"Would a CBD rich tincture or a combination of THC/CBD be more effective? Would topicals help?"
Chronic pain is the #1 symptom in Adhesive Arachnoiditis. Also included in the top 10 symptoms: muscle spams, joint pain and sleep disturbances. I would start with a CBD:THC 1:1 ratio and work with your provider or the dispensary pharmacist to titrate and tailor a custom dose/ratio. Every body reacts differently to different medications. Medical cannabis has been shown to be effective in providing pain relief and aiding in a more restful sleep.