In medical programs across the United States and beyond, a number of conditions qualify patients to gain access to medicinal cannabis, from post-traumatic stress disorder to cancer, seizures, and migraines. In addition, many people also use cannabis to relieve symptoms of chronic pain.
In 2021, an estimated 20.9% of U.S. adults, or 51.6 million people, experienced chronic pain, according to the Center for Disease Control and Prevention.
For a bit of perspective on the prevalence of cannabis use for chronic pain, a new study published in The Journal of the American Medical Association found that, among 1,661 individuals with chronic pain in the 36 states with active medical cannabis program in March to April 2022, 31% of adults reported having ever used cannabis to manage their pain, 23.2% reported using cannabis to manage their pain in the past month, and 23.2% used cannabis in the past 30 days.
Although most hemp- and cannabis-based products don’t have FDA approval and more research is needed to fully uncover the potential benefits of the plant medicine, available research and anecdotal evidence suggest that cannabis and its compounds can help to relieve pain and pain-related symptoms.
When considering the best cannabis strains for pain, one important element is its classification, namely if a strain is a sativa, indica, or hybrid. While there’s admittedly a lot more to cannabis, some classifications tend to be more effective at treating certain symptoms than others.
So, when it comes to managing pain, is sativa or indica the better choice? Keep reading to learn how to scope out the best marijuana for pain!
- Cannabis and hemp strains are typically separated into sativa, indica, and hybrid classifications.
- Indica and sativa strains have their own unique physical characteristics, along with unique physiological effects.
- Indica strains tend to be the best weed for pain, but don’t write off every hybrid or sativa, either.
- Classification can tell you a lot about a strain, but cannabinoid content, terpenes, and the specific strain and its lineage can also inform pain-relieving effects.
Indica vs. Sativa
You’ll generally find cannabis and hemp strains labeled as sativa, indica, or hybrid. Sativa and indica strains tend to differ both in their appearance and also in their physiological effects. That means you can typically expect distinct effects from sativa strains versus their indica counterparts.
As far as looks go, indica plants are typically short and stocky, with broad leaves. Sativas, on the other hand, are generally taller, with skinnier leaves and sometimes have a somewhat lanky appearance.
When looking at effects, sativas are known to generally encourage an uplifting high focused in the head. This feeling usually manifests with increased alertness, creativity, energy, and a cerebral feeling of euphoria. For this reason, many people consider sativas ideal for daytime use.
Indicas usually fall on the other side of the spectrum, encouraging more of a body high, stimulating appetite, also good for relaxation and sleep. Given these effects, many consumers use indica strains in the evening or at night.
Which brings us to the question at hand: Should you go with an indica or sativa for pain?
Is Indica or Sativa Better for Pain Relief?
In the search for the best strain for pain, you guessed it — indicas are often the best strains for pain relief. And it makes sense! Indica strains often have more sedating, body-focused effects that can be especially suited to help with pain relief.
The uplifting attributes of sativas make it great for assisting with mood, increasing energy, and enhancing focus, though using sativa for pain is not uncommon.
It’s important to understand that not every sativa or indica is exactly the same. There are some sativas that are more mellow and some indicas that are more energizing. Cannabis is complex, and there’s a lot more to consider than simply a sativa, indica, or hybrid classification.
For example, consider that research has found THC and CBD on their own have potentially significant pain-relieving effects, sativa or indica classification aside, with a number of studies confirming that cannabis use can reduce or eliminate the need for opioid prescriptions among patients with chronic pain.
As the cannabis space continues to grow, many consumers, advocates, and experts are also pushing to expand the way we categorize cannabis, exploring terpenes, the flavonoid compounds in cannabis, and their potential medicinal effects, along with other minor cannabinoids that could influence the specific effects of a strain.
Best Strains for Pain: Considering Hybrids
We’ve talked a lot about sativas and indicas, but what about hybrids?
To further complicate the conversation of cannabis classification, hybrids are often divided into three categories: “pure” hybrid, sativa-dominant hybrid, and indica-dominant hybrid. A pure hybrid is generally considered to be very even-keeled in its effects, a 50/50 indica and sativa split, if you will. Sativa-dominant and indica-dominant hybrids are pretty self-explanatory, leaning a bit more to one side or another.
This distinction is generally made based on the strain lineage and cross strains used to breed a hybrid, along with expected effects.
Hybrids are a great option, considering you can take advantage of the potential benefits both sativa and indica strains have to offer! You may find that a hybrid is the best cannabis strain for pain, depending on your specific needs. For example, if you’re looking for some of the sedating effects of an indica strain without being put to sleep, an indica-dominant hybrid could be a good bet, or a hybrid crossed with a heavy indica known for its pain relieving properties.
Conversely, while many sativa strains are used to help with stress, some users may find that some pure sativas cause a bit too much raciness in the head. In that case, a sativa-dominant hybrid could be the answer, a strain that’s still uplifting without going straight to the head.
The Bottom Line
Given the shift in cannabis policy over the last several decades, there’s still a lot of catching up to do in regard to cannabis research. However, mounting evidence suggests that there is indeed a relationship between cannabis and pain relief.
When considering the best weed strains for pain, sativa and indica classification is surely a primary element of the conversation. Indicas tend to be some of the best strains for pain relief, but that doesn’t mean you should immediately write off all hybrid and sativa options.
Strain classifications aren’t cut and dry, and cannabis is also complex. So, while looking at whether a strain is a sativa or indica is one major factor to consider, looking at strain lineage, cannabinoids like THC and CBD and their content, terpenes, and other factors is important when exploring cannabis and its effects.
On your search for a pain-relieving cannabis strain, just a little knowledge can go a long way!
Bicket, M. C., Stone, E. M., & McGinty, E. E. (2023). Use of Cannabis and Other Pain Treatments Among Adults With Chronic Pain in US States With Medical Cannabis Programs. JAMA Network Open, 6(1), e2249797. https://doi.org/10.1001/jamanetworkopen.2022.49797
Boehnke, K. F., Litinas, E., & Clauw, D. (2016). Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain. The Journal of Pain, 17(16), 739–744. https://doi.org/10.1016/j.jpain.2016.03.002
Capano, A., Weaver, R. L., & Burkman, E. (2020). Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate Medicine, 132(1), 56–61. https://doi.org/10.1080/00325481.2019.1685298
Lynch, M. A., & Ware, M. A. (2015). Cannabinoids for the Treatment of Chronic Non-Cancer Pain: An Updated Systematic Review of Randomized Controlled Trials. Journal of Neuroimmune Pharmacology, 10(2), 293–301. https://doi.org/10.1007/s11481-015-9600-6
Rikard, S. M. (2023). Chronic Pain Among Adults — United States, 2019–2021. Centers for Disease Control and Prevention. https://doi.org/10.15585/mmwr.mm7215a1