A Growing Interest in CBD and Physical Therapy

One need only to look through medical articles or talk to health care providers at conferences to realize that medical marijuana (MMJ) is becoming a widely accepted area of study for pain management and other applications.

Medical indications for cannabinoids include neurological conditions such as multiple sclerosis (MS), muscular dystrophy (MD), and Parkinson disease (PD)—all conditions addressed by physical therapists (PTs).

That’s why a growing number of PTs are looking at (or revisiting) the use of MMJ by patients, based on published evidence and patient experiences. An increasing number of PTs also are advocating for its use in some instances, saying it may be safer than are drugs such as opiates, muscle relaxants, and anti-inflammatories. Still, both medical professionals and patients are questioning whether cannabis and cannabinoids are the solution. They’re asking “Can it really help?” “What are the side effects?” “Is it safe?” and “Is it legal?” These are all questions for which PTs should be prepared.

CBD and physical therapy

Understanding the Terminology:

The terms “marijuana” and “cannabis” often are used interchangeably, particularly in the United States, but they are 2 separate entities.

1. Marijuana

In general, marijuana refers only to parts of the Cannabis sativa plant or derivative products that contain substantial levels of tetrahydrocannabinol (THC), the chemical compound that is found in the highest concentrations in the cannabis plant and is primarily responsible for the plant’s intoxicative qualities.

2. Cannabis

Cannabis is a broad term that can be used to describe organic products (eg, cannabinoids, marijuana, and hemp) derived from the Cannabis sativa plant. These products exist in various forms and are used for medical, industrial, and recreational purposes. Given its broad potential, the all-encompassing word “cannabis” has been adopted as the standard terminology within scientific and scholarly communities for organic products derived from the Cannabis sativa plant.

3. Cannabinoids

Cannabinoids are a group of active chemical compounds found in cannabis. Among the more than 100 different types of cannabinoids are THC and cannabidiol.Under US law, cannabis plants with very low levels of THC—not more than 0.3%—are considered “industrial hemp.”

4. Cannabidiol (CBD)

CBD stands for cannabidiol. It is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, which is a cousin of the marijuana plant. While CBD is a component of marijuana (one of hundreds), by itself it does not cause a “high.” According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.”

Knowledge Is Power

It can be difficult to get an unbiased view of MMJ and cannabis. On one hand, although the FDA website contains updated information about states that have legalized marijuana, it’s a federal website that, along with other federal sites (such as for the Centers for Disease Control and Prevention), presents a certain perspective. Sites that are strongly pro-cannabis (such as the National Organization for Reform of Marijuana Laws [NORML] and the Marijuana Policy Project), meanwhile, present a different perspective.

As you gear up to begin incorporating hemp-derived CBD products in your practice, take a moment to educate your team on CBD. This is a product that lacks substantial research about its efficacy. In order to build trust with patients when incorporating CBD, you and your team should strive to educate yourselves on how to use topical CBD products. 

In conclusion, keep in mind that using CBD as a complement to therapy is still controversial, and both you and your patient should be comfortable in using it associated to PT treatment. Perhaps it is better to manage your plan of treatment according to a patient that already uses MMJ, collect results, and then propose it to the patient that is not familiar with it.

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