How to Use Cannabis For Holistic Pain Management

Pain is a multifaceted, individualistic phenomenon that occurs both in our brains and our bodies. 

As humans, each of us anticipates, perceives, and physically experiences pain differently. Furthermore, uncontrolled pain is one of the most common reasons patients try medical cannabis. In fact, among adults with chronic pain in states with medical cannabis laws, 3 out of 10 people reported using cannabis to manage their pain

Understanding the types of pain, the role of the endocannabinoid system (ECS) in pain modulation, and how to use medical cannabis can help you achieve holistic pain relief. 

Types of Pain

Throughout our bodies are specialized sensory receptors called nociceptors which alert our brain to painful or potentially harmful stimuli. When stimulated they produce different types of pain. The following are some examples of pain type:

Acute pain is short-term pain that usually lasts for less than three months. It is caused by an injury, surgery, or illness and is often described as sharp, intense, and sudden. Most importantly, medical cannabis is not recommended for treating acute pain. 

Chronic pain persists for more than three months. Various conditions, such as arthritis, fibromyalgia, or nerve damage, cause it. 

Breakthrough pain is a flare of pain that happens even though you regularly take pain medicine for acute or chronic pain.

Neuropathic pain is caused by damage or injury to the nerves. It can result in burning, stabbing, or shooting pain. Neuropathic pain can be caused by conditions such as diabetes, multiple sclerosis, or nerve damage due to chemotherapy or radiation therapy. 

Migraines are headaches characterized by recurrent attacks of moderate to severe throbbing and pulsating pain on one side of the head. The pain is caused by the activation of nerve fibers within the wall of brain blood vessels traveling inside the meninges (three layers of membranes protecting the brain and spinal cord).

Inflammatory pain is caused by inflammation in the body. It can result from conditions such as arthritis and autoimmune diseases like Crohn’s disease or lupus.

Bone pain is aching tenderness, or another discomfort in the bone. One of the most common symptoms of bone cancer is bone pain.

The role of the ECS in pain

The endocannabinoid system (ECS) is a complex network of cannabinoid receptors, endocannabinoid molecules, and enzymes that play a crucial role in pain processing and regulation. In fact, the ECS exhibits anti-nociception abilities that reduce pain sensations with regulatory actions at all stages of pain processing pathways. 

There are two main types of cannabinoid receptors known as CB1 and CB2. CB1 receptors heavily populate the pain-processing area of the brain and central nervous system which control our perception of pain. While CB2 receptors heavily populate our immune system and the peripheral nervous system and work to reduce inflammatory pain. Additionally, these CB receptors act in concert with other pain-modulating receptors, such as our body’s opioid receptors  (more on this later in the article) to alter the pain experience. Finally, Transient Receptor Potential Cation Channel Subfamily V member 1 (TRPV1) plays a part in mediating inflammation, pain perception, and body temperature. Inhibiting this receptor may help reduce pain, as CBD “blocks” or “occupies” the area/s pain signals are being sent.

Below is an image showing how our pain receptors interaction with the cannabinoid receptors to alter our pain perception:

Cannabis for holistic pain management

Both major cannabinoids, THC and CBD, influence the signals received by nociceptors altering how we perceive and experience pain. Additionally, both act exhibit anti-inflammatory properties by preventing the production of chemicals that cause chronic inflammation. Finally, cannabinoids act on nerve and non-nerve tissues to help reduce the sensations caused by neuropathic pain. 

Cannabis and reducing opioid use 

Opioid crisis and the lack of effective treatment pushed cannabis to the forefront as a possible exit-drug for those struggling with addiction. In 2016, a study released by the University of Michigan revealed a statistic of reduction of opiate use by 64% amongst chronic pain patients who used medical marijuana. Then in 2021, a collaborative study from University of California, Davis and Yale University found an increase from one to two storefront dispensaries in a county is associated with an estimated 17% reduction in all opioid related mortality rates. Given these statistics, it is easy to see that cannabis is a supportive therapy to reducing and even eliminating the chronic use of opioids.   

How to use cannabis for holistic pain management

The five most common ways to use cannabis for holistic pain management are:

  • Inhalation or smoking cannabis is the fastest way to experience pain relief. However, it is also the fastest way cannabis is eliminated in the body so those who smoke find that after 2 hours their pain may increase again. Cannabis communities like Leafly offer reviews of different chemovar (strains) from thousands of people also seeking pain relief.
  • Ingestion or taking cannabis by mouth is a discrete method that can provide 4 to 6 hours of pain relief. However, onset can take up to 90 minutes before the body may experience relief. Additionally, ingestion of THC requires smaller doses because THC is converted to a more potent metabolite once it reaches the liver. It is this active, potent metabolite that affords the hours of relief. Common products are CBD oil,  THC oil, gummies, chocolate, and even drinks.  
  • Transdermal Patches are applied to skin and are a novel way to achieve a consistent dose over several hours and even days. Transdermal effects can be felt as soon as 30 minutes to an hour, and last as long as 3 days. Transdermal patches come in a variety of doses of THC, CBD, or a combination of both, so it is easy to find the right one to fit your pain relief needs. Additional transdermal products include gels and lotions, however the effects of these products usually only last 2 to 4 hours.
  • Suppositories work by allowing cannabinoids to pass through the mucosal layer in the rectum or vagina. Additionally, they are a great cannabis delivery option for people who can no longer swallow. Suppositories begin to work within 30 minutes to 1 hour and the effects can last between 5 to 8 hours. 
  • Topical application is applied to skin and is great for joint pain, minor burns, and rashes. Topically applied cannabis begins to take effect between 15 to 30 minutes and lasts between 2 and 4 hours. 

One important aspect of understanding the onset (when it begins to work) and the duration (how long it lasts) of ways to use cannabis as medicine is the ability to layer doses. For example, your pain level is at an 8 on a scale from 0 to 10 with ten being the worst. You can smoke a couple puffs on a pipe and ingest a 5 mg gummy. By the time the effects of the smoked cannabis starts to wear off, the ingested effects will begin thus, giving you immediate yet, longer lasting relief.  

How to start dosing cannabis

Understanding how to choose the right cannabis dose is vital to optimal pain relief. As a holistic cannabis nurse, the recommendation is to “start low and go slow.” If you are new to cannabis, start with the lowest dose, such as 1-2 mg, and slowly increase the dose amount until you achieve the effect you desire. 

Cannabis works in a “biphasic” manner. This scientific word simply means that too small of dose may cause unwanted side effects or ineffective pain relief. Likewise, too large of a dose may cause unwanted side effects or an INCREASE in pain. Tracking the dose(s) used in a journal is extremely helpful for finding your optimal dose.

Expert guidance with a certified holistic cannabis nurse 

At Sage Integrative Wellness, our certified holistic cannabis nurse has guided many clients to find their optimal dose and manage their pain effectively. If you have questions or want personalized guidance from a nurse, click here to book a free consultation.

A Direct consultation is required for any recommendations to be made, and in no way should the information provided in this article be understood to be or construed as recommendations, suggestions, or advice concerning individual health. Information provided in this article is for informational and educational purposes only. Information on this website is not intended to diagnose, claim, cure, heal, or correct any illness or medical condition. Always consult a licensed healthcare provider when considering a change to your wellness routine. Always consult a licensed healthcare provider when you stop or start taking medication, supplements, herbs, or vitamins. 


Pain is a complex response to harmful stimuli. Understanding the different types of pain, the role the ECS plays in pain modulation, and how to use medical cannabis allows you to experience holistic pain management. Additionally the use of cannabis has been shown to reduce opioid use and opioid-related deaths. Different methods of cannabis consumption for pain management include inhalation, ingestion, transdermal patches, suppositories, and topical application. The importance of starting with a low dose and gradually increasing it is emphasized for avoiding unwanted side effects. Finally, engaging a certified holistic cannabis nurse for personalized guidance will help you find optimal pain relief.

Nurse Author Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC is a double board certified holistic nurse, Amen Clinics certified professional brain health coach, holistic medical content writer, and medical content reviewer for Sage Integrative Wellness, LLC and various national and international wellness companies and media companies. Dominique offers holistic nurse consulting for businesses, media companies, and organizations in holistic medical content writing and medical content reviewing upon request. She’s a passionate neurodiverse nurse advocate striving to transform healthcare and culture through awareness, holistic education and research, and integrative brain health nurse coaching.

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