From Flower to Function: Medical Cannabis Modalities in Orthopedic Practice

Medical cannabis (MC) is a potential therapeutic option for managing several chronic pain and cancer-related symptoms, as well as multiple sclerosis-related spasticity. Despite increasing acceptance and availability in the United States, significant knowledge gaps remain regarding its modalities, pharmacokinetics, and indications, which present a barrier to use for both clinicians and patients. MC is of particular interest within orthopedics, given the prevalence of chronic musculoskeletal pain and acute postoperative pain following surgical procedures. Evidence suggests that MC can alleviate these conditions and reduce opioid consumption, revealing it as a potentially valuable adjunctive therapy within a multimodal pain management regimen that addresses larger public health concerns brought about by the ongoing opioid crisis, characterized by growing opioid misuse and overdose. Federal and state regulations governing MC use and distribution remain complex and variable, however, creating practical challenges for both orthopedic surgeons and patients. This Current Concepts narrative review aims to synthesize the current evidence on MC’s various modalities and pharmacologic properties, with a focus on its specific applications in orthopedic care. The review also aims to clarify the regulatory considerations that orthopedic surgeons must navigate when counseling patients and integrating MC into management plans.