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大麻与CBD用于疼痛 资料

本页面由机器翻译，尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能在考虑大麻或CBD是否能帮助管理您的疼痛。处于您这种情况的许多患者都在询问同样的问题。一些脊柱疼痛患者估计，医用大麻可以治疗他们一半以上的症状。事实上，每三位脊柱疼痛患者中就有一位已经在使用医用大麻。

对于拇指腕掌关节骨关节炎患者，大量人群有兴趣尝试口服或外用医用大麻。大多数因手部和上肢问题就诊的患者会考虑使用医用大麻。他们认为这是治疗常见骨科疾病的一种安全治疗方案。然而，费用是许多人使用的主要障碍。

如果您接受过关节镜下肩袖修复术，CBD可以成为您疼痛管理计划的一部分。与安慰剂相比，在1年随访时，患者报告的结果未见缺陷。1年随访时也未见功能缺陷。您可以在术后疼痛管理中考虑使用CBD，而不会对结果产生不利影响或长期不利影响。

大麻类药物也适用于治疗周围神经病变。现有证据表明，医用大麻对慢性肌肉骨骼疼痛和神经病理性疼痛具有疗效和安全性。对于接受初次全膝关节置换术的患者，合成大麻素（THC）似乎不会限制阿片类药物的摄入量。

请注意，在全关节置换术的背景下，规律使用大麻可能与阿片类药物使用量增加有关。由于这种关联，目前无法基于此关联提出关于围手术期疼痛管理中大麻使用的具体指导。

骨科运动医学领域的多数调查受访者认为，CBD在术后和慢性疼痛管理中发挥作用。此外，79%的脊柱疼痛患者认为大麻可以减少阿片类药物的使用。虽然关于医用大麻在手部和上肢疾病中疗效的确定性结论仍需进一步研究，但许多人发现它有帮助。

实际发生的情况

您的身体使用复杂的受体系统来管理疼痛和炎症。大麻二酚（通常称为CBD）与该受体系统相互作用。在手术后（如关节镜下肩袖修复术）使用时，它不会导致患者报告结局的缺陷。这意味着您对结果的满意度与服用安慰剂时相同。

在一年的随访中，使用CBD未显示功能缺陷。您可以将其作为术后疼痛管理计划的一部分，而无需担心其对康复产生长期的不利影响。对许多人而言，它有助于管理不适，且不会妨碍您正常活动或使用肩膀。

基于大麻的药物也适用于治疗周围神经病变（即神经性疼痛）。现有证据表明，医用大麻对慢性肌肉骨骼疼痛和神经性疼痛具有疗效和安全性。然而，在全关节置换术（关节置换）的背景下，常规使用大麻可能与阿片类药物使用量增加有关。由于这种关联，目前无法就围手术期疼痛管理中大麻的具体使用提出指导建议。

患者经常寻求医用大麻以缓解疼痛。患有脊柱疼痛的患者估计，医用大麻可以治疗其超过一半的脊柱疼痛。三分之一的脊柱疼痛患者已经在使用医用大麻。79%的脊柱疼痛患者认为大麻可以减少阿片类药物的使用。

手部护理领域的兴趣同样高涨。大量患有拇指腕掌关节骨关节炎的患者有兴趣尝试口服或外用形式的医用大麻，以治疗其拇指腕掌关节疼痛。80.9%的因手部和上肢主诉就诊的患者表示会考虑使用医用大麻。患者认为医用大麻是常见骨科疾病的一种安全治疗选择。

合成形式的大麻素（THC）似乎不会限制原发性全膝关节置换术后的阿片类药物摄入量。骨科运动医学社区的大多数调查受访者认为，CBD在术后和慢性疼痛管理中发挥作用。然而，关于医用大麻在手部和上肢疾病中疗效的明确结论仍需进一步研究。成本被确定为因手部和上肢主诉就诊的患者使用医用大麻的主要障碍。

预期情况

您可能想知道大麻或CBD是否能帮助管理您的疼痛。目前的证据表明，CBD可以作为您疼痛管理计划的一部分，且不会对您的康复造成损害。例如，在关节镜下肩袖修复术后，与安慰剂相比，使用CBD并未导致一年后随访时患者报告的结局更差或功能缺陷更多。这意味着您可以将其作为多模式疼痛管理方案的一部分，而无需担心其对长期预后产生不利影响。

许多患者对这些治疗方式感兴趣。骨科运动医学领域的多数调查受访者认为，CBD在术后和慢性疼痛管理中发挥作用。大量患有拇指腕掌关节骨关节炎的患者有兴趣尝试口服或外用医用大麻。事实上，大多数因手部和上肢主诉就诊的患者会考虑使用医用大麻，其中80.9%的人认为这是一种安全的治疗选择。

然而，对于所有适应症，证据尚不明确。关于医用大麻在手部和上肢疾病中疗效的确切结论仍需进一步研究。您还应意识到，在全关节置换术的背景下，常规使用大麻可能与阿片类药物使用量增加有关。尽管如此，许多脊柱疼痛患者认为大麻可能减少阿片类药物使用；其中79%的人持有此观点。一些脊柱疼痛患者估计，医用大麻可以治疗他们超过一半的脊柱疼痛，且三分之一的人已经在使用它。

费用是使用医用大麻的主要障碍，尤其是在因手部和上肢主诉就诊的患者中。虽然目前的证据证明了其在慢性肌肉骨骼和神经病理性疼痛中的有效性和安全性，但您应与您的外科医生讨论这些选择。他们可以帮助您权衡潜在益处与成本以及个体风险，例如与关节置换手术中阿片类药物使用量增加相关的风险。

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

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].
  • 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].
  • 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].
  • 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].
  • 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].
  • One in three patients with spine pain already use medical cannabis [5].
  • Most survey respondents in the orthopaedic sports medicine community believe that CBD has a role in postoperative and chronic pain management [6].
  • 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].
  • Cannabis use does not affect outcomes after total hip arthroplasty [11].
  • 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 long-term detrimental effects after arthroscopic rotator cuff repair [2].
  • 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].

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

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