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The Role of the Cannabinoid System in Pain Control: Basic and Clinical Implications

  • Other Pain (AD Kaye and N Vadivelu, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this review is to provide a comprehensive update of the different known components of the endogenous cannabinoid system and the mechanisms of action, as it applies to analgesia.

Recent Findings

Following the discovery of the endogenous cannabinoid system in the early 1990s and the subsequent characterization of the cannabinoid receptor, there has been a renewed interest in cannabinoid research. Recent work has demonstrated its efficacy as a pharmacologic agent. There is limited evidence in the literature about the understanding of the endocannabinoid system and its role in the treatment and management of acute and chronic pain. Further work may elucidate additional roles for the endocannabinoid system within our nervous system and, moreover, additional subtypes of cannabinoid receptors have yet to be discovered.

Summary

Cannabinoid compounds mediate their biological effects via binding and subsequent activation of cannabinoid receptors. These receptors are located throughout the body and make up the endocannabinoid system. These receptors are best understood and have been cloned, type 1 (CB1) and type 2 (CB2) [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)] [ (1, 2)]. The CB2 receptor is located primarily in the immune system. CB1 receptors are primarily located in the nervous system with the highest concentrations in the brain and lower concentrations in the spine and peripheral nervous tissues. Cannabinoids may be promising treatments for neuropathic pain with limited evidence, whereas, the evidence for other uses is insufficient.

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Authors and Affiliations

  1. Creighton University School of Medicine, Phoenix Regional Campus, Phoenix, AZ, USA

    John Wolf, Stephen Giacomazzi & Daniel Smoots

  2. Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA

    Ivan Urits & Mariam Salisu Orhurhu

  3. Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA

    Vwaire Orhurhu

  4. Department of Anesthesiology, Mount Sinai Medical Center of Florida, Miami Beach, FL, USA

    Jacquelin Peck

  5. Restorative Care Arizona, Phoenix, AZ, USA

    Charlie Piermarini

  6. Pain Management Centers of America, Paducah, KY, USA

    Laxmaiah Manchikanti

  7. Department of Anesthesiology, Louisiana State University Health Sciences Center, Shreveport, LA, USA

    Alan D. Kaye, Rachel J. Kaye & Omar Viswanath

  8. Valley Anesthesiology and Pain Consultants, Envision Physician Services, Phoenix, AZ, USA

    Omar Viswanath

  9. Department of Anesthesiology, University of Arizona College of Medicine, Phoenix, Phoenix, AZ, USA

    Omar Viswanath

  10. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

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Corresponding author

Correspondence to Ivan Urits.

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Conflict of Interest

John Wolf, Vwaire Orhurhu, Jacquelin Peck, Mariam Salisu Orhurhu, Stephen Giacomazzi, Daniel Smoots, Charlie Piermarini, Laxmaiah Manchikanti, Rachel J. Kaye, and Omar Viswanath declare no conflict of interest.

Alan Kaye is a Section Editor for Current Headache and Pain Reports. He has not been involved in the editorial handling of this manuscript. Dr. Kaye is also a speaker for Merck.

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This article is part of the Topical Collection on Other Pain

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Wolf, J., Urits, I., Orhurhu, V. et al. The Role of the Cannabinoid System in Pain Control: Basic and Clinical Implications. Curr Pain Headache Rep 24, 35 (2020). https://doi.org/10.1007/s11916-020-00873-9

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