Initial evidence suggests Oral delivery is probably the most optimal.
The following are the guidelines suggested by the American Academy of Neurology related to cannabis use for symptoms of MS:
The American Academy of Neurology (AAN), an association of neurologists and neuroscientists dedicated to promoting high-quality care for people with nervous system disorders, released a “Summary of evidence-based guideline: Complementary and alternative medicine in MS” in 2014, including the following conclusions on the evidence regarding marijuana and its derivatives:
Oral cannabis extract and synthetic THC (tetrahydrocannabinol — a major active component of cannabis) are probably effective for reducing patient-reported symptoms spasticity and pain, but not MS-related tremor or spasticity measured by tests administered by the physician. For these cannabis derivatives the most commonly reported side effects were dizziness, drowsiness, difficulty concentrating and memory disturbance.
Sativex oral spray (GW Pharmaceuticals) is probably effective for improving patient-reported symptoms of spasticity, pain and urinary frequency, but not bladder incontinence, MS-related tremor or spasticity measured by tests administered by the physician.
Smoked cannabis research studies have not produced enough evidence to assess its safety or effectiveness for treating MS symptoms including spasticity, pain, balance, posture and cognition changes.
The long-term safety of marijuana use for MS symptom management is not yet known.
This text was extracted from the National Multiple Sclerosis Society website. It is a site you may want to visit.