"Would you recommend a particular CBD product for relief of her pain (mostly back and leg pain)? Would you recommend adding THC to the CBD if she also has trouble staying asleep at night?"
Several preclinical studies demonstrated that modulating the endocannabinoid system may be useful in treating some motor symptoms of Parkinson’s disease. Unfortunately though, results from clinical studies have been inconclusive and conflicting. However, "an open-label observational study assessing the clinical effect of cannabis on motor and non-motor symptoms of PD revealed significant improvement after treatment in tremor (P < 0.001), rigidity(P = 0.004), and bradykinesia (P < 0.001)."
Also, typical neuropathological features of Parkinson’s include degeneration of dopaminergic neurons–several studies suggest that cannabis has antioxidant, anti-inflammatory and other properties that could be neuroprotective, which may explain some of the positive results some studies have show regarding cannabis and Parkinson’s.
And although the research regarding cannabis and motor symptoms of PD has been conflicting, cannabis has been shown to mitigate many of the non-motor symptoms which often accompany Parkinson’s, such as insomnia, pain, anxiety and depression.
Altogether, I consider cannabis as a valuable adjunctive medicine for the treatment of Parkinson’s, which should improve the quality of life for most patients afflicted with Parkinson’s disease and may even slow the progression of the disease and reduce motor symptoms.
Higher concentrations of CBD vs THC, such as 20CBD:1THC, will lessen, or even eliminate psychoactive effects, while still providing pain relief. However, products with similar levels of CBD and THC, such as 1:1, are more effective at treating pain, insomnia and anxiety. So, for most people, it takes some trial and error before finding a compromise that provides noticeable relief, while also avoiding unwanted side effects.
As an example:
For pain and PD treatment-
https://www.cbd.org/cbd-soft-gels-41 – take one capsule every three to four hours. Each pill should contain 2.5mg of THC, which will likely cause mild psychoactive effects.
If you’d like to avoid any psychoactive effects, I’d recommend a product, such as https://www.cbd.org/products/chocolates/18-1-chocolate, also taken every three to four hours
For sleep and PD treatment-
https://www.cbd.org/products/chocolates/1-1-chocolate – take one piece one to two hours before bedtime.
Hope this helps!