Targeting the endocannabinoid system for the management of low back pain

Low back pain (LBP) is a major unmet clinical need. The endocannabinoid system (ECS) has emerged as a promising therapeutic target for pain, including LBP. This review examines the evidence for the ECS as a therapeutic target for LBP. While preclinical studies demonstrate the potential of the ECS as a viable therapeutic target, clinical trials have presented conflicting findings. This review underscores the need for innovative LBP treatments and biomarkers and proposes the ECS as a promising avenue for their exploration. A deeper mechanistic understanding of the ECS in LBP could inform the development of new pain management strategies. •Low back pain (LBP) is a major global health issue with a complex pathophysiology.•The endocannabinoid system (ECS) represents a putative novel target for treating LBP.•The current evidence for cannabis, cannabinoids and ECS modulators in LBP is limited.•Elucidating the role of the ECS in LBP may facilitate identification of biomarkers and novel therapies.