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Which Is Better for Back Pain - Sativa or Indica?

Some of the 39% of Americans who suffer from back pain (according to CDC data) turn to medical marijuana to ease their symptoms, but if you’re new to medical cannabis, you might be wondering whether sativa or indica is more effective for back pain.

While the sativa vs indica classification doesn’t tell the whole story, indicas have a reputation for being the more analgesic and relaxing of the two—making indicas ideal for relieving back pain at night. In contrast, sativas combine energy with pain relief for a pick-me-up during the day.

Apart from the overarching classification (sativa or indica), the cannabinoid percentages and terpene profiles of each strain also affect its “package” of benefits, making these important factors to take into account when choosing cannabis products for back pain.

The Lowdown on Sativa vs Indica for Back Pain

Indica strains are popular for back pain thanks to their body-focused, relaxing effects. They are well-suited for evening use when you want to wind down and ease the pain so you can drift off to sleep. Popular indicas for pain include Northern Lights, which is a pure indica strain, and Blueberry, which is an indica-dominant hybrid strain.

Sativa strains for back pain are more energizing and uplifting, and some people prefer to use them in the morning for relief and an extra boost when they need to get things done. Many of the best medical marijuana strains for muscle pain—including AC/DC and Harlequin—are sativas or sativa-dominant hybrids.

The CBD and THC Levels of a Given Strain Also Affect its Physical and Psychological Effects

In addition to the indica/sativa division, cannabinoid percentages also make a big difference in the effects of medical cannabis strains on back pain. High-CBD and high-THC strains both offer therapeutic benefits that can be helpful for treating pain but have very different physiological effects.

Whereas THC binds to cannabinoid receptors directly (like a lock and key) and acts on the parts of the brain that control sensory input, judgment, and coordination, CBD modulates the way that THC binds to the receptors and keeps the body’s own “feel-good” chemicals circulating for longer. Both of these mechanisms can help with back pain, but the effects on mood and mental function are quite different.

THC and Pain Relief

THC influences cannabinoid receptors located in the nerve cells and immune cells. When the receptors in the nerve cells are activated, it reduces the sensation of pain.

In addition to its effects on the nervous system, THC is known for causing a feeling of being “high.” This high also has a role in how pain is experienced; highs can lower the degree to which consumers are affected by pain because the feeling of euphoria helps to take their minds off their physical discomfort.

CBD and Pain Relief

Studies such as Argueta et al (2020) have shown that CBD has pain-relieving properties. This study lists potential benefits of CBD-heavy products such as improved sleep, effectiveness in treating intractable pain, and improved quality of life. CBD has also demonstrated anti-inflammatory potential in preclinical trials, making it a good choice for back pain that’s caused by inflammation.

Whereas high-THC products are intoxicating, CBD-only products don’t induce a high, meaning that you can take them without the same risk of altered perception, impaired coordination, or uncharacteristic behavior. CBD can, however, make some people feel drowsy, so it’s important to clear some space in your schedule when trying CBD-based products for the first time.

Terpenes Are Also Influential on a Given Strain’s Analgesic Potential

Whether you prefer strains that are higher in THC or CBD, it’s also important to take the strain’s terpene profile into account. When choosing a cannabis strain, look for strains that are high in terpenes that work to reduce pain and/or fight inflammation.

Some of the terpenes present in cannabis plants that could be helpful for relieving back pain and muscle spasms include:

  • Myrcene

  • Limonene

  • Caryophyllene

  • Pinene

  • Linalool

Strains that are high in these terpenes include Harlequin, Sour Diesel, Bubba Kush, Blue Dream, Granddaddy Purple, and Wedding Cake.

How Does Cannabis (as a Whole Plant) Help With Back Pain?

The cannabis plant has natural pain-killing and muscle-relaxing qualities. It reduces pain by blocking the transmission of pain signals from your nerves to your brain. Some studies have shown medical marijuana to be particularly effective in treating chronic pain caused by nerve damage, as is the often case in patients suffering from back pain.

Cannabis also has anti-inflammatory properties, meaning it can be used to treat inflammation caused by conditions like arthritis, or other degenerative conditions that result in changes to the lumbar, cervical, or thoracic spine areas. These anti-inflammatory properties may also go some way to treating pain caused by fractures, ruptures, sprains, or abnormalities caused by congenital disorders.

Topical Oils for Relieving Pain

Generally, people who are researching the question “Is sativa or indica better for back pain” are thinking about ingested forms of cannabis—smoked, vaped, dabbed, or eaten. However, if you would prefer not to inhale cannabis or medical marijuana isn’t legal in your state, CBD hemp oil could be a good option.

As we stated previously, CBD has anti-inflammatory properties, and researchers have observed relief from localized pain and inflammation in animals simply by applying CBD gels to the skin. When chronic pain affects one particular part of your body rather than being generalized, a topical oil may be a good solution for pain relief without the high.

Do You Need a Medical Marijuana Card to Take Cannabis for Back Pain?

As of June 2023, medical marijuana is legal in 38 states including Arizona, New York, and California. In many of these states—including Arizona and California—adults can also purchase recreational cannabis with a government-issued photo ID.

While back-pain sufferers in Arizona (aged 21 and above) can simply go to a dispensary and buy marijuana, there are several benefits of applying for an AZ medical marijuana card:

  • MMJ patients in Arizona can buy medical-grade cannabis at lower prices because it's exempt from the 16% excise tax.

  • You can purchase and possess greater quantities of cannabis.

  • You can purchase cannabis edibles with higher THC levels.

  • You can enjoy certain workplace and housing protections.

In Arizona, as in many other states, chronic pain is a qualifying condition for medical marijuana—and you can often obtain a physician’s certification with a quick physical evaluation. Once you’ve been approved, remember that you’ll need to renew your AZ medical marijuana card every two years.

Find Relief with the Right Medical Cannabis Strain for Back Pain

Chronic back pain, or discomfort caused by nerve pain, is something that many people live with. However, cannabis strains that offer the right medicinal benefits can help you ease the pain so that you can go about your daily life.

Whether you ultimately decide to try indicas, sativas, hybrid marijuana strains, or all three to relieve pain, it’s always best to consult with an experienced medical marijuana doctor and purchase medical-grade marijuana from a reputable dispensary. High-quality products at the right dose and frequency could soon help you experience an improved quality of life.


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