The Endocannabinoid System and Osteopathic Medicine

Written by Sabina Pulone

The osteopathic approach to medicine is based on the principle of self-healing and the self-regulating capacity of the human body. Osteopathic manipulations, allopathic therapies (aka Western medicine), and lifestyle modifications together with philosophical concepts form the basis of this kind of medicine.

Disfunctions in the endocannabinoid system (ECS) largely reflect impaired body functions and influence overall well-being. The principles regulating osteopathic medicine can be closely related to an intervention on the ECS. This system is formed by endocannabinoid receptors (CB1 and CB2), endogenous ligands, and the enzymes metabolizing them. Exogenous cannabinoids are derived from cannabis plants and are capable of interacting with cannabinoid receptors and modulating their activity.

Acting on CB1 and CB2 receptors, cannabinoids can be employed for treating many functional disorders and can be integrated with endogenous ligands for cannabinoid receptor activation or inhibition. The perception of pain, psychological disorders, inflammatory responses, and neuro-degenerative diseases can be controlled by acting on the ECS and the body can reach and maintain homeostasis through self-healing mechanisms.

Osteopathic physicians can enhance endocannabinoid functions by promoting a beneficial therapeutic strategy including food supplements, physical exercises, and stress, alcohol, and/or drug reduction. Cardiac pulse, respiration, and gastrointestinal motility are “biological oscillators” modulated by the ECS that reflect the close interrelation between endogenous or exogenous cannabinoids and body functionalities. While CB2 receptors are mainly spread in the peripheral nervous system (PNS) and linked to the immune response, CB1 receptors are largely concentrated in the central nervous system (CNS) thus influencing brain capabilities and consciousness. Acting on the ECS constitutes a valid medicinal approach to solve human impairments, in a dynamic interaction of body and mind, as specified in one of the principles of osteopathic medicine. [1]

The onset of an illness is largely influenced by internal factors like structure and gene expression, but also by extrinsic factors like unhealty habits. Due to the different CB receptors distribution and the different structures within CB1 and CB2, it is possible to assert that they influence different mind/body functionalities. In vivo studies have demonstrated that augmentation of endocannabinoids or exogenous receptor agonists like phytocannabinoids at specific sites can serve as method to produce therapeutic effects. For example, rodent studies showed pain relief by enhancing endocannabinoid production in highly CB1 expressing sites like the dorsal horn in the spinal cord and the periaqueductal gray in the brain. Osteopathic principles can be confirmed and validated by continuing neuroscientific researches and investigating the close correlation between ECS and mind/body functionalities.



[1] McPartland, John M. The endocannabinoid system: An osteopathic perspective. The Journal of the American Osteopathic Association. 2008;108(10):586–600.doi:10.7556/jaoa.2008.108.10.586 [journal impact factor = 0.8; times cited = 40]



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Sabina Pulone

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