Chronic Pain After a Rugby Injury and Could Medical Marijuana Be a Solution?

One of the most contact-heavy of all the sports, rugby injuries can take a really long time to overcome. Some players recover in time, but for others, they remain a cause of chronic pain for many years afterwards. As debate surrounding medical cannabis increases, can it be used to assist those injured on the pitch?

The repetitive traumatisation of the human body through scrums, tackles, and impacts in a single match exposes it to a plethora of musculoskeletal injuries in the long term. For some players, these injuries give them a perpetual source of pain long after the immediate post-injury phase has ended.

Chronic pain conditions, including nerve damage, joint deterioration, or post-operative issues, become daily afflictions. The amateur player who has only played a few years on the pitch might experience lower back pain, aching shoulders, or arthritis years after they've retired from the game. The combined effects of successive impacts may be hard to quantify, but for most, the outcome is a lower quality of life that traditional pain relief cannot completely alleviate. With traditional avenues not delivering enough, some individuals have sought regulated alternatives like medical marijuanas, usually through prescription routes in nations where it's available.

Medical specialists usually prescribe a mix of non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, and, in serious instances, opioid-based drugs for managing pain chronically. Although the treatments are helpful in the short run, they do carry some disadvantages.

Prolonged use of the drugs can cause gastrointestinal side effects or compromise the liver, and both cause well-documented dependency risks. The extent of these conditions inevitably proves a cycle of frustration for their rugby players: temporary relief and then recurrence, and at times, little prospect of long-term relief. In a few instances, the patient then considers intrusive procedures like hip or knee replacements with their extensive recoveries and less than always predictable outcomes.

With increasing numbers of patients now searching for sources of relief, interest has developed in alternative methods, among them, the legally controlled prescription of medical cannabis flower as part of a multifaceted pain relief approach.

Medical cannabis describes cannabis-derived products used under the guidance of a physician for possible therapeutic effects. Some cannabis-derived drug preparations contain compounds known as THC (tetrahydrocannabinol) and CBD (cannabidiol) and interact with the body's endocannabinoid system—a system of receptors involved in the regulation of processes like pain, mood, and sleep.

These initial studies indicate that cannabis preparations could impact the experience of pain and, notably, the experience of neuropathic pain, which has long been resistant to treatment by conventional drugs. The reports from patient experience encompass less pain intensity, enhanced quality of sleep, and less opioid dependency. These results are, however, preliminary and do not form part of strong clinical data yet. It is also important to highlight that medical cannabis patients must consult a healthcare professional, since responses may vary extremely from person to person and the approach will depend on a patient’s medical conditions and history.

Medical cannabis access in professional sport has ambiguous legal and ethical aspects in many jurisdictions. Some countries like the UK, Canada, and certain states in Australia condone medical access, whereas others enforce absolute prohibitions. Current players also have other regulations imposed upon them by organisations like World Rugby or their respective anti-doping agencies, even if the treatment would be legally available otherwise.

But retired players now enjoy greater accessibility to alternative options, and a few of them now speak out for better access and investigation. These players speak about ongoing pain in their joints, sleeplessness, and post-operative pain as their accounts highlight the extent of existing treatment options. Advocacy cannot substitute for strict science, however, and the athlete community keeps on demanding wider clinical trials to investigate safety, effectiveness, and longer term consequences.

Medical cannabis has side effects ranging from dizziness and tiredness to appetite changes for some patients. Additionally, every strain and every formulation does not have an equal effect on every patient and over-the-counter CBD oils labelled for pain relief may also be very variable in quality and consistency.

Finally, the question of whether medical cannabis might be able to treat chronic pain from rugby has no straightforward answer. The best available evidence would suggest it may be beneficial for some patients, but research remains essential. Controlled trials assessing outcomes over time and comparing standardised dosing and types of product would be necessary before any firm conclusions could be reached.

Meanwhile, current and former players must approach things carefully and responsibly. Medical cannabis as part of their pain regimen should be discussed with physicians who know the product and the player's history of injury. It may hold promise for relief but also calls for respect, oversight, and intense study. If former players are trying to regain comfort and agility, the future may very well hold medical cannabis, but always under the close supervision of competent professionals.