Understanding the Orthopedic Conditions for Which Patients Are Seeking Medical Cannabis Certification

Juliet Chung; Yusuf Mahmoud; Sina Ramtin; Gianna Uhler; Asif M Ilyas; Ari Greis

doi:10.7759/cureus.52829

Understanding the Orthopedic Conditions for Which Patients Are Seeking Medical Cannabis Certification

Cureus. 2024 Jan 23;16(1):e52829. doi: 10.7759/cureus.52829. eCollection 2024 Jan.

Authors

Juliet Chung^{1

2}, Yusuf Mahmoud², Sina Ramtin², Gianna Uhler³, Asif M Ilyas⁴, Ari Greis⁵

Affiliations

¹ Orthopaedic Surgery, Penn State College of Medicine, Hershey, USA.
² Orthopaedic Surgery, Rothman Orthopaedic Institute Foundation for Opioid Research & Education, Rothman Opioid Foundation, Philadelphia, USA.
³ Physical Medicine and Rehabilitation, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA.
⁴ Orthopaedics, Rothman Orthopaedic Institute at Thomas Jefferson University, Rothman Opioid Foundation, Philadelphia, USA.
⁵ Department of Medical Cannabis, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA.

Abstract

Background: Amid the ongoing national crisis of opioid misuse in the United States, medical cannabis (MC) has emerged as a potential alternative for chronic pain conditions. This study was performed to understand which orthopedic conditions patients are seeking MC certification for.

Methods: This prospective study was conducted at the Department of Medical Cannabis, Rothman Orthopaedic Institute, Philadelphia, PA, USA. It included consecutive patients with chronic musculoskeletal noncancer pain who were certified for MC, following the Pennsylvania state certification process. Data collected included demographic data, diagnoses, anatomic site of pain, and Patient-Reported Outcomes Measurement Information System (PROMIS) global health scale. The outcome measures from the PROMIS global health scale were used to generate Global Physical Health (GPH) quality of life (QoL) T scores and Global Mental Health (GMH) QoL T scores.

Results: A total of 78 patients were available for analysis following initial MC certification, with 50 (64%) being female and 28 (36%) male. The average age was 63 years with 60% of patients in the 65+ age group. Ethnically, 73 (92%) identified as White, and 70 (90%) were not of Hispanic or Latino origin. The most common reason for seeking MC certification was low back pain (56%), followed by neck pain (21%) and then extremity complaints. The mean GPH QoL T score was 43.71 with a standard deviation of ± 9.86 (p-value = 0.001), while the mean GMH QoL T score was 46.85 with a standard deviation of 8.28 (p-value = 0.0015).

Conclusion: MC cannabis certification was more often sought by women than men and most common for spinal complaints, specifically lower back followed by cervical spine concerns.. This cohort of patients had lower GPH QoL and GMH QoL T scores compared the US general population, representing a significant reduction in the overall physical and mental health.

Keywords: medical cannabis; medical cannabis certification; musculoskeletal conditions; orthopaedic; orthopaedics.