Cannabis against chronic musculoskeletal pain: A scoping review on users and their perceptions

Abstract Background Chronic musculoskeletal pain (CMP) may lead to reduced physical function and is the most common cause of chronic non cancer pain. Currently, the pharmacotherapeutic options against CMP are limited and frequently consist of pain management with non-steroidal anti-inflammatories, gabapentinoids or opioids, which carry major adverse effects. Although the effectiveness of medical cannabis (MC) for CMP still lacks solid evidence, several patients suffering from it are exploring this therapeutic option with their physicians.Objectives Little is known about MC users suffering from CMP. We aimed to increase this knowledge, useful for health care professionals and patients considering this treatment, as well as for researchers planning rigorous randomized clinical trials on the effectiveness of MC.Methods We conducted a scoping literature review, according to the methods developed by Arksey and O’Malley, to describe the views and perceptions of adult patients who had consumed MC to relieve chronic CMP. The review includes patients’ perceptions on MC against other non-cancer pain since most of the literature reports on both, as well as their demographic characteristics, patterns of MC use, and perceived positive and negative effects.Results Participants of the 49 included studies reported that MC use helped them to reduce CMP and other chronic non-cancer pain, with only minor adverse effects, and some reported improved psychological well-being.Where MC was legally available, persistent users were frequently young or middle-aged men, and the preferred form of use was smoking. The information from these studies has several methodological limitations and results are exploratory.Conclusion MC users suffering from CMP or other chronic non-cancer pain, perceived more benefits than harms. However, these user reported experiences must be examined by well-designed and methodologically sound clinical or observational studies, particularly regarding CMP, since reports on CMP are very scarce.