People who do not respond to traditional therapies for chronic lower back pain showed “large, sustained, and statistically robust improvements” when they began using medical cannabis, according to the findings of a recently published study. Researchers at Rabin Medical Center in Israel completed the study, which was published in the peer-reviewed journal Biomedicines in May.
To conduct the study, the research team examined longitudinal data from 241 patients with treatment-resistant lower back pain from 2020 to 2025. All patients included in the study reported severe, persistent back pain prior to cannabis therapy, even with the use of opioid analgesics, NSAIDs, and physiotherapy for at least one year. Additionally, 80.5% had prior SSRI/SNRI use, and 38.6% had prior anticonvulsant use.
Study Focused on Smoked or Vaporized Cannabis
The cannabis used in the study had a variety of cannabinoid potencies, with THC levels ranging from 4% to 22% and CBD levels from 2% to 22%. The researchers noted that they chose to study inhaled (smoked or vaporized) cannabis “because of its rapid onset, on-demand titratability, and patient preference.”
The researchers determined that cannabis not only “markedly and durably” improved pain symptoms, but it was also accompanied by reductions in the use of other medications, including powerful painkillers.
“Inhaled cannabis was associated with large, sustained, and statistically robust improvements in pain, disability, and pain interference, accompanied by near-total displacement of opioids, NSAIDs, antidepressants, and gabapentinoids,” the authors of the study wrote.
Lower Back Pain Affects 20% of Adults at Any Given Time
In their introduction to the study, the researchers explained the importance of finding alternative therapies for patients with lower back pain.
“Chronic low back pain (CLBP) is the leading cause of years lived with disability worldwide and affects approximately one in five adults at any given time,” they wrote. “Conventional pharmacotherapy—opioids, anticonvulsants (gabapentin, pregabalin), antidepressants (selective serotonin and serotonin–noradrenaline reuptake inhibitors), nonsteroidal anti-inflammatory drugs (NSAIDs), and structured physiotherapy—provides at best modest, transient relief and is associated with substantial dose-limiting toxicity, dependency risk, and clinical disappointment over multi-year horizons. Opioid analgesics in particular have driven a global crisis of dependency, overdose, and death, prompting major guideline bodies to discourage their long-term use for non-cancer back pain.”
Patients Reduced Their Opioid Use with Medical Cannabis
The researchers determined that nearly all of the study participants (95.4%) reduced their use of opioids. They also found medical cannabis to be safe and well-tolerated, with only three patients leaving the study due to adverse events. Only two patients (0.8%) discontinued the study because they found medical cannabis to be ineffective.
“The within-patient benefit-risk profile…supports consideration of cannabis as a potentially clinically meaningful, opioid-sparing option in patients who have failed multimodal conventional therapy, pending confirmation in randomized comparative trials,” the researchers concluded, according to a report from cannabis news outlet Marijuana Moment.
Researchers Call for Additional Studies
While the study's results are encouraging, the authors called for additional research on the use of medical cannabis to treat chronic lower back pain.
“Randomized comparative trials of inhaled cannabis versus continued multimodal therapy in refractory CLBP are needed before causal claims can be made,” they wrote. “In their absence, and pending such confirmation, these data support consideration of inhaled cannabis as a potentially clinically meaningful, opioid-sparing option for patients who have failed conventional multimodal therapy.”
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