There is no single strain for pain. Pick by lab numbers: total THC, total CBD, and terpenes on a certificate of analysis. Then match the method and dose to the pain. The indica and sativa words on the jar describe plant shape and flowering time. They do not predict pain relief.
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Read the Certificate of Analysis First
Legal US shops test each batch. The COA lists total THC, total CBD, minor cannabinoids, terpenes, and pass or fail results for mold, pesticides, and heavy metals. Ask for it. A jar without a COA is an unknown.
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Compare two numbers first: total THC and total CBD. Then read the terpene list. Terpenes run from about 0.1% to 3% of dry weight.
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Cannabinoids
- THC binds CB1 receptors in the brain and CB2 receptors on immune cells. It changes pain signaling and perception.
- CBD does not bind CB1 at high rates. It acts as a negative allosteric modulator and can raise THC blood levels in some products.
- CBG and CBN sit under 1% in most flower. Human pain data for both is thin.
Terpenes
- Beta-caryophyllene binds CB2 receptors. This occurs at doses a person can inhale or eat. It appears in black pepper and cloves.
- Myrcene is the most common cannabis terpene. It shows up in hops and lemongrass.
- Linalool and limonene appear in lavender and citrus peel. Animal studies show effects on pain and swelling. Human trials are few.
- Pinene appears in pine needles and rosemary.
A 2017 National Academies review found substantial evidence for cannabis in chronic pain in adults. It found moderate evidence for better sleep in chronic pain and for MS spasticity. Evidence for other pain types is limited. No strain cures pain. The goal is a lower pain score and better function.
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Indica, Sativa, and Hybrid
These terms come from plant biology. Indica plants are short with wide leaves and flower in 8 to 10 weeks. Sativa plants are tall with narrow leaves and flower in 10 to 16 weeks. Lab data show chemical profiles overlap across both groups. Trust the COA over the label.
Method Sets Onset and Duration
- Inhalation: onset 1 to 5 minutes, duration 1 to 4 hours.
- Oral edibles, capsules, tinctures: onset 30 to 120 minutes, duration 4 to 8 hours. Liver enzymes convert THC to 11-hydroxy-THC, which is stronger.
- Topical: no psychoactive effect in most cases. Evidence for joint pain is mixed.
Dose
Start low. For oral THC, 1 mg to 2.5 mg is a common start. Wait 2 hours before adding more. For inhaled, take 1 to 2 puffs and wait 15 minutes. CBD trials for pain use 10 mg to 600 mg per day. More THC is not better for pain; it raises side effect risk.
Keep a log: product name, batch number, THC mg, CBD mg, method, time, pain score before and after.
Check Drug Interactions
CBD inhibits the CYP2C19 and CYP3A4 enzymes. This affects warfarin, clopidogrel, some anti-seizure drugs, and others. The FDA label for Epidiolex lists these interactions. Talk to a pharmacist if you take prescription medicine. Sleepiness, dry mouth, and dizziness are the common side effects.