13 patients with spasticity-associated pain caused by chronic upper motor neuron syndrome (UMNS) received nabilone or placebo for 4-week periods in random order with a 1-week washout period. 11 patients completed the study and were analyzed. Significant improvement in pain was found with nabilone 1mg per day compared to the placebo. No significant improvements were found for spasticity, motor function and daily activities with either nabilone or placebo. Two patients experienced mild adverse events in the nabilone phase versus two patients in the placebo phase.