Cannabis and CBD for Pain Info Evidence
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
What you're feeling
You may be wondering if cannabis or CBD can help manage your pain. Many patients in your position are asking the same question. Some people with spine pain estimate that medical cannabis could treat more than half of their symptoms. In fact, one in three patients with spine pain were already using medical cannabis.
For those with osteoarthritis of the thumb basal joint, large numbers would be interested in trying oral or topical medical cannabis. Most patients seeing doctors for hand and upper-extremity complaints would consider using medical cannabis. They perceive it as a safe treatment option for common orthopedic conditions. However, cost is a major barrier to use for many.
If you have had arthroscopic rotator cuff repair, CBD can be part of your pain plan. It shows no deficits in patient-reported outcomes versus placebo at 1-year follow-up. There are no functional deficits at 1-year follow-up either. You can consider CBD in your postoperative pain management without detrimental effects on outcome or long-term detrimental effects.
Cannabis-based medicines are also applicable for treating peripheral neuropathy. Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain with medical cannabis. For patients undergoing primary total knee arthroplasty, a synthetic form of cannabinoid (THC) does not appear to limit opioid intake.
Be aware that regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty. Because of this link, no specific guidance in the use of cannabis in perioperative pain management can be suggested based on that association.
Most survey respondents in the orthopaedic sports medicine community believed that CBD has a role in postoperative and chronic pain management. Additionally, 79% of patients with spine pain believe cannabis could reduce opioid usage. While definitive conclusions regarding the efficacy of medical cannabis in hand and upper extremity conditions require continued investigation, many find it helpful.
What's actually happening
Your body uses a complex system of receptors to manage pain and inflammation. Cannabidiol, often called CBD, interacts with this system. When you use it after surgery, such as arthroscopic rotator cuff repair, it does not cause deficits in your patient-reported outcomes. This means your satisfaction with the results remains the same as if you had taken a placebo.
At one-year follow-up, CBD use shows no functional deficits. You can consider it part of a postoperative pain management plan without worrying about long-term detrimental effects on your recovery. For many, it helps manage the discomfort without hindering your ability to move or use your shoulder normally.
Cannabis-based medicines are also applicable for treating peripheral neuropathy, which is nerve pain. Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain with medical cannabis. However, regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty, or joint replacement. Because of this link, no specific guidance in the use of cannabis in perioperative pain management can be suggested based on that association.
Patients often look to medical cannabis for relief. Patients with spine pain estimated that medical cannabis could treat more than half of their spine pain. One in three patients with spine pain were already using medical cannabis. Seventy-nine percent of patients with spine pain believe cannabis could reduce opioid usage.
Interest is also high in hand care. Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain. Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis, at 80.9%. Patients perceive medical cannabis as a safe treatment option for common orthopedic conditions.
A synthetic form of cannabinoid (THC) does not appear to limit opioid intake after primary total knee arthroplasty. Most survey respondents in the orthopaedic sports medicine community believed that CBD has a role in postoperative and chronic pain management. However, definitive conclusions regarding the efficacy of medical cannabis in hand and upper extremity conditions require continued investigation. Cost is identified as a major barrier to medical cannabis use among patients presenting for hand and upper-extremity complaints.
What to expect
You may wonder if cannabis or CBD can help manage your pain. Current evidence suggests that CBD can be part of your pain management plan without causing harm to your recovery. For example, after arthroscopic rotator cuff repair, using CBD did not lead to worse patient-reported outcomes or functional deficits at one-year follow-up compared to a placebo. This means you can consider it as part of a multimodal pain management regimen without worrying about long-term detrimental effects on your outcome.
Many patients are interested in these treatments. Most survey respondents in the orthopaedic sports medicine community believe CBD has a role in postoperative and chronic pain management. Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trying oral or topical medical cannabis. In fact, most patients presenting for hand and upper-extremity complaints would consider using medical cannabis, with 80.9% viewing it as a safe treatment option.
However, the evidence is not yet definitive for all conditions. Definitive conclusions regarding the efficacy of medical cannabis in hand and upper extremity conditions require continued investigation. You should also be aware that regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty. Despite this, many patients with spine pain believe cannabis could reduce opioid usage; 79% of them hold this view. Some patients with spine pain estimated that medical cannabis could treat more than half of their spine pain, and one in three were already using it.
Cost is a major barrier to medical cannabis use among patients presenting for hand and upper-extremity complaints. While current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain, you should discuss these options with your surgeon. They can help you weigh the potential benefits against the costs and individual risks, such as the association with increased opioid use in joint replacement surgery.
Evidence & references
Overview
- Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on patient-reported outcomes versus placebo at 1-year follow-up after arthroscopic rotator cuff repair [1].
- Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without long-term functional deficits at 1-year follow-up after arthroscopic rotator cuff repair [2].
- Cannabis-based medicines are applicable for the treatment of peripheral neuropathy [3].
- Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty [4].
- No specific guidance in the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage in total joint arthroplasty [4].
- Patients estimated medical cannabis could treat more than half of their spine pain [5].
- One in three patients with spine pain already uses medical cannabis [5].
- 79% of patients with spine pain believe cannabis could reduce opioid usage [5].
- Most survey respondents in the orthopaedic sports medicine community believed that CBD has a role in postoperative and chronic pain management [6].
- Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain [7].
- Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) [8].
- Patients presenting for hand and upper-extremity complaints perceive medical cannabis as a safe treatment option for common orthopedic conditions [8].
- Cost is identified as a major barrier to medical cannabis use in patients presenting for hand and upper-extremity complaints [8].
- A synthetic form of cannabinoid (THC) does not appear to limit opioid intake after primary total knee arthroplasty [9].
- Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain regarding medical cannabis in hand surgery [17].
- Definitive conclusions regarding the efficacy of medical cannabis in hand and upper extremity conditions require continued investigation [17].
How It Works
- Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on patient-reported outcomes at 1-year follow-up after arthroscopic rotator cuff repair [1].
- Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without long-term functional deficits at 1-year follow-up after arthroscopic rotator cuff repair [2].
- Buccally absorbed cannabidiol (CBD) demonstrates an acceptable safety profile and shows significant promise in reducing pain in the immediate peri-operative period following arthroscopic rotator cuff repair compared to control [14].
- Cannabis-based medicines are applicable for the treatment of peripheral neuropathy [3].
- Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty [4].
- No specific guidance in the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage in total joint arthroplasty [4].
- Patients estimated that medical cannabis could treat more than half of their spine pain [5].
- One in three patients with spine pain were already using medical cannabis [5].
- 79% of patients with spine pain believe that cannabis could reduce opioid usage [5].
- Most survey respondents in the orthopaedic sports medicine community believed that cannabidiol (CBD) has a role in postoperative and chronic pain management [6].
- Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain [7].
- Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) [8].
- Patients presenting for hand and upper-extremity complaints perceive medical cannabis as a safe treatment option for common orthopedic conditions [8].
- Cost is identified as a major barrier to the use of medical cannabis among patients presenting for hand and upper-extremity complaints [8].
- A majority of sports medicine surgeons believe that cannabidiol (CBD) has a role in post-operative and chronic pain management [10].
- A synthetic form of cannabinoid (THC) does not appear to limit opioid intake after primary total knee arthroplasty [9].
- Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after total hip arthroplasty to help guide orthopaedic surgeons in counseling patients [11].
- Cannabis-based medicine did not provide clinical improvement in pain compared with a placebo in patients with traumatic brachial plexus injuries [12].
- Patients with documented cannabis dependence demonstrated higher odds of developing wound complications following hand and wrist soft-tissue surgical procedures [15].
What the Evidence Shows
- Cannabidiol (CBD) use after arthroscopic rotator cuff repair demonstrates no deficits in patient-reported outcomes versus placebo at 1-year follow-up [1].
- Cannabidiol (CBD) use after arthroscopic rotator cuff repair demonstrates no functional deficits at 1-year follow-up [2].
- Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on outcome [1].
- Cannabidiol (CBD) can be considered in a post-operative multimodal pain management regimen without long-term detrimental effects [2].
- Buccally absorbed cannabidiol (CBD) demonstrates an acceptable safety profile following arthroscopic rotator cuff repair [14].
- Buccally absorbed cannabidiol (CBD) shows significant promise in reduction of pain in the immediate peri-operative period following arthroscopic rotator cuff repair compared to control [14].
- Cannabis-based medicines are applicable for the treatment of peripheral neuropathy [3].
- Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty [4].
- No specific guidance in the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage in total joint arthroplasty [4].
- Patients estimated medical cannabis could treat more than half of their spine pain [5].
- One in three patients with spine pain already use medical cannabis [5].
- 79% of patients with spine pain believe cannabis could reduce opioid usage [5].
- Most survey respondents in the orthopaedic sports medicine community believe that CBD has a role in postoperative and chronic pain management [6].
- Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain [7].
- Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) [8].
- Patients presenting for hand and upper-extremity complaints perceive medical cannabis as a safe treatment option for common orthopedic conditions [8].
- Cost is identified as a major barrier to medical cannabis use among patients presenting for hand and upper-extremity complaints [8].
- A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management [10].
- A synthetic form of cannabinoid (THC) does not appear to limit opioid intake after primary total knee arthroplasty [9].
- Cannabis use does not affect outcomes after total hip arthroplasty [11].
- Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after total hip arthroplasty to help guide orthopaedic surgeons in counseling patients [11].
- Cannabis-based medicine did not provide clinical improvement in pain compared with a placebo in patients with traumatic brachial plexus injuries [12].
- Cannabis-based medicine did not provide clinically important benefit as an adjuvant to standard multimodal drug therapy for neuropathic pain in traumatic brachial plexus injuries [16].
- Higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing total joint arthroplasty [13].
Practical Considerations
- Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without detrimental effects on patient-reported outcomes versus placebo at 1-year follow-up after arthroscopic rotator cuff repair [1].
- Cannabidiol (CBD) can be considered in a postoperative multimodal pain management regimen without long-term detrimental effects after arthroscopic rotator cuff repair [2].
- Cannabis-based medicines are applicable for the treatment of peripheral neuropathy [3].
- Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty [4].
- No specific guidance in the use of cannabis in perioperative pain management can be suggested based on the association between regular cannabis use and increased opioid usage in total joint arthroplasty [4].
- Patients estimated medical cannabis could treat more than half of their spine pain [5].
- One in three patients with spine pain already uses medical cannabis [5].
- 79% of patients with spine pain believe cannabis could reduce opioid usage [5].
- Most survey respondents in the orthopaedic sports medicine community believed that CBD has a role in postoperative and chronic pain management [6].
- Large numbers of patients with osteoarthritis of the thumb basal joint would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their pain [7].
- Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) [8].
- Patients presenting for hand and upper-extremity complaints perceive medical cannabis as a safe treatment option for common orthopedic conditions [8].
- Cost is identified as a major barrier to medical cannabis use among patients presenting for hand and upper-extremity complaints [8].
- A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management [10].
- A synthetic form of cannabinoid (THC) does not appear to limit opioid intake after primary total knee arthroplasty [9].
- Cannabis use does not affect outcomes after total hip arthroplasty [11].
- Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after total hip arthroplasty to help guide orthopaedic surgeons in counseling patients [11].
- Higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing total joint arthroplasty [13].
Key Evidence
- [L2] These findings suggest that CBD can be considered in a postoperative multimodal pain management regimen without detrimental effects on outcome. [1] (10.1177/23259671231222265)
- [L2] These findings suggest that CBD can be considered in a post-operative multimodal pain management regimen without long-term detrimental effects. [2] (10.1177/2325967123s00172)
- [L2] These findings suggest the applicability of cannabis-based medicines for peripheral neuropathy. [3] (10.1016/j.jhsa.2024.09.015)
- [Paper] Regular cannabis use may be associated with increased opioid usage in the context of total joint arthroplasty, and no specific guidance in the use of cannabis in perioperative pain management can be suggested based on this discovery. [4] (10.1097/corr.0000000000003472)
- [L4] Patients estimated medical cannabis could treat more than half of their spine pain, with one in three patients already using medical cannabis, and 79% of patients believe cannabis could reduce opioid usage. [5] (10.1186/s13018-024-04558-6)
- [L4] Most survey respondents believed that CBD has a role in postoperative and chronic pain management. [6] (10.1177/23259671231191766)
- [L4] Large numbers of these patients would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain. [7] (10.1016/j.jhsa.2021.10.018)
- [L3] Most patients presenting for hand and upper-extremity complaints would consider using medical cannabis (80.9%) and perceive it as a safe treatment option for common orthopedic conditions, with cost identified as a major barrier to use. [8] (10.1016/j.jhsg.2022.02.009)
- [L1] Despite enthusiasm for cannabis after orthopaedic surgical procedures, this THC does not appear to limit opioid intake after primary TKA. [9] (10.1016/j.arth.2026.02.047)
- [L4] A majority of sports medicine surgeons believe that CBD has a role in post-operative and chronic pain management. [10] (10.1177/2325967123s00336)
- [L3] Further studies are warranted to determine the efficacy and safety of perioperative cannabis use after THA to help guide orthopaedic surgeons in counseling patients. [11] (10.1016/j.arth.2023.03.040)
- [L1] Cannabis-based medicine did not provide clinical improvement in pain compared with a placebo in patients with traumatic brachial plexus injuries. [12] (10.1097/corr.0000000000003221)
- [L1] Higher-level studies are needed to ascertain the impact of cannabis use for patients undergoing TJA. [13] (10.1016/j.arth.2023.07.008)
- [L1] Buccally absorbed CBD demonstrates an acceptable safety profile and shows significant promise in reduction of pain in the immediate peri-operative period following ARCR compared to the control. [14] (10.1016/j.jse.2023.02.032)
- [L2] Patients with documented cannabis dependence demonstrated higher odds of developing wound complications following hand and wrist soft-tissue surgical procedures. [15] (10.1016/j.jhsg.2026.100948)
- [Paper] This is a commentary on a randomized controlled trial by Kittithamvongs et al., which found no clinically important benefit to cannabis-based treatment as an adjuvant to standard multimodal drug therapy for neuropathic pain in traumatic brachial plexus injuries. [16] (10.1097/corr.0000000000003265)
- [L4] Current evidence demonstrates efficacy and safety for chronic musculoskeletal and neuropathic pain, but definitive conclusions regarding efficacy in hand and upper extremity conditions require continued investigation. [17] (10.1016/j.jhsa.2022.11.008)
References
[1] Cannabidiol for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair Demonstrates No Deficits in Patient-Reported Outcomes Versus Placebo: 1-Year Follow-up of a Randomized Controlled Trial. Orthopaedic Journal of Sports Medicine. 2024. DOI: 10.1177/23259671231222265 [2] Poster 186: Cannabidiol for Post-Operative Pain Control after Arthroscopic Rotator Cuff Repair Demonstrates No Functional Deficits at 1-Year. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00172 [3] The Use of Cannabinoids in the Treatment of Peripheral Neuropathy and Neuropathic Pain: A Systematic Review. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.09.015 [4] CORR Insights®: Do Medical and Recreational Marijuana State Laws Impact Trends in Postoperative Opioid Prescriptions Among Patients Who Have Undergone TJA?. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003472 [5] Perceptions in orthopedic surgery on the use of cannabis in treating pain: a survey of patients with spine pain (POSIT Spine). Journal of Orthopaedic Surgery and Research. 2024. DOI: 10.1186/s13018-024-04558-6 [6] Perceptions and Opinions on Cannabidiol in the Orthopaedic Sports Medicine Community. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/23259671231191766 [7] Assessment of Medical Cannabis in Patients With Osteoarthritis of the Thumb Basal Joint. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2021.10.018 [8] Hand Surgery Patient Perspectives on Medical Cannabis: A Survey of Over 600 Patients. Journal of Hand Surgery Global Online. 2023. DOI: 10.1016/j.jhsg.2022.02.009 [9] A Synthetic Form of Cannabinoid Does Not Decrease Opioid Use After Total Knee Arthroplasty: A Prospective, Randomized, Triple-Blind, Placebo-Controlled Study. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.02.047 [10] Poster 373: Perceptions & Opinions on Cannabidiol Among Sports Medicine Orthopaedic Surgeons. Orthopaedic Journal of Sports Medicine. 2023. DOI: 10.1177/2325967123s00336 [11] Cannabis Use Does Not Affect Outcomes After Total Hip Arthroplasty. The Journal of Arthroplasty. 2023. DOI: 10.1016/j.arth.2023.03.040 [12] Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. Clinical Orthopaedics & Related Research. 2024. DOI: 10.1097/corr.0000000000003221 [13] Cannabis Use Following Total Joint Arthroplasty is Associated With Increased Risks? A Meta-Analysis. The Journal of Arthroplasty. 2024. DOI: 10.1016/j.arth.2023.07.008 [14] Effects Of Cannabidiol On Post-Operative Pain Following Arthroscopic Rotator Cuff Repair. Journal of Shoulder and Elbow Surgery. 2023. DOI: 10.1016/j.jse.2023.02.032 [15] Is Cannabis Dependence Associated with Postoperative Infections in Hand and Wrist Surgeries?. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.100948 [16] CORR Insights®: Does Cannabis-based Medicine Improve Pain and Sleep Quality in Patients With Traumatic Brachial Plexus Injuries? A Triple-blind, Crossover, Randomized Controlled Trial. Clinical Orthopaedics & Related Research. 2024. DOI: 10.1097/corr.0000000000003265 [17] Medical Cannabis in Hand Surgery: A Review of the Current Evidence. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.11.008
