PAIN CONTROL – pain management formula Cannabinoid Clinic


PAIN CONTROL – pain management cannabinoid formula, 600 mg cannabinoids, 200 mg terpenes

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Benefits of cannabinoids and terpenes in managing pain

Several clinical trials have been conducted and published in which participants used either synthetic or plant-based cannabinoids, as well as smoking cannabis for relieving pain. Trials conducted using synthetic cannabinoids gave different results. The trials have mainly used dronabinol and cesamet (nabilone), both synthetic analogues of THC, meaning they are very similar to it and bind to the same receptors. Patients are selected very carefully for clinical trials, usually with very specific pain symptoms, so it is often difficult to draw general conclusions from such studies that would help a typical pain patient.

Most of the trials have confirmed a pain relief. In the case of rheumatoid arthritis, mobility improved and morning stiffness was alleviated, and in most patients sleep has been improved as well.

Many researches on pain focused on effect of THC or its analogues. However, lately an increasing number of patients’ experience and researches show the importance of CBD and other plant-based cannabinoids and terpenes in case of chronic pain. From the perspective of the inflammatory theory of pain, as well as central and peripheral sensitisation in chronic pain, the use of plant-based cannabinoids is rational.

Formulation’s key ingredients are the following:

  1. Cannabidiol or CBD

CBD is known to have a high anti-inflammatory effect and to regulate activity of neurons. It also modulates endocannabinoid system, especially anandamide concentrations as it decreases its degradation and thus causing its higher concentration. It also binds to TRPV, serotonin and other receptors. CBD cannot be expected to provide immediate pain relief, but when used over a long period of time, it can provide central and peripheral desensitisation, pain relief, improved sleep and general well-being.

  1. Cannabidiolic acid or CBDA

CBDA has several effects that are important in addressing pain, reducing swelling, and has its own mechanism of pain relief action, which occurs at lower doses than CBD. CBDA is particularly important in pain that has an inflammatory component and in chronic pain where hyperalgesia or hypersensitivity to pain stimuli is present.

  1. Cannabigerol or CBG

Cannabigerol (CBG) has significant analgesic and anti-erythraemic effects (alleviation of morbid redness of the skin), inhibits AEA uptake and binds to TRPV1-receptors. CBG also modulates certain enzymes in the biochemical cascade of pain, contributing to the analgesic action of the formulation.

  1. Limonene

Limonene is a terpene found in various plants and is well studied. It has a wide range of effects, including effect on pain. It has proved particularly useful for chronic muscular-skeletal pain and for hypersensitivity to pain stimuli. In Slovenia, many patients suffer from muscular-skeletal pain, especially in fibromyalgia and multiple sclerosis, which is why we have included limonene in the formulation.

  1. Rosemary essential oil

Rosemary essential oil contains a number of active ingredients, including but not limited to terpenes such as camphene, pinene, limonene, myrcene, as well as other active ingredients such as carnosic acid, carnosol, and rosmarinic acid. Traditionally, rosemary extracts have been used for various problems, such as spasms, pain, headaches, and migraines. Today, science confirms the effectiveness of rosemary’s active ingredients in treating pain, especially pain associated with muscle spasms and tension, such as migraines and tension headaches.

  1. Lemon grass essential oil

Lemon grass essential oil contains terpenes, alcohols, ketones, aldehydes, and esters. In terms of addressing pain, the most important terpene is myrcene, obtained from lemon grass essential oil. Its analgesic activity has been demonstrated in several different research models and dose-dependent analgesia has been demonstrated.

In adjacent tabs, read the texts written by dr. Tanja Bagar about what science today says about the pain and how cannabinoids supplement the established pain relief therapies.

Additional information


10ml, 30ml

science on pain

Pain is an interesting phenomenon. We can neither see it nor objectively measure it. However, we all know it and have already felt it. Pain is deeply personal and subjective feeling. It can be limited to a certain body part as in the case of an injury, or it can be more scattered as in fibromyalgia, for example. On average, each person experiences 10 types of pain every year. Chronic pain affects 22% of Slovenian adults, and by far the most common chronic pain is low back pain and spinal pain, with one in three people over the age of 60 suffering from some type of chronic pain.

Plants and pain have an interesting connection because much of our understanding of what pain is and how it works is owed to the plant world. Willow’s bark (Salix spp.) has contributed to aspirin’s development, for example, and explanation of the pain-relieving action of prostaglandins and their role in inflammation. Poppy (Papaver somniferum) has provided us with one of the strongest natural analgesics – morphine – and led to the discovery of the endorphin and enkephalinergic systems. Capsaicin, a component of chilli (Capsicum annuum etc.) also contributed to our understanding of the mechanism of pain, leading to the discovery of TRPV1 channels. Similarly, the THC’s isolation from the Cannabis sativa L. led to a discovery of the body’s own endocannabinoid system, which, among other things, affects pain.

Acute pain has a surprisingly large importance for our life and development. Usually, it is a sign of tissue damage, and is a primary signal that teaches us of what is dangerous. The sensation of pain has persisted through millions of years of evolution, improving the survival chances of many species. In medicine, we have relatively good approaches in treating acute pain – from rest and recovery from injuries, to the use of local heating or ice, non-steroidal anti-inflammatory medicines (aspirin, ibuprofen, etc.), to analgesics, opiates, and muscle relaxants. Over time, the injury heals and we are ready for new challenges again, although even in the treatment of acute pain, we sometimes encounter situations where we cannot successfully relieve the pain with existing pharmaceutical approaches.

Chronic pain is another story altogether. Wild animals, for example, do not show chronic pain as such behaviour would be a sign of weakness in animal world and would provoke an attack. On the contrary, it seems that people somehow learned that obvious showing of pain and conversation about it bring us a lot of attention and comfort, even sympathy, and sometimes even a financial benefit. Of course, this is not true for all people suffering from chronic pain. This type of pain is a puzzler for medicine, it is difficult to treat and often does not respond to medication, even opiates. Patients with chronic pain often find themselves in a situation where they cannot relieve their pain and carry out their daily activities with the available medication.

There are different theories of how pain is caused, covering different aspects of the biochemical processes that occur with the onset of pain. A sensation of pain is transmitted by certain nerve fibres that transmit pain impulses from the pain site to brain where numerous factors affect the perception of pain. These specific neurons are called nociceptors. Their role is to detect and respond to harmful or potentially dangerous stimuli by sending a “possible threat” signal to the spinal cord and brain. If brain estimates a threat as a real one, they create a sensation of pain that directs our attention to the painful part of the body, so we can avoid the danger or confront it. This is called nociception. Already children learn that oven is “ouch” and they should not touch it. Recently, many researches confirm the theory that the origin of all pain is fundamentally inflammation and the inflammatory response. This means that every sensation of pain is based also on inflammatory reaction. Such perspective on pain enables different approaches in treatment of pain, namely by treating the inflammation causing the pain as well.

Author: dr. Tanja Bagar, assist. prof.


A combination of cannabinoids and standard pain relief therapy

Another important perspective on pain relief are combinations of cannabinoids and standard analgesic medicines. Based on studies and experience, it is evident that we can successfully add cannabinoids to the existing pain relief treatment. In many cases, this combination is even better in relieving pain than any single medicine, which is particularly important from the perspective of the widespread use of opioids and also because of the so-called opioid crisis that is already present in many countries. Several important effects of the combination of opioids and cannabinoids have been observed: the addition of cannabinoids prevented the development of opioid tolerance, reduced withdrawal symptoms, and when the effect of opioids diminished over time, cannabinoids were able to restore opioid analgesia. This combination also enables use of lower opioid dosages with the same effects which decreases the occurrence and severity of adverse effects. Cannabinoids relieve pain through a variety of receptor and non-receptor mechanisms, including direct analgesic and anti-inflammatory actions, modulatory effects on neurotransmitters, and interactions with endogenous and prescribed opioids.

In the USA, pain is the most common cause for patients to look for hemp and cannabinoids. Most patients find a proper dosage and can also adjust it according to the daily level of pain. There is no doubt that cannabinoids have a huge potential in pain therapy that can no longer be ignored, and it is therefore essential to address the endocannabinoid system in chronic pain.

There are several types of pain and its causes. It is important to establish the reason for pain and to treat it using the best possible therapy. Sensation of pain and its effect on patient’s life are very individual. Many aspects of the response to pain depend on cultural factors, but it is good to remember that pain is a powerful physiological reflex that has been maintained and strengthened over evolution. Chronic pain management requires an interdisciplinary approach, as there are many biochemical loops that perpetuate pain.

Author: dr. Tanja Bagar

Generally, oral absorption of cannabinoids is very low. Only about 3–10% of the ingested cannabinoids come into bloodstream. Absorption of CBD is importantly influenced by two factors: different metabolism of each individual and absorption potential of the CBD oil (full-spectrum CBD oil with sufficient CBD has the highest absorption potential, isolated CBD has the lowest).

It is up to each individual to find the appropriate oral dosage of a cannabinoid formulation. We recommend you start with only 2–3mg (1–2 drops) and increase the daily dosage for a drop or two. Patients with severe problems need dosages up to 100mg per day. The usual daily dosage is between 15 and 30mg. Apply cannabinoid formulation under a tongue and keep it there for a minute or longer. A part of the CBD will be absorbed through the capillaries under the tongue. Its effect is felt after approximately 15 minutes. Then swallow the CBD drops. After ingestion, it takes about one and a half hour for CBD to reach its peak level in blood. CBD’s effect slowly clears up within 4-8 hours after ingestion.

Cannabinoid’s absorption can be significantly improved by applying them after a meal, especially a meal rich in fat.

Important: Cannabinoids inhibit (slow down) functioning of the CYP450 enzyme, which metabolises many medicines. Generally, this causes a higher level of these medicines in blood. You should take this into account and talk to your doctor to adjust (probably lower) the dose of the medicine. At levels of up to 30mg of cannabinoids (approx. 15 drops), no serious interactions with most medicines have yet occurred.