Quick answer
Quick answer
Yes, in many places. 2 state programs name chronic back pain on the official list, and 14 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.
Understanding chronic back pain
Ongoing back pain can limit work, sleep, exercise and time with family, and it often comes with stiffness, muscle spasms and low mood. Care usually combines physical therapy and exercise, anti-inflammatory and nerve pain medicines, injections, and sometimes surgery, with opioids used more cautiously than in the past.
Symptoms patients hope to ease
- Constant aching in the lower back
- Muscle spasms and stiffness, especially in the morning
- Shooting nerve pain down the leg (sciatica)
- Pain that disrupts sleep
- Flare-ups after sitting, standing or lifting
- Low mood and stress from living with daily pain
Does chronic back pain qualify in your state?
- AL AlabamaNot listed by name
- AK AlaskaDoctor's discretion
- AZ ArizonaNot listed by name
- AR ArkansasNot listed by name
- CA CaliforniaDoctor's discretion
- CO ColoradoDoctor's discretion
- CT ConnecticutListed as “Post laminectomy syndrome with chronic radiculo…”
- DE DelawareDoctor's discretion
- FL FloridaDoctor's discretion
- HI HawaiiDoctor's discretion
- IL IllinoisNot listed by name
- KY KentuckyNot listed by name
- LA LouisianaDoctor's discretion
- ME MaineDoctor's discretion
- MD MarylandNot listed by name
- MA MassachusettsNot listed by name
- MI MichiganNot listed by name
- MN MinnesotaDoctor's discretion
- MS MississippiNot listed by name
- MO MissouriDoctor's discretion
- MT MontanaNot listed by name
- NV NevadaNot listed by name
- NH New HampshireNot listed by name
- NJ New JerseyNot listed by name
- NM New MexicoNot listed by name
- NY New YorkDoctor's discretion
- ND North DakotaListed as “Spinal stenosis or chronic back pain, including…”
- OH OhioNot listed by name
- OK OklahomaDoctor's discretion
- OR OregonNot listed by name
- PA PennsylvaniaNot listed by name
- RI Rhode IslandNot listed by name
- SD South DakotaNot listed by name
- UT UtahNot listed by name
- VT VermontNot listed by name
- VA VirginiaDoctor's discretion
- WA WashingtonNot listed by name
- DC Washington, D.C.Doctor's discretion
- WV West VirginiaNot listed by name
What the research says
Stronger evidence. Back pain is the most common form of chronic pain, where the National Academies found substantial evidence of benefit.
- The 2017 National Academies review found substantial evidence that cannabis and cannabinoids can reduce chronic pain in adults, although the average benefit in trials was modest.
- Most chronic pain trials studied nerve-related pain or mixed pain groups, and fewer trials have focused on back pain specifically.
- Recent evidence reviews suggest products with higher THC may give small short-term pain relief, with more side effects such as dizziness and sleepiness.
- Patient surveys consistently list back pain among the most common reasons people use medical cannabis, and many report using fewer other pain medicines.
Sources: National Academies of Sciences, Engineering, and Medicine, The Health Effects of Cannabis and Cannabinoids (2017); FDA approvals; published trials. General information, not medical advice.
How doctors approach chronic back pain
Doctors often consider oral products or tinctures for steady, longer-lasting relief, and inhaled forms for faster relief during flare-ups.
Balanced THC and CBD products are commonly discussed, since they may ease pain with fewer side effects than high-THC products alone.
Topical creams and balms are sometimes tried for localized muscle pain, though evidence for them is limited.
Evening use is common when pain disrupts sleep, and starting low and going slow helps limit dizziness and grogginess.
Risks and precautions
- Combining cannabis with opioids, muscle relaxants such as cyclobenzaprine, gabapentin or pregabalin can increase drowsiness and the risk of falls.
- Never stop or change opioid doses on your own, because sudden changes can cause withdrawal and other risks.
- Dizziness and slower reactions can make lifting or exercise less safe right after a dose.
- New weakness, numbness in the groin area, or loss of bladder or bowel control needs urgent medical care, not self-treatment.
- Avoid cannabis during pregnancy or breastfeeding, and never drive while impaired.
- Not recommended during pregnancy or breastfeeding, and never drive while impaired.
What to bring to your evaluation
Imaging reports such as an MRI, CT or X-ray of your spine.
Notes from your doctor, orthopedic surgeon, pain specialist or physical therapist describing your diagnosis.
A list of treatments you have tried, including medicines, injections, therapy and surgery, and how well they worked.
A pain diary showing pain levels, sleep and activities that trigger flare-ups.
A government photo ID and proof that you live in your state.
Don't have records handy? Many patients are evaluated on their history alone.
Start my free checkHow to get certified for chronic back pain
Answer a few questions
Pick your state, tell us your symptoms and what you've already tried. Review your answers and contact you to schedule your video visit.Meet your doctor by video
Join from your phone or laptop. Have a photo ID ready. The doctor reviews your history and decides whether cannabis is right for you.Get certified and registered
Pay the evaluation fee, then submit your state registry form. The doctor files your certification. We walk you through the state form line by line.
Chronic back pain: 9 common questions
Does chronic back pain qualify for a medical marijuana card?
Yes, in many places. 2 state programs name chronic back pain on the official list, and 14 more let the certifying provider decide. Either way, a provider licensed in your state has to evaluate you and agree that cannabis is appropriate.
Which states list chronic back pain as a qualifying condition?
As of our latest check of each state's official list: Connecticut and North Dakota. Providers can also certify it in Alaska, California, Colorado, Delaware, Florida, Hawaii, Louisiana, Maine and 6 more, which don't use a fixed list. Lists change, so confirm on your state's page before you apply.
Can I get certified for chronic back pain online?
Yes, in 12 of those states — including Connecticut, California, Delaware, Hawaii, Louisiana and 7 more — your first evaluation can happen by video with a provider licensed there. In 4 others, such as North Dakota, Alaska, Colorado and 1 more, the first visit must be in person, and renewals can usually be done online.
Does CBD or THC work better for back pain?
Most pain studies that showed benefit used products containing THC, often balanced with CBD. CBD alone has less research for pain, though some people find it helpful with fewer side effects. Many doctors start with a balanced product and adjust based on how you respond.
Can cannabis interact with my pain medications?
Yes, cannabis can add to the drowsiness caused by opioids, muscle relaxants, gabapentin and pregabalin. This raises the risk of falls and slowed breathing at higher doses. Share your full medicine list with your doctor, and do not change prescribed doses on your own.
Can I use cannabis alongside physical therapy?
Many people do, and easing pain may make it easier to stay active. Avoid using a dose that makes you dizzy or foggy right before exercise, since balance and judgment matter. Tell your physical therapist what you are using so they can plan sessions safely.
Can cannabis help me use fewer opioids?
Some patients report needing fewer opioids, but research on whether cannabis reliably reduces opioid use is mixed. Any opioid reduction should be planned with your prescriber, usually as a slow taper. Never stop opioids suddenly.
Do cannabis creams work for back pain?
Topical products may help some people with surface muscle soreness, but there is little research on them for deep back pain. They generally do not cause a high. They can be a low-risk option to try alongside other approaches.
Is cannabis safe for older adults with back pain?
Older adults can use it, but they are more sensitive to dizziness, confusion and falls, and often take medicines that can interact. Very low starting doses and slow increases are important. Let a family member or caregiver know what you are taking.