Strong Evidence Supports Cannabinoids for MS Spasticity and Pain

Two high-quality systematic reviews concluded that nabiximols, oral cannabis extract, and synthetic THC are probably effective for reducing patient-reported spasticity and central pain in multiple sclerosis.

Rice, Jessica et al.·Current neurology and neuroscience reports·2018·Strong EvidenceReview
RTHC-01811ReviewStrong Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Strong Evidence
Sample
Not reported

What This Study Found

Nabiximols (Sativex), oral cannabis extract (OCE), and synthetic THC are probably effective for patient-reported spasticity and central pain in MS. However, OCE and synthetic THC did not reduce physician-measured spasticity scores. Cannabinoids were generally well-tolerated, though risks include psychosis in at-risk individuals and cardiovascular events.

Key Numbers

Most study participants used 20-40 mg of THC daily in divided doses. Cannabinoids were the only complementary/alternative medicine intervention with strong evidence in MS. Adverse events were more common with cannabinoids but serious adverse events were rare.

How They Did This

Review synthesizing findings from two recent high-quality systematic reviews of cannabinoid use in MS, with discussion of available formulations and dosing.

Why This Research Matters

MS patients frequently deal with spasticity and pain that are difficult to control with conventional medications. This review provides the strongest available evidence base for using cannabinoids as a treatment option for these symptoms.

The Bigger Picture

MS was one of the first neurological conditions to generate high-quality cannabinoid research. The evidence here represents a model for how cannabinoid therapies can be rigorously evaluated and has influenced medical cannabis policies worldwide.

What This Study Doesn't Tell Us

Patient-reported spasticity improvements did not match physician-measured scores, raising questions about the nature of the benefit. Optimal dosing remains uncertain. Long-term safety data is limited.

Questions This Raises

  • ?Why do patient-reported and physician-measured spasticity outcomes differ?
  • ?What is the optimal THC:CBD ratio for MS symptoms?
  • ?Could lower doses be equally effective with fewer side effects?

Trust & Context

Key Stat:
20-40 mg of THC daily in divided doses was the effective range in most clinical trials for MS symptoms.
Evidence Grade:
Strong - based on two high-quality systematic reviews of clinical trials, the highest level of evidence available.
Study Age:
Published in 2018.
Original Title:
Cannabinoids for Treatment of MS Symptoms: State of the Evidence.
Published In:
Current neurology and neuroscience reports, 18(8), 50 (2018)
Database ID:
RTHC-01811

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Does cannabis help with MS symptoms?

Two high-quality systematic reviews found strong evidence that nabiximols, oral cannabis extract, and synthetic THC are probably effective for reducing patient-reported spasticity and central pain in MS. Most participants used 20-40 mg THC daily.

What form of cannabis works best for MS?

Nabiximols (Sativex oral spray), oral cannabis extract, and synthetic THC all showed effectiveness for MS spasticity and pain. Nabiximols is the most studied and is approved for MS spasticity in several countries.

Read More on RethinkTHC

Cite This Study

RTHC-01811·https://rethinkthc.com/research/RTHC-01811

APA

Rice, Jessica; Cameron, Michelle. (2018). Cannabinoids for Treatment of MS Symptoms: State of the Evidence.. Current neurology and neuroscience reports, 18(8), 50. https://doi.org/10.1007/s11910-018-0859-x

MLA

Rice, Jessica, et al. "Cannabinoids for Treatment of MS Symptoms: State of the Evidence.." Current neurology and neuroscience reports, 2018. https://doi.org/10.1007/s11910-018-0859-x

RethinkTHC

RethinkTHC Research Database. "Cannabinoids for Treatment of MS Symptoms: State of the Evid..." RTHC-01811. Retrieved from https://rethinkthc.com/research/rice-2018-cannabinoids-for-treatment-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.