The analysis.

Cannabis and its pharmacologically active constituents, phytocannabinoids, have long been reported to have multiple medicinal benefits. Cannabidiol (CBD) is a noneuphoria producing constituent of cannabis that has the potential to relieve pain. It has demonstrated efficacy for multiple physical and mental problems2,3,5,6,8,9. Prior to 2012, there were only 9 published studies on the use of cannabinoids for medicinal treatment, however, in recent year over 50 studies have examined the effects of CBD. In some studies, CBD has shown to decrease anxiety and helped increase the duration of sleep in varying doses2,11,12. Most of the research done has been in animal models that have shown potential benefits, but clinical data remains limited in the research. To our knowledge, this is the first study to examine the use of nano-cannabidiol with sebrium to treat low back pain.

To further examine this association, we conducted we reviewed a cohort of patients with a history of low back pain who took nano-CBD with Sebrium DCD to examine the synergistic effect on objective and subjective measures of pain. A cohort ex National Football League (NFL) players who had chronic lower back pain were identified from a network of players. All players completed an initial questionnaire that included the Roland-Morris Low Back Pain and Disability Questionnaire (RM) and Numerical Pain Rating Scale (NPRS) to assess objective and subjective pain score as well as whether or not they were currently taking opioids and NSAIDs through an online portal. All players had documented use of a single capsule, consisting of 25mg nano-CBD composed of 100% hemp and 75 mg Sebrium DCD that they took two times a day for 30 days. All players continued to take their daily medications as needed, and their normal daily physical activity was not restricted. After one month, the players completed the same questionnaires to assess their measure of pain.

The results.

There were 40 players who were reviewed for this analysis. All players were male, average age 44 ± SD (Range) who have been retired for at least 1 year from the NFL. The average initial RM score was 4.45 ± 3.33 [Range 1-20] compared to post treatment 2.95±2.36 [Range 0-13]. Average initial NPRS was 6±1 [Range 1-6] compared to 3±1 [Range 1-6] post treatment. 100% of players had a decrease in NPRS post treatment. 73% of players had an improvement in their RM score (Table 1). Initially 17 (43%) players reported opiate use and 39 (98%) reported NSAID use. After treatment, 28% reported decrease in opiate use and 93% reported decrease NSAID use.

There were no adverse events or reported early stopping of treatment. In addition, 77% of participants reported nano CBD helped with falling asleep and staying asleep and 83% reported that they felt less anxious.

The potential benefits of cannabis-based medicine for pain have been positive, but the limited research provides an opportunity to explore its benefits. Some studies suggest that CBD can be used to treat neuropathic pain and provide an alternative pain management option1,4,7,10,13. Our results indicate that the use of nano CBD in combination with Sebrium can have remarkable pain relief for the treatment of chronic low back pain. Our findings found that nano-CBD with Sebrium can help decrease pain, decrease opiate and NSAID use. To our knowledge, this is the first report on the use of nano-CBD with Sebrium to treat lower back pain, and future studies should be conducted to assess its synergistic effect to treat lower back pain in a large cohort of patients.

Improvement (%)Number of Players


1. Aviram J, Samuelly-Leichtag G. Efficacy of Cannabis-Based Medicines for Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Physician. 2017;20(6):E755-E796.

2. Busse JW, Wang L, Kamaleldin M, et al. Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis. JAMA. 2018;320(23):2448-2460. doi:10.1001/jama.2018.18472.

3. Caroleo MC, Brizzi A, De Rosa M, et al. Targeting Neuropathic Pain: Pathobiology, Current Treatment and Peptidomimetics as a New Therapeutic Opportunity. Curr Med Chem. 30 2019. doi:10.2174/0929867326666190530121133.

4. Dray A, Read SJ. Arthritis and pain. Future targets to control osteoarthritis pain. Arthritis Res Ther. 2007;9(3):212. doi:10.1186/ar2178.

5. Echeverria-Villalobos M, Todeschini AB, Stoicea N, Fiorda-Diaz J, Weaver T, Bergese SD. Perioperative care of cannabis users: A comprehensive review of pharmacological and anesthetic considerations. J Clin Anesth. 2019;57:41-49. doi:10.1016/j.jclinane.2019.03.011.

6. Fujita S, Dreyer HC, Drummond MJ, et al. Nutrient signalling in the regulation of human muscle protein synthesis. J Physiol. 2007;582(Pt 2):813-823. doi:10.1113/jphysiol.2007.134593.

7. Lowin T, Schneider M, Pongratz G. Joints for joints: cannabinoids in the treatment of rheumatoid arthritis. Curr Opin Rheumatol. 2019;31(3):271-278. doi:10.1097/BOR.0000000000000590.

8. Mallick-Searle T, St Marie B. Cannabinoids in Pain Treatment: An Overview. Pain Manag Nurs Off J Am Soc Pain Manag Nurses. 2019;20(2):107-112. doi:10.1016/j.pmn.2018.12.006.

9. Mondello E, Quattrone D, Cardia L, et al. Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain. J Pain Res. 2018;11:1761-1767. doi:10.2147/JPR.S166617.

10. O’Brien M, McDougall JJ. Cannabis and joints: scientific evidence for the alleviation of osteoarthritis pain by cannabinoids. Curr Opin Pharmacol. 2018;40:104-109. doi:10.1016/j.coph.2018.03.012.

11. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23. doi:10.7812/TPP/18-041.

12. Teitelbaum J. A Hemp oil, CBD, and Marijuana Primer: Powerful Pain, Insomnia, and Anxiety-relieving Tools! Altern Ther Health Med. 2019;25(S2):21-23.

13. Yanes JA, McKinnell ZE, Reid MA, et al. Effects of cannabinoid administration for pain: A meta-analysis and meta-regression. Exp Clin Psychopharmacol. 2019;27(4):370-382. doi:10.1037/pha0000281.

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