Spinal Cord Injury
Damage to the spinal cord resulting in temporary or permanent changes in motor, sensory, or autonomic function. Cannabis has moderate evidence for reducing spasticity and managing neuropathic pain in spinal cord injury patients.
- 15 states
- QUALIFYING IN
- Moderate
- EVIDENCE
- T09.3XXA
- ICD-10
Reviewed by Laura H. Meyer
Qualifying states
What it is
Spinal cord injury (SCI) results from damage to the spinal cord by trauma, disease, or congenital condition, producing temporary or permanent changes in motor, sensory, and autonomic function below the level of injury. Severity and functional impact depend on injury level and completeness. Common chronic complications include spasticity, neuropathic pain, autonomic dysreflexia, and bladder/bowel dysfunction.
Cannabis and cannabis-derived therapies
The 2017 NASEM consensus report identified substantial evidence that oral cannabinoids improve patient-reported spasticity symptoms. A finding that applies to MS spasticity and is generally extended to other causes of central spasticity including spinal cord injury.
Evidence for neuropathic pain control following SCI is more variable but has been reported as a primary benefit by patients in survey and clinical studies. Cannabis is a qualifying condition basis under most state medical programs that list spinal cord injury or central neuropathic pain.
Frequently asked questions
How strong is the cannabis evidence for spinal cord injury?
Moderate for spasticity and neuropathic pain (the two most common chronic complications of SCI). The 2017 NASEM report identified substantial evidence that oral cannabinoids are effective for improving patient-reported spasticity symptoms, and substantial evidence for chronic pain in adults. SCI-specific trials are smaller than MS trials but consistent in direction.
Is any cannabis-derived product FDA-approved for SCI?
No. No cannabis or cannabinoid product is FDA-approved specifically for spinal cord injury in the United States. Nabiximols (Sativex), an oromucosal THC/CBD spray, is approved in many other countries for MS-related spasticity and is sometimes referenced in SCI literature; it is not FDA-approved in the US.
Which SCI symptoms have the most cannabis-related evidence?
Spasticity and neuropathic pain have the most consistent evidence. Sleep disturbance, appetite, and bladder spasticity are also commonly cited in patient surveys; trial evidence in these domains is more limited. Cannabis is most commonly used as adjunctive therapy alongside standard SCI management (baclofen, gabapentinoids, antispasmodics).
What practical considerations apply when SCI patients use cannabis?
Cannabis can interact with baclofen, gabapentin, opioids, and antispasmodics through additive CNS depression. Smoking is contraindicated in patients with respiratory compromise (high cervical injuries). Edibles, oils, and tinctures are generally preferred. Patients should coordinate cannabis use with their physiatry, pain-management, and primary-care teams.
Sources
- NASEM: The Health Effects of Cannabis and Cannabinoids (2017)accessed May 15, 2026
“Substantial evidence that oral cannabinoids are effective for improving patient-reported spasticity symptoms.”
- NIH National Institute of Neurological Disorders and Stroke: Spinal Cord Injuryaccessed May 15, 2026