Effect of Δ9-tetrahydrocannabinol and cannabidiol on myofascial pain modulation in patients with temporomandibular disorder: a prospective crossover study

TL;DR

A study found that a combination of Δ9-tetrahydrocannabinol and cannabidiol significantly reduced pain and improved jaw function in patients with temporomandibular disorder.

Contribution

This is the first prospective crossover study to demonstrate the analgesic and functional benefits of Δ9-THC/CBD in TMD patients.

Findings

Δ9-THC/CBD reduced TMD pain from 7.35 to 3.50 on the VAS scale.

Mouth opening increased from 45.9 mm to 49.9 mm with Δ9-THC/CBD therapy.

Functional pain dropped by ∼90%, with near elimination of allodynia and hyperalgesia.

Abstract

•Δ9-THC/CBD reduced TMD pain from 7.35 to 3.50 on the VAS scale.•Functional gain: mouth opening increased from 45.9 mm to 49.9 mm.•Significant improvement in mandibular protrusion and laterality.•∼90 % reduction in functional pain; allodynia and hyperalgesia nearly absent.•Superior analgesic effect vs. placebo, with large effect size (d > 0.8).

Δ9-THC/CBD reduced TMD pain from 7.35 to 3.50 on the VAS scale.

Functional gain: mouth opening increased from 45.9 mm to 49.9 mm.

Significant improvement in mandibular protrusion and laterality.

∼90 % reduction in functional pain; allodynia and hyperalgesia nearly absent.

Superior analgesic effect vs. placebo, with large effect size (d > 0.8).

Temporomandibular Disorder (TMD) often causes chronic orofacial pain and functional limitations, with conventional treatments providing suboptimal results. Phytocannabinoids such as Δ9-Tetrahydrocannabinol (Δ9-THC) and Cannabidiol (CBD) have analgesic and anti-inflammatory properties, but evidence in TMD is scarce.

To evaluate the efficacy of Δ9-THC/CBD therapy in reducing pain and improving mandibular function in TMD patients.

Twenty adults with chronic myofascial pain (DC/TMD diagnosis) participated in a blinded, crossover, non-randomized study. Participants underwent two consecutive 90-day phases: placebo followed by Δ9-THC/CBD therapy (1:1 ratio, starting with a dose of 2 mg/day in the first week, gradually adjusting an increase of 2 mg/week until reaching 10 mg/day in the fifth week, sublingually), without washout. Outcomes included pain intensity (VAS), muscle sensitivity (algometry), mandibular function (mouth opening, protrusion, laterality) and pain sensitivity (allodynia/hyperalgesia). Data were analyzed using linear mixed models for repeated measures.

Δ9-THC/CBD improved all outcomes versus baseline and post-placebo (p < 0.001; Cohen’s d > 0.8). Mouth opening increased from 45.9 mm to 49.9 mm; VAS pain decreased from 7.35 to 3.50. Functional pain dropped by ∼90%, with near elimination of allodynia and hyperalgesia. Placebo effects were minimal.

Δ9-THC/CBD therapy provided substantial analgesic and functional benefits in TMD patients, supporting its potential as a therapeutic alternative. Larger randomized studies are recommended to validate these findings and explore underlying mechanisms.

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