Anytime our bodies are injured, infected, or otherwise assailed, the immune system springs to action. White blood cells, our fast-acting, ever-circulating immunity first responders, release signaling proteins into the affected area to protect it, help push out potential pathogens and kick-start the healing process.

But the downside of this natural, life-saving immune response can range from unpleasant to downright life-threatening: Those proteins increase blood flow and spark fluid secretions that produce the redness, swelling, hotness and pain we’ve come to know as inflammation. Left untreated, inflammation is its own kind of menace.

And all too often, that inflammation is caused by the immune system falsely identifying harmless substances – even our own tissues – that produce painful and often chronic conditions like arthritis, ulcerative colitis (severe bowel irritation), skin conditions, asthma, and general soreness and joint pain.

Treatments for inflammation are as diverse as its causes.

Mass-market drugs by the dozen are used to treat inflammation, from over-the-counter aspirin, ibuprofen, and naproxen to prescribed cortosteroids (like prednisone) that are reliable and effective, but can carry severe side-effects. Herbal, dietary and other natural remedies, including drug-free botanical and fish-oil supplements, have spiked in popularity in recent years. And who hasn’t put a cold compress on swelling from a sports injury?

Most people use, or have used, some combination of these methods, depending on the type and severity of the condition they’re treating. But some of the most popular inflammation treatments have serious downsides; even Pfizer, which manufactures Advil, warns against long-term use of its active ingredient ibuprofen, which can cause ulcers, liver damage and kidney damage when taken in high doses over long periods of time.

And steroids can cause more serious issues – even in the short-term – like fluid retention, high blood pressure, mood and memory swings and hormonal imbalance.

For some, cannabis can be an effective natural alternative.

Though the evidence is widely scattered and still developing, cannabis has been shown to help alleviate inflammation of all kinds, and in ways that are different from conventional drugs.

Unlike hormone-mimicking steroids and ibuprofen, which work by blocking prostaglandins that are released in the brain in response to illness and injury, cannabis compounds have been shown to to suppress cytokines and chemokines, those inflammation-causing proteins that are released locally by white blood cells.

A comprehensive scientific peer review, partially funded by the National Institutes of Health and published in 2009 in the journal Future Science under the heading “Cannabinoids as novel anti-inflammatory drugs,” concluded that “targeting cannabinoid receptor–ligand interactions may constitute a novel window of opportunity to treat inflammatory and autoimmune disorders.”

Put simply, the compounds in cannabis may be able to identify when and where the immune system is over-reacting, then down-regulate those responses at the site instead of throughout the body.

Cannabis may be especially promising for GI tract inflammation.

The review singles out cannabis as being particularly effective for inflammatory bowel disease (IBD), an umbrella term for disorders in which the colon becomes inflamed. That can include, but isn’t limited to, ulcerative colitis and Crohn’s disease, which may not be caused not by the immune system attacking the body itself, but rather its tendency to go after harmless substances in the gut such as bacteria and certain types of food.

“Cannabinoids have been shown to regulate the tissue response to excessive inflammation in the colon … controlling the cellular pathways leading to inflammatory responses. These results strongly suggest that modulation of the physiological activity of the cannabinoid system during colonic inflammation might be a promising therapeutic tool for the treatment of several diseases characterized by inflammation of the GI tract.”

That’s a strong statement, especially coming from what’s arguably the most comprehensive published writing on cannabis and inflammation.

The review cites 130 clinical studies – mostly involving lab mice – and similar academic reviews and papers. It concludes that receptors in the endocannabinoid system, a network of signal pathways closely intertwined with the central nervous system that helps maintain homeostasis, are found on immune cells, suggesting that “cannabinoids play an important role in the regulation of the immune system.”

As promising as this all sounds, the review – and all of the supporting research – is missing a key element, one that’s never been done: a clinical trial involving humans.

That’s about to change.

Dr. Sue Sisley, the pioneering medical researcher whose groundbreaking study of cannabis for PTSD is now 10 years in the making, agrees with the general findings of the 2009 review. And she’s about to take it a step further.

“We’ve had some evidence that cannabis seems to affect the inflammation response pathway,” says Sisley, whose study is partially supported by Eaze. “Pain is almost always accompanied by inflammation. Arthritis, colitis … ‘itis’ means inflammation. So if you have a way of suppressing the inflammatory pathway, then you get some subjective relief.”

But Sisley’s research, a first-of-its-kind, placebo-controlled, blind clinical study that’s observed more than 70 former U.S. soldiers for their response to cannabis therapy, will also provide a line of sight into how cannabinoids can affect inflammation in the human body.

“We’ve never really quantified the degree of anti-inflammation,” Sisley tells Eaze. “We’re doing that, drawing blood for markers for inflammation. We measure it pre-treatment and post-treatement to be able to see if the cannabis they’re taking is having an impact on the inflammatory process.”

The results of Sisley’s research won’t be known to anyone – not even Sisley – until it’s completed later this year or early next. When it comes, a positive outcome could spark renewed interest in further exploring the development of cannabis therapies for inflammation – including what kinds of consumption methods, strains and terpene profiles may be best for certain types of inflammatory response.

What are the best terpenes for managing pain?

Even Sisley concedes that we’re many years away from “precision medicine,” the idea that specific cannabis therapies can be pointed directly at specific indications. Throughout the cannabis community, it’s believed that strains high in the terpenes Myrcene (prevalent in mangoes, hops, and thyme) and Pinene (smells like a pine forest, as you probably guessed) may have the most anti-inflammatory properties, though there’s only anecdotal evidence to support this. (Editor’s note: Products featured in this article are high in these terpenes).

Individual brands are already formulating vaporizer oils and other products especially for pain and inflammation with what they’ve learned about these effects, like the relief pen from dosist.

In the meantime, people who have turned to cannabis for pain management have found that it has an unexpected side-effect of its own: They’ve left ibuprofen behind.

“I last took an Advil … maybe a month or two ago?” says 38-year-old Holly Byerly, who spoke with Eaze during Pain Awareness Month. “I used to take it pretty consistently for my neck pain, or a headache. I only took it a couple of months ago because I didn’t have any CBD and couldn’t get any.”

She wasn’t the only one. Eaze spoke to dozens of people who manage pain with cannabis – and it kept coming up.

“It just slowly replaced Advil for me,” said Katherine L., a 25-year-old Los Angeles resident who works at a talent agency and suffers from lower hip and back pain. “I would say it’s more effective than Advil in some ways … It’s definitely a different animal.”

• Disclaimer: The opinions expressed in this article by Eaze and Eaze customers are published for educational and informational purposes only, and are not intended to serve as or substitute for a diagnosis, treatment or medical advice. Please consult a local physician or other health care professional for your specific health care and/or medical needs or concerns.

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