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Cannabis routine for AS pain management #278702
08/02/17 05:44 PM
08/02/17 05:44 PM
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Anja Offline OP
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Anja  Offline OP
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Hi everyone.

I've gotten PMs from several people asking me more specific questions regarding how I use cannabis to manage pain from my AS, so I wanted to post my routine more publicly in case it would be helpful for more people. Cannabis has been life-changing for me, but it is NOT a miracle cure, just one very powerful tool in a set of other beneficial initiatives. I use cannabis daily in various forms, in conjunction with a biologic (Cimzia, 200mg sub-q injections every other week), NSAID (Celebrex, 100mg every 12 hours), and opioid (Tramadol, 50mg every six hours as needed). I have seen enough of an improvement in my quality of life that (under the supervision of both my rheumatologist and primary care physician) I have begun to slowly taper my Tramadol, as well as the Lexapro and Trazodone that I have been on for anxiety/depression and insomnia.

I essentially try to lay a foundation of edibles for longer maintenance of pain and add in vaping (flower/oil) for more immediate relief. My typical daily schedule (with strain types) goes something like this:

First thing in the morning: 15mg of Endoca Hemp Oil drops(CBD-only sativa strain), sublingual.

With breakfast: One dropper of alcohol based tincture of AC/DC (sativa strain with CBD to THC ratio of 20:1, so no head high), sublingual. I'll repeat this again about halfway through the day if it's a bad pain day.

After breakfast and repeated every 1-1.5 hours or so throughout the day: 2-3 inhalations (of 3 seconds each) of either C02 oil vape pen or vaporizer with flower-filled cartridge of sativa dominant strains.

After dinner, then hourly until bedtime: 2-3 inhalations (of 3 seconds each) of either C02 oil vape pen or vaporizer with flower-filled cartridge of indica dominant strains.

Bedtime: One dropper of glycerine based tincture of a heavy, intense indica strain.

Anytime, as needed: Topical CBD/THC pain salve for temporary relief of localized pain and swelling.

I also will ingest an infused gummy or CBD/THC capsules, as needed, especially if I am somewhere that I don't have easy (or discreet) access to my tinctures or vapes. If I feel that I need an extra boost of THC for quick-acting pain management during the day, I'll add a bit of ice hash or kief to the flower in my vaporizer.

The sativa/sativa-dominant strains that I have liked so far are: Pineapple Fields (for fatigue and pain), Harlequin (pain/inflammation), Golden Goat (pain, stress, depression), Space Queen (pain, stress, nausea), Hollywood Haze (fatigue, pain), Super Lemon Haze (fatigue, pain, depression), AC/DC (pain, inflammation)

50/50 sativa-indica strain: Bubblegum (anxiety, pain)

The indica strains that I have liked so far are: Kosher Kush, MK Ultra, Tikun Olam's Or, Strawberry Fields, Alchemist. All of those have helped a lot with muscle spasms, insomnia, anxiety, and night-time pain.

The key for me has been the strong indica strains at night. Getting my muscles to relax, easing my pain, and getting better/more sleep from the indicas has been life-changing. Coupling that with some good sativas that help with energy and pain during the day is really nice. It took a few weeks to figure out what kind of dosing would be effective. I have not had any bad side effects so far (sometimes a bit of dry mouth/eyes, but I already had that to an extent because of the AS!). The only strain that I tried and really didn't like was Sour Diesel; it gave been a lot of weird forehead pressure that was unpleasant.

I definitely follow the "start low and go slow" mentality as I figure out what to try. The tinctures/capsules are essential for longer lasting relief, with the oil/flower vape for shorter acting effects. I also prefer to use concentrates (like C02 oil or shatter) over flower because I can more effectively micro-dose. The only downside is that the dispensary I have access to right now doesn't have a variety of strains in concentrate form, so if there is a strain that I need/want in particular, I usually have to settle for flower. I'm looking into trying to make my own infused edibles with flower that I buy from the dispensary, but I haven't tried it yet.

I'd be interested to hear more about what other people do for their own treatment. It's been empowering to be able to fine-tune my own medicine with this and be able to have the knowledge to respond to how my body is feeling on a given day. I feel much less hopeless.

I'm happy to answer any questions or speak more about my experiences if anyone is interested.


Female, early 30s. Dx AS July 2016, symptomatic 13 years.
Current meds: Cosentyx (150mg injections every 2 weeks) since April 2018. Tramadol (100mg every 6 hours) since January 2017. Celebrex (200 mg every 12 hours) since July 2017. Medical cannabis tincture/oil/vape/topicals.
Ineffective meds/ intolerance: Remicade (3 months). Cimzia (6 months). Enbrel (6 months). MTX w/ folic acid (2 months). Plaquenil (3 months). Prednisone (1 month).
Re: Cannabis routine for AS pain management [Re: Anja] #278709
08/04/17 12:43 PM
08/04/17 12:43 PM
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Thesnakejakw Offline
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Thc/cbds never worked for me made pain worse I tried vaping too hard on my chest due to my ankylosing spondylitis affecting my rib cage , edibles don't work the CBD pills don't work , for pain. I am in hospital right now and the only thing that 100 percent got away my back pain was diladid (hydromophone) .3 ml per 10 minutes with a pain control pump. Now I am given oxycodone. At home I am given Hydrocodone up to 6 a day and 4 Soma a day and that helps also a little not as much as the oxycodone but still enough to get me through the day somewhat .I smoked weed all my teenage life and glad I don't need to or have desire to do so anymore opiods are a better solution for me but if cbd/ thc works go for it I just sharing my solutions and trials with it


Diagnosed 4+ months ago with as causes chest pain and severe back pain . Medications : methotrexate .6 per week in divided doses, Prednisone tapering off 2 5mg daily, folic acid mg daily, dicloymine for stomach pain and cramping , ranitidine 150mg twice daily and Prilosec 20mg extended release once daily , Carispodol (Soma) 350mg 5 times daily , oxycodone 10mg every 4 hours as needed
Re: Cannabis routine for AS pain management [Re: Thesnakejakw] #278722
08/08/17 03:04 PM
08/08/17 03:04 PM
Joined: Jul 2016
Posts: 26
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Anja Offline OP
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Anja  Offline OP
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I'm wish you speedy relief from your pain, snakejakw! I'm glad that opioid medications work well for you and that you have access to the amounts/type that provides you comfort. I benefit from opioids, too. It's interesting how unique everyone's experiences can be and how differently our bodies respond to disease and treatment.


Female, early 30s. Dx AS July 2016, symptomatic 13 years.
Current meds: Cosentyx (150mg injections every 2 weeks) since April 2018. Tramadol (100mg every 6 hours) since January 2017. Celebrex (200 mg every 12 hours) since July 2017. Medical cannabis tincture/oil/vape/topicals.
Ineffective meds/ intolerance: Remicade (3 months). Cimzia (6 months). Enbrel (6 months). MTX w/ folic acid (2 months). Plaquenil (3 months). Prednisone (1 month).
Re: Cannabis routine for AS pain management [Re: Anja] #280701
07/05/18 04:32 PM
07/05/18 04:32 PM
Joined: Nov 2007
Posts: 459
St George, UT
Britefutr Offline
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Britefutr  Offline
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Posts: 459
St George, UT
Thank you very much for this post. Ahh the idea of 100% pain relief in my back is one of my favorite fairytales. I would settle for 50% pain relief. I’m in a tough spot right now. I’ve gone through most of the anti-TNF in the last 20 years, now trying to get one more covered by insurance. It’s the last one for AS. And lucky me I was approved for disability and went straight onto Medicare with a supplement plan.

The only anti-TNF drug it covers is Enbrel. It doesn’t cover any generics. Really, I’m not kidding. My oxycodone ER, oxycodone, temazepam, cyclobenzaprine... you get the idea. They only cover the brand names. And of course my co-pay for those drugs is more than I would go pay just cash out-of-pocket using GoodRX for the generics. Such a scam. Their were only a couple of plans available in my area I’m hoping for something better next year. But in the meantime I am turning to some cannabis to see if I can get some relief. Anything that can get me off of opioids would be wonderful. Unfortunately I can’t take a very high doses of opioids without getting extreme headaches. So I have been living off a 15 mg dose of each for the last 10 years. I am also no longer allowed steroids. My wonderful adrenal gland has decided to fail me. My love hate relationship with prednisone is now over. I’m trying to look on the bright side I’m going to be in a lot more pain but damn I’m gonna lose some weight! I’m eager to try some of these recommendations thanks again for the post.

Last edited by Britefutr; 07/05/18 04:38 PM. Reason: Typos

Sebeth
---------------
AS onset at age 13, finally diagnosed in 1989, age 22!
Currently awaiting Cosentyx.
IBS, Polycythemia Vera, Anticardiolipid Syndrome,
Myositis, Adrenal Insuffiency, Asthma, etc...

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