Hypermobility spectrum disorders (HSDs) encompass a range of connective tissue conditions characterised by joint instability and chronic pain. These disorders span from asymptomatic hypermobility to generalised joint hypermobility affecting multiple parts of the body. Hypermobile Ehlers-Danlos syndrome (hEDS) shares many features with HSDs, including generalised hypermobility, musculoskeletal issues, and mild skin hyperextensibility.
Approximately 3% of the UK population may be affected by HSDs, with women and children experiencing these conditions more commonly and with greater severity. For many individuals with HSD/hEDS, persistent pain represents the primary reason for seeking medical support. Those affected often develop complex pain patterns involving different mechanisms.
Challenges in Managing Hypermobility-Related Pain
The mechanisms underlying pain in HSD and hEDS remain relatively under-researched, making effective treatment challenging to achieve. Current conventional approaches typically include:
- Pain management medications
- Physical therapy programmes
- Cognitive behavioural therapy
Despite these interventions, many patients continue to experience pain that significantly limits their functionality and negatively impacts their mental, physical, and social wellbeing. There is a clear need to explore additional options for managing hypermobility-associated chronic pain more effectively.
Medical Cannabis, the Endocannabinoid System, and Chronic Pain
Modern research has identified the endocannabinoid system (ECS) as potentially significant in pain regulation. Cannabinoids interact with receptors within the ECS, which may influence pain signalling pathways.
However, it’s important to note that no randomised controlled trials have specifically investigated medical cannabis for chronic pain associated with HSD/hEDS.
Real-World Evidence: The UK Medical Cannabis Registry
In 2019, Curaleaf Clinic (formerly Sapphire Medical Clinic) established the UK’s first patient registry to track real-world outcomes of medical cannabis patients. The UK Medical Cannabis Registry provides valuable insights into patient responses to CBMPs in clinical settings.
A recent analysis of data from the UK Medical Cannabis Registry evaluated outcomes in patients prescribed medical cannabis for mobility-associated chronic pain.
What the Registry Data Shows
The study assessed patient-reported outcome measures (PROMs) at baseline and multiple follow-up points (1, 3, 6, 12, and 18 months). These measures included:
- Pain: Changes were observed in perceived pain severity and interference in a proportion of participants across all follow-up points.
- Health-Related Quality of Life: Patients reported a change in mobility, anxiety, and depression levels between baseline and all subsequent periods as measured by the EQ-5D-5L.
- Other Quality of Life measures: Changes in sleep quality and anxiety were also noted.
- Adverse Events: A total of 50 patients reported one or more adverse event, primarily moderate in severity, with headache, fatigue, and lethargy being the most common.
Research Limitations and Future Directions
It’s essential to understand that the registry’s observational design does not allow for the determination of a causal relationship between medical cannabis treatment and the reported outcomes. The findings indicate its potential for some patients with hypermobility-related pain, but further research is needed to fully understand the role of cannabis-based medicines in managing HSDs and hEDS.
Contributing to Medical Cannabis Research
We appreciate all patients who participate in the UK Medical Cannabis Registry. Your involvement helps advance our understanding of cannabis-based medicines across various conditions, including hypermobility-associated chronic pain.
Patients can join the Curaleaf Access Scheme to potentially reduce the cost of their ongoing treatment while contributing to essential research. Initiatives like the UK Medical Cannabis Registry play a vital role in improving patient care and informing future clinical guidelines for medical cannabis in the UK.
This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional regarding treatment options for your specific condition.
