Angst F, Angst J, Ajdacic-Gross V, Aeschlimann A, Rössler W. Epidemiology of back pain in young and middle-aged adults: a longitudinal population cohort survey from age 27–50 years. Psychosomatics. 2017;58(6):604–13.

Article  PubMed  Google Scholar 

Casiano VE, Dydyk AM, Varacallo M. Back Pain. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2021, StatPearls Publishing LLC. 2021.

Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C, et al. Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Res. 2016;5.

Organization WH. https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions. Published 2021.

Relieving pain in america: a blueprint for transforming prevention, care, education, and research. Washington (DC). 2011.

• Rubinstein SM, de Zoete A, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019;364:l689. A systematic review on current modalities for low back pain treatment and management.

Article  PubMed  PubMed Central  Google Scholar 

Traeger A, Buchbinder R, Harris I, Maher C. Diagnosis and management of low-back pain in primary care. CMAJ. 2017;189(45):E1386–95.

Article  PubMed  PubMed Central  Google Scholar 

Deyo RA, Von Korff M, Duhrkoop D. Opioids for low back pain. BMJ. 2015;350:g6380.

Article  PubMed  PubMed Central  Google Scholar 

Kolber MR, Ton J, Thomas B, Kirkwood J, Moe S, Dugré N, et al. PEER systematic review of randomized controlled trials: management of chronic low back pain in primary care. Can Fam Physician. 2021;67(1):e20–30.

Article  PubMed  PubMed Central  Google Scholar 

Chou R, Wagner J, Ahmed AY, Blazina I, Brodt E, Buckley DI, et al. Treatments for acute pain: a systematic review. Rockville (MD). 2020.

Abdel Shaheed C, Maher CG, Williams KA, Day R, McLachlan AJ. Efficacy, tolerability, and dose-dependent effects of opioid analgesics for low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016;176(7):958–68.

Article  PubMed  Google Scholar 

Krebs EE, Gravely A, Nugent S, Jensen AC, DeRonne B, Goldsmith ES, et al. Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain: the SPACE randomized clinical trial. JAMA. 2018;319(9):872–82.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lee SW, Shen J, Kim SJ, Chun SY, Kim P, Riaz J, et al. US trends of opioid-use disorders and associated factors among hospitalized patients with spinal conditions and treatment from 2005 to 2014. Spine. 2020;45(2):124–33.

Article  PubMed  Google Scholar 

Nicol AL, Hurley RW, Benzon HT. Alternatives to opioids in the pharmacologic management of chronic pain syndromes: a narrative review of randomized, controlled, and blinded clinical trials. Anesth Analg. 2017;125(5):1682–703.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Lee C, Lin M, Martins KJB, Dyck JRB, Klarenbach S, Richer L, et al. Opioid use in medical cannabis authorization adult patients from 2013 to 2018: Alberta, Canada. BMC Public Health. 2021;21(1):843.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Safakish R, Ko G, Salimpour V, Hendin B, Sohanpal I, Loheswaran G, et al. Medical cannabis for the management of pain and quality of life in chronic pain patients: a prospective observational study. Pain Med. 2020;21(11):3073–86.

Article  PubMed  Google Scholar 

Okusanya BO, Asaolu IO, Ehiri JE, Kimaru LJ, Okechukwu A, Rosales C. Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: a systematic review. Systematic Reviews. 2020;9(1).

Montero-Oleas N, Arevalo-Rodriguez I, Nunez-Gonzalez S, Viteri-Garcia A, Simancas-Racines D. Therapeutic use of cannabis and cannabinoids: an evidence mapping and appraisal of systematic reviews. BMC Complement Med Ther. 2020;20(1):12.

Article  PubMed  PubMed Central  Google Scholar 

Pratt M, Stevens A, Thuku M, Butler C, Skidmore B, Wieland LS, et al. Benefits and harms of medical cannabis: a scoping review of systematic reviews. Syst Rev. 2019;8(1):320.

Article  PubMed  PubMed Central  Google Scholar 

Khan SP, Pickens TA, Berlau DJ. Perspectives on cannabis as a substitute for opioid analgesics. Pain Manag. 2019;9(2):191–203.

Article  PubMed  Google Scholar 

• Lucas P, Boyd S, Milloy MJ, Walsh Z. Cannabis significantly reduces the use of prescription opioids and improves quality of life in authorized patients: results of a large prospective study. Pain Med. 2021;22(3):727–39. A recent study on medical cannabis and opioid use.

Article  PubMed  Google Scholar 

Takakuwa KM, Sulak D. A survey on the effect that medical cannabis has on prescription opioid medication usage for the treatment of chronic pain at three medical cannabis practice sites. Cureus. 2020;12(12):e11848.

PubMed  PubMed Central  Google Scholar 

Shah A, Hayes CJ, Lakkad M, Martin BC. Impact of medical marijuana legalization on opioid use, chronic opioid use, and high-risk opioid use. J Gen Intern Med. 2019;34(8):1419–26.

Article  PubMed  PubMed Central  Google Scholar 

Barry AR, Chris CE. Treatment of chronic noncancer pain in patients on opioid therapy in primary care: a retrospective cohort study. Can Pharm J (Ott). 2020;153(1):52–8.

Article  PubMed  Google Scholar 

Orhurhu V, Urits I, Olusunmade M, Olayinka A, Salisu Orhurhu M, Uwandu C, et al. Cannabis use in hospitalized patients with chronic pain. Adv Ther. 2020;37(8):3571–83.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ehrlich GE. Low back pain. Bull World Health Organ. 2003;81(9):671–6.

PubMed  PubMed Central  Google Scholar 

• First L, Douglas W, Habibi B, Singh JR, Sein MT. Cannabis use and low-back pain: a systematic review. Cannabis Cannabinoid Res. 2020;5(4):283–9. A systematic review on general cannabis use and low back pain.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kim TE, Townsend RK, Branch CL, Romero-Sandoval EA, Hsu W. Cannabinoids in the treatment of back pain. Neurosurgery. 2020;87(2):166–75.

Article  CAS  PubMed  Google Scholar 

Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021;372:n160.

Article  PubMed  PubMed Central  Google Scholar 

Training C. Cochrane handbook for systematic reviews of interventions. 2022.

Duthey B. https://www.who.int/medicines/areas/priority_medicines/BP6_24LBP.pdf. Published 2004.

(JBI) JBI. https://jbi.global/critical-appraisal-tools.

Bias CM. https://methods.cochrane.org/bias/risk-bias-non-randomized-studies-interventions. Published 2022.

Practice BB. https://bestpractice.bmj.com/info/toolkit/learn-ebm/what-is-grade/. Published 2022.

Eskander JP, Spall J, Spall A, Shah RV, Kaye AD. Cannabidiol (CBD) as a treatment of acute and chronic back pain: a case series and literature review. J Opioid Manag. 2020;16(3):215–8.

Article  PubMed  Google Scholar 

Ko GD, Bober SL, Mindra S, Moreau JM. Medical cannabis - the Canadian perspective. J Pain Res. 2016;9:735–44.

Article  PubMed  PubMed Central  Google Scholar 

Toor J, Kars M, Deygoo J, Dowling O, Hameed A. Medical marijuana and the discontinuation of opioids in a patient with neuropathic chronic pain. Reg Anesth Pain Med. 2017;42(6).

Zarabian K, Wannon A, Chin M, Kogan M. The intersection between integrative medicine and neuropathic pain: a case report. Explore (NY). 2021.

Yeung B, Patel P, Nelson A, Dayal R. Cannabidiol in the geriatric population: a novel treatment option for chronic back pain. Pain Physician. 2018;21(3):E294.

Google Scholar 

Takakuwa KM, Hergenrather JY, Shofer FS, Schears RM. The impact of medical cannabis on intermittent and chronic opioid users with back pain: how cannabis diminished prescription opioid usage. Cannabis Cannabinoid Res. 2020;5(3):263–70.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Vigil JM, Stith SS, Adams IM, Reeve AP. Associations between medical cannabis and prescription opioid use in chronic pain patients: a preliminary cohort study. PLoS ONE. 2017;12(11):e0187795.

Article  PubMed  PubMed Central  Google Scholar 

Mondello E, Quattrone D, Cardia L, Bova G, Mallamace R, Barbagallo AA, et al. Cannabinoids and spinal cord stimulation for the treatment of failed back surgery syndrome refractory pain. J Pain Res. 2018;11:1761–7.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ueberall MA, Essner U, Mueller-Schwefe GH. Effectiveness and tolerability of THC:CBD oromucosal spray as add-on measure in patients with severe chronic pain: analysis of 12-week open-label real-world data provided by the German Pain e-Registry. J Pain Res. 2019;12:1577–604.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Haroutounian S, Ratz Y, Ginosar Y, Furmanov K, Saifi F, Meidan R, et al. The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain: a prospective open-label study. Clin J Pain. 2016;32(12):1036–43.

Article  PubMed  Google Scholar 

Yassin M, Oron A, Robinson D. Effect of adding medical cannabis to analgesic treatment in patients with low back pain related to fibromyalgia: an observational cross-over single centre study. Clin Exp Rheumatol. 2019;37 Suppl 116(1):13–20.

Bebee B, Taylor DM, Bourke E, Pollack K, Foster L, Ching M, et al. The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Med J Aust. 2021;214(8):370–5.

Article  PubMed  Google Scholar 

Miller NS, Ipeku R, Oberbarnscheidt T. A review of cases of marijuana and violence. Int J Environ Res Public Health. 2020;17(5).

Gunn RL, Skalski L, Metrik J. Expectancy of impairment attenuates marijuana-induced risk taking. Drug Alcohol Depend. 2017;178:39–42.

Article  PubMed  PubMed Central  Google Scholar 

Memedovich KA, Dowsett LE, Spackman E, Noseworthy T, Clement F. The adverse health effects and harms relat