Post Laminectomy Syndrome (PLS)—a chronic pain condition that can follow spinal surgery—has long challenged both patients and physicians. As traditional pain management options, including opioids, face increasing scrutiny for their side effects and addiction potential, medical marijuana is gaining attention as a potential alternative.
PLS, also known as failed back surgery syndrome, is marked by persistent pain following spinal decompression surgery. It affects an estimated 10% to 40% of patients who undergo laminectomies. Symptoms include ongoing back or leg pain, numbness, and limited mobility, often leading to reduced quality of life and long-term reliance on pain medications.
Recent clinical insights suggest that cannabis-based therapies may help alleviate neuropathic and inflammatory pain in PLS patients. Cannabinoids such as THC and CBD interact with the body’s endocannabinoid system to modulate pain perception, inflammation, and muscle spasticity. A 2020 study published in Current Pain and Headache Reports highlighted the growing body of evidence for cannabinoids in treating chronic pain conditions, including those involving neuropathic pain pathways similar to PLS.
Patients in states where medical marijuana is legal have reported improvements in daily function, reduced pain levels, and a decreased need for opioid medications. A case series published in the Journal of Pain Research in 2019 found that patients with spine-related chronic pain experienced “clinically meaningful pain relief” with the use of medical cannabis. This aligns with recommendations from the National Academies of Sciences, Engineering, and Medicine, which in 2017 concluded there is substantial evidence that cannabis is effective for chronic pain in adults.
Despite growing support, marijuana remains a Schedule I substance federally in the U.S., complicating large-scale studies and insurance coverage. Nonetheless, as more states expand medical cannabis programs, the potential for its use in treating conditions like PLS continues to draw interest from both clinicians and patients seeking alternatives to conventional pharmaceuticals.
References:
[1] Fine, P. G., & Rosenfeld, M. J. (2020). The Endocannabinoid System, Cannabinoids, and Pain. Current Pain and Headache Reports, 24(10), 65.
[2] Ueberall, M. A., & Essner, U. (2019). Effectiveness and tolerability of THC:CBD oromucosal spray as add-on measure in patients with severe chronic pain: a real-world study. Journal of Pain Research, 12, 3393–3404.
[3] National Academies of Sciences, Engineering, and Medicine. (2017). The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington, DC: The National Academies Press.
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