported outcomes. Different product types compared.
What this study cannot tell us
No control group. Self-reported outcomes. Small outcome sample (n=78). Product types not randomly assigned.
How to read the evidence
Longitudinal design with validated outcomes, but lack of control group limits causal claims.
When this study was published
2026 publication
The bigger picture
Medical cannabis may be most useful as an adjunct that improves quality of life around a condition rather than reversing the condition itself.
Questions still open
- Why did CBD-only work for spasticity but not spasms? Would combining cannabis with physical therapy improve functional outcomes?
Common questions
Can cannabis treat muscle spasticity?
Which type of cannabis worked best?
Read the original research
Investigating the effectiveness and adverse events of medicinal cannabis for patients with muscle spasticity or spasms.
The Journal of pharmacology and experimental therapeutics, 393(1), 103780
Citation
Nastatos, Xenia L; Schubert, Elise A; Wheate, Nial J. (2026). Investigating the effectiveness and adverse events of medicinal cannabis for patients with muscle spasticity or spasms.. The Journal of pharmacology and experimental therapeutics, 393(1), 103780. https://doi.org/10.1016/j.jpet.2025.103780
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