Endocannabinoid System and the Role of Medical Cannabis in Treating Spasticity: A Narrative Review

Abstract

To date, over 500 phytocannabinoids have been identified from the Cannabis sativa plant, among which ∆9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most significant. Both molecules interact with the endocannabinoid system and produce therapeutic effects in various neurological disorders, including spasticity. The proposed mechanism of action suggests that THC modulates the hyperexcitability of the lower motor neuron, leading to a reduction in muscle tone, while CBD exerts an anti-inflammatory effect, aiding in pain reduction. The therapeutic application of these molecules in individuals with refractory spasticity of diverse etiologies has been shown to alleviate symptoms such as cramps, pain, and insomnia, which, in turn, has resulted in reduced doses of antispastic and analgesic drugs. This narrative review aims to briefly enlighten the Spanish-speaking community about the physiology of the endocannabinoid system, the pharmacology of cannabinoids, their administration methods, and synthesizes the most pertinent findings from studies suggesting these molecules as potential therapies for refractory spasticity.

Keywords

• cannabidiol
• dronabinol
• endocannabinoids
• cannabis
• muscle spasticity