Medical Cannabis for Concussions

There are more than 3 million cases of concussions a year and modern medicine is adopting new treatment options for the wide variety of symptoms associated with concussions.

A concussion is a traumatic brain injury that changes the normal functioning of the brain. It occurs after a direct blow to the head or any injury that shakes the brain inside the skull. Typically the symptoms are temporary and resolve within a range of days to weeks. A minority of concussion symptoms can be longer lasting and can persist for months.

There are a constellation of symptoms that include but are not exclusive to memory impairments, physical symptoms, sleep disturbances, and changes in emotional affect. The physical symptoms are most prevalent and include headaches, dizziness, nausea, balance problems, blurry vision and fatigue. Patients also complain of feelings of fogginess, difficulty concentrating, forgetfulness, and emotional labiality. Patients state they are more irritable with increased anxiety and feeling of sadness. Affected children are more difficult to identify due to their inability to verbalize these vague symptoms.

It is critical to rest the brain immediately after a concussion and time to allow the brain to heal and return to normal functioning. Typically treatment after the rest period is directed towards the persistent symptoms. For dizziness and balance issues, physical therapy can be beneficial by performing vestibular Ocular rehabilitation and/or gait and balance retraining. Physical therapy also aids in treatment of headaches with massage, electrical stimulation, and soft tissue techniques directed at the neck. Medications such as magnesium and antidepressants have also been found to relieve headaches.

There is also evidence of the benefits of using medical cannabis to treat post concussive syndrome. Studies have shown how cannabis can reduce the damage to the brain and help patients manage a variety of symptoms associated with post concussive syndrome. Cannabinoids found in cannabis, specifically cannabidiol (CBD), activate our own bodies’ endocannabinoid system. CBD binds to CB receptors 1 and 2. CBD also binds to 5-Hydroxytriptamine1A receptors. These receptors provide protection against neural damage following tramatic brain injury. CBD has found to reduce intracellular Ca+, decrease leukocytes and our inflammatory response. On a cellular level CBD decreases glutamate buildup that leads to neurotoxicity.

Aside from the neuroprotective mechanisms of CBD, medical cannabis aids with a spectrum of other symptoms associated with concussion. Difficulty falling asleep and/or staying asleep is found to have improved with medical cannabis. Cannabis has also been found to alleviate stress levels and depression associated with poor functioning from post concussive syndrome. There have also been studies showing the benefits of cannabis for muscle spasms and pain. Many people with concussions suffer from neck pain and associated muscle spasms that are typically treated with opiates and muscle relaxers. Medical cannabis may be a safe and efficacious alternative treatment to opiates, which are increasingly linked to physical dependence/abuse.

Large scale studies have been limited due to the federal government’s restriction on medical cannabis research. These laws are currently being changed and should allow for more research into the medical benefits of cannabis for a whole variety of conditions including concussions.

About the Author, Dr. Keyur Patel: Currently the DO, Research & Development for the Compassionate Certification Centers, Dr. Keyur Patel is Vice-President/CMO of D&P Medical Group and serves as Medical Co-Director of the Wound & Hyperbaric Center.