Anxiety and Chronic Pain

5 minutes

Anxiety and chronic pain can be deeply connected, often creating a cycle where one worsens the other. Anxiety can heighten sensitivity to pain, while chronic pain can lead to stress, worry, and a diminished quality of life. Breaking this cycle can feel overwhelming, but there’s growing evidence of the use of medical cannabis for both conditions.

Understanding the Link Between Anxiety and Chronic Pain

Chronic pain is a complex condition and does not simply represent the severity of pain signals that travel from the body to the brain. How your brain interprets that signal, and therefore the severity of pain, will also depend on your broader physical and mental wellbeing.

Anxiety, whether in the form of an anxiety disorder or general feelings of worry, can interact with chronic pain in different ways, creating a challenging cycle that can be difficult to manage.

How Anxiety Can Interact with Chronic Pain

While anxiety disorders do not directly cause chronic pain, it is one of many factors that can lead to acute pain becoming chronic as well as the persistence and severity of that pain. Anxiety disorders often lead to thought patterns or behaviours that exacerbate pain or make recovery more difficult.

  • Central Sensitisation: This process occurs when nerves in the spinal cord become overly sensitive after an injury, causing chronic pain even after the initial issue heals. Anxiety disorders may amplify this process.
  • Catastrophising: People living with anxiety disorders often experience heightened or disproportionate worry, which can worsen the perception of pain. This thought pattern, where pain is viewed as insurmountable, may increase both the intensity and duration of pain.
  • Secondary Effects: Anxiety disorders can indirectly worsen chronic pain through issues like disrupted sleep, reduced physical activity, or social isolation. Poor sleep is known to intensify pain, while avoiding movement or social interactions may limit coping strategies and support systems, creating further challenges.

Beyond clinical anxiety disorders, general worry or stress can also play a role in chronic pain. Stress can undermine healthy coping mechanisms, such as maintaining a balanced sleep schedule or staying physically active, both of which are important for managing chronic pain.

How Chronic Pain Can Contribute to Anxiety

Living with chronic pain is physically and emotionally demanding, and the challenges it brings can sometimes lead to anxiety disorders. Persistent pain may limit your ability to work, socialise, or enjoy everyday activities, which can contribute to feelings of helplessness, fear, or frustration over time.

Research shows that people with chronic pain are significantly more likely to experience anxiety and depression 12. Pain can also interfere with sleep, social activities, and work, adding to the stress and worry. This can create a loop where pain increases anxiety, and anxiety then worsens the pain, making it harder to break free3.

Medical Cannabis for Anxiety and Chronic Pain

Medical cannabis is gaining attention in individuals with anxiety and chronic pain, particularly for those who haven’t found relief with traditional treatments. The compounds in cannabis, like tetrahydrocannabinol (THC) and cannabidiol (CBD), interact with your body’s endocannabinoid system, which regulates your pain, mood, and other essential functions.

Medical Cannabis Treatment and Anxiety

For anxiety, medical cannabis may offer an alternative for people who haven’t responded well to other treatments. Dr James Rucker, an NIHR Clinician Scientist specialising in psychiatric conditions, highlights its use in individuals with conditions like anxiety, PTSD, and depression that have proven difficult-to-treat. Watch the video below to hear him discuss how medical cannabis may support individuals with anxiety.

Dr Rucker highlights that “Medical cannabis shows promise for psychiatric conditions that have been hard to treat using traditional methods.” This makes it an option worth considering for those who have not benefitted from first-line treatments.

Medical Cannabis Treatment and Chronic Pain

When it comes to chronic pain, medical cannabis is not a first-line option, but can be considered for those with pain longer than three months which hasn’t improved with other treatments. Dr Michael Platt, a pain consultant at Curaleaf Clinic, explains how the key compounds in cannabis have been shown to affect the nervous system and inflammation4.

Cannabinoids, such as THC and CBD, have been shown to affect the firing of receptors in the nervous system that regulate the movement of pain signals from the site of injury up to the brain.

Recent work conducted at Imperial College London, alongside Curaleaf International researchers, has shown that terpenes, a minor compound found in medical cannabis, can also affect the firing of peripheral pain signals. Additionally, cannabinoids, terpenes, and flavonoids, have also been shown to affect inflammation, an important component of pain in some conditions. It’s important to remember that this research has largely been conducted in laboratories on individual cells or animals, such as mice. Further research is needed in humans to confirm these specific effects.

Watch the video below to hear Dr Platt discuss how medical cannabis is prescribed to patients using a low-and-slow approach.

Dr Rucker and Dr Platt stress the importance of a tailored approach. Whilst medical cannabis is not the right option for everybody, starting with low doses and adjusting as needed helps patients find the right dose for their symptoms while minimising side effects. For many, medical cannabis offers hope where traditional treatments have fallen short.

Real Stories from Medical Cannabis Patients

Hearing directly from patients can make all the difference when considering medical cannabis. At Curaleaf Clinic, patients like Leigh and Lorna have shared how this treatment has transformed their lives.

Leigh, who uses medical cannabis for anxiety, found it gave him a renewed sense of control:

“For the first time now, I can make serious plans about my future.” Leigh emphasises the importance of working with professionals who understand cannabis and its potential, making his journey one of empowerment and hope.

Lorna, who manages fibromyalgia pain, praises the clinic’s professionalism and compassion:

“I’ve had nothing but absolute professionalism,” says Lorna. “And what’s equally important for me is the level of respect and compassion for me as a patient.” Lorna’s story shows how medical cannabis, combined with expert care, can provide effective relief.

If you’re thinking about medical cannabis as a treatment option, the first step is speaking to your GP. Leigh’s advice to others is simple: “If you feel like you’re not getting the satisfaction from regular medication, I’d definitely go see your GP and ask them to write you a referral.” Once you have a referral, the team at Curaleaf Clinic will assess your case and, if eligible, create a treatment plan tailored to your needs.

Conclusion

Anxiety and chronic pain can feel like a never-ending cycle, but medical cannabis offers a potential way forward. By addressing the symptoms of both conditions, it may help improve your mental and physical wellbeing.

For more information, read our article on the effects of medical cannabis for chronic pain patients with and without co-morbid anxiety in the Expert Review of Neurotherapeutics. You can also explore our video series, featuring patient stories and expert insights, or visit our Getting Started page. Our team is here to answer your questions and help you explore your options.

Sources

1 McWilliams, L.A., Cox, B.J. and Enns, M.W. (2003). Mood and anxiety disorders associated with chronic pain: an examination in a nationally representative sample. Pain, 106(1), pp.127–133. doi:https://doi.org/10.1016/s0304-3959(03)00301-4.
2 Mullins, P.M., Yong, R.J. and Bhattacharyya, N. (2023). Associations between chronic pain, anxiety, and depression among adults in the United States. Pain Practice, 23(6). doi:https://doi.org/10.1111/papr.13220.
3 Fisher, E., Heathcote, L.C., Eccleston, C., Simons, L.E. and Palermo, T.M. (2017). Assessment of Pain Anxiety, Pain Catastrophizing, and Fear of Pain in Children and Adolescents With Chronic Pain: A Systematic Review and Meta-Analysis. Journal of Pediatric Psychology, 43(3), pp.314–325. doi:https://doi.org/10.1093/jpepsy/jsx103. Available at: https://academic.oup.com/jpepsy/article/43/3/314/4034672#186670245.
4 Top Doctors. (2022). Sapphire Medical. [online] Available at: https://www.topdoctors.co.uk/medical-articles/can-chronic-pain-be-treated-with-cannabinoids [Accessed 20 Dec. 2024].

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