Treating chronic pain can be notoriously difficult. The causes are often complex with symptoms that present differently in each patient, and many treatments have negative side effects or risks of dependence. With concerns about opioid addiction growing, many people are opting for more natural and less risky pain management methods such as CBD.
In this era of self-empowered patients, cannabidiol (CBD) has become an emerging pain management tool. But using CBD oil for pain is nothing new: for thousands of years, people have used the cannabis plant medicinally to treat pain and other ailments.
But does using CBD for pain really work, and is it effective long-term?
How does CBD work?
CBD interacts through the endocannabinoid receptors in your brain and immune system. So to understand how CBD interacts with your body, first you need to understand the endocannabinoid system (ECS).
The ECS maintains homeostasis in the body. If other bodily systems experience disruption, the endocannabinoid system steps in to correct the imbalance and maintain equilibrium. You can find more information on the ECS in our article by clicking here.
CBD acts on the endocannabinoid system’s receptors, triggering a pain-relieving and anti-inflammatory response. Its unique ability to directly interact with these receptors suggests that it may help to relieve chronic pain. CBD allows the body to use its own endocannabinoids more effectively, and its effect on the body’s peripheral and central nervous systems, along with the immune system, means it can help with a wide variety of physical benefits.
Often confused with THC, the compound in marijuana that produces a “high”, CBD does not contain any psychoactive elements. Using CBD products is the best way for people to access the pain-relieving benefits of cannabinoids without the psychoactive or impairing effects.
CBD as a treatment for pain is a rapidly evolving area of research. The ban on CBD products in the twentieth century meant that cannabis studies unfortunately halted, and the science is still catching up today. While it’s often noted that CBD has a lack of published studies on use in humans, it’s not for lack of interest. The table below, which shows published studies containing the keyword “cannabis” from 1960 until 2014, demonstrates the drastic downturn in studies on cannabis after it became a Schedule I drug in the USA in 1970.
As a result, our understanding of how CBD functions within the human body is changing as more research is conducted. Many animal studies support CBDs potential as a treatment for pain, seizures, inflammation, anxiety, and athletic recovery. Through its modulation of the endocannabinoid, inflammatory, and nociceptive (pain sensing) systems, CBD’s pain-relieving effects have been demonstrated in multiple animal trials. While more studies on humans are needed, the findings are promising. Anecdotal claims support these initial findings, and due to CBD’s relative safety and low risk of dependence, many are opting to give CBD oil a try.
So What do the CBD Clinical Trials Reveal?
A meta-analysis of clinical trials found evidence that cannabinoids exhibit analgesic activity, especially in neuropathic pain. This 2018 review analyzed studies on cannabinoids conducted between 1975 and March 2018. Researchers were looking for how well CBD oil relieves pain including pain from cancer, fibromyalgia, and neuropathic pain. The study concluded that CBD generally caused no or few negative side effects and was effective in pain management overall. However, more long-term studies are needed to better assess the risks and benefits. Researchers noted that “In conclusion, the evidence from current research supports the use of medical cannabis in the treatment of severe pain in adults. Careful follow-up and monitoring of patients using cannabis/cannabinoids are mandatory.”
A 2016 study evaluated transdermal cannabinoid use to reduce pain and inflammation in rats with arthritis. For four consecutive days, researchers applied CBD gel to rats topically. The rats were treated with either 0.6, 3.1, 6.2, or 62.3 milligrams (mg) per day. Researchers noticed no adverse side effects, and the rats receiving 6.2 mg/day had noticeable reduction in pain and swelling. In fact, researchers found that “transdermal CBD gel significantly reduced joint swelling, limb posture scores as a rating of spontaneous pain, immune cell infiltration and thickening of the synovial membrane in a dose-dependent manner.” This study raises exciting questions about the use of CBD to treat arthritis pain, and many arthritis patients report significant improvement in symptoms after introducing CBD to their pain management routine.
Another study looking at cannabinoids for treatment of malignant melanoma tumors noted that “synthetic cannabinoids have been implicated in inhibiting cancer cell proliferation, reducing tumor growth, and reducing metastasis.” Findings indicated a significant decrease in tumor size in the mice treated with CBD compared to the control group. With malignant melanoma tumors carrying a poor prognosis despite traditional treatment avenues, CBD’s potential in this area is exciting.
Another cancer-related pain study from 2010 treated subjects with an oral spray consisting of a THC-CBD combined extract in conjunction with opioids. This multicenter, double-blind, randomized, placebo-controlled, and parallel-group study program found that subjects receiving the THC-CBD combined extract experienced more effective pain relief than patients using solely opioids. This table demonstrates the exciting findings:
Most Common Treatment-Related Adverse Events (Reported by Three or More Patients)
|Description of Event||THC:CBD n (%)||THC extract n (%)||Placebo n (%)|
|Somnolence||8 (13)||8 (14)||6 (10)|
|Dizziness||7 (12)||7 (12)||3 (5)|
|Confusion||4 (7)||1 (2)||1 (2)|
|Nausea||6 (10)||4 (7)||4 (7)|
|Vomiting||3 (5)||4 (7)||2 (3)|
|Raised gamma GT*||2 (3)||5 (9)||1 (2)|
*Gamma GT=gamma glutamyl transferase.
The THC:CBD spray indicated in the left column demonstrates clear improvements over the THC and placebo group.
Another 2012 study supported these findings, concluding that THC:CBD oral sprays consistently decreased reported pain levels in cancer patients. The research demonstrated that the long-term use of THC:CBD spray was generally well tolerated. Plus, effectiveness did not decrease in cancer patients with long-term use. Notably, patients receiving THC:CBD oral spray treatment did not seek to increase their dose of THC:CBD or other pain-relieving medication over time.
According to the National Cancer Institute (NCI), clinical trials support the use of cannabinoids to treat nausea, pain, appetite loss, and vomiting resulting from chemotherapy treatments.
A study from 2015 published in Neurotherapeutics looked at cannabinoids to treat epilepsy with promising results: researchers concluded that CBD can be used to reduce seizures effectively, particularly in patients with treatment-resistant symptoms. “These studies suggest that CBD avoids the psychoactive effects of the endocannabinoid system to provide a well-tolerated, promising therapeutic for the treatment of seizures, while whole-plant cannabis can both contribute to and reduce seizures.” CBD was found to interact with numerous receptor systems in the human body. In combination with other cannabinoids, CBD was noted to influence the endocannabinoid system and increase the body’s levels of anandamide. Anandamide is a compound linked to pain regulation which can lift mood and lower pain perception. The researchers noted that further research in this area is needed to better understand the link between CBD and anandamide.
A recent review from 2020 ave subjects with intractable continuous pain a combination of 1:1 CBD:THC. Researchers found that the addition of CBD yielded better pain-relieving results than THC alone. They found a positive correlation between CBD and pain relief, inflammation reduction, and sleep improvement. The study concluded that the CBD:THC formula consistently reduced the mean pain scores in chronic pain patients with multiple sclerosis. Plus, it also demonstrated positive effects for epilepsy patients, and was demonstrated to impart analgesia in certain conditions while improving quality of life.
CBD was further shown to help with chronic neuropathy pain in humans in a 2017 review and meta-analysis. Tricky to treat, neuropathic pain is pain resulting from direct damage to the nerves. Multiple sclerosis, herniated discs, and even shingles can cause neuropathic pain. In this study, 11 randomized controlled trials with 1,219 patients were analyzed, and researchers found that CBD consistently reduced pain in patients with constant neuropathic pain. The study noted that “ Use of selective cannabinoids was also associated with improvements in quality of life and sleep with no major adverse effects.”
An exciting 2017 study showed that “in adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.” It also found that oral cannabinoids are effective antiemetics for adults with chemotherapy-induced nausea and vomiting. Overall, the study found substantial evidence that CBD oil effectively treats adults experiencing severe pain.
This same study also showed promising results for patients with multiple sclerosis (MS). MS is an autoimmune condition that affects the nerves and brain and can impact many bodily functions. In this study, short-term use of oral CBD was shown to help patients in their reported spasticity symptoms. Patients saw fewer muscle spasms, reduction in related pain, and improvement in quality of life. Many MS patients note marked improvements in their systems with regular CBD treatment.
These findings were also supported by a study in the Journal of Experimental Medicine, which found that CBD can reduce pain and inflammation. Not only that, but subjects were not found to be likely to build up a tolerance to CBD. The study concluded that cannabinoids, including CBD, are promising new treatment options for those suffering from chronic pain.
A 2008 study gave subjects a mix of CBD and THC for treatment of persistent pain. Results demonstrated both the safety and efficacy of CBD for treatment of peripheral neuropathic pain, rheumatoid arthritis, and cancer pain. The study found that CBD was well tolerated, with researchers noting that CBD’s “adjunctive addition to the pharmacological armamentarium for treatment of pain shows great promise.”
Not only that, but CBD may also relieve some of the pain and hardship of quitting smoking. Recent studies have illuminated the role of the endocannabinoid system in nicotine addiction. A 2013 randomized double blind placebo controlled study examined the impact of ad-hoc use of cannabidiol for people attempting to quit smoking. In this study, 24 smokers were randomized to receive an inhaler of CBD (n=12) or placebo (n=12) for one week. Subjects were told to use the inhaler when they felt tempted to have a cigarette. Results demonstrated that smokers treated with the placebo showed no differences in the number of cigarettes they smoked. However, smokers treated with CBD “significantly reduced the number of cigarettes smoked by ~40% during treatment.” Plus, these effects were maintained at future check-ins. This data indicates that CBD is a possible treatment for nicotine addiction.
Aside from pain relief and tobacco cessation, studies show that CBD may also be an effective treatment for patients experiencing opioid drug withdrawal, help combat anxiety, prevent Alzheimer’s disease, reduce THC-induced psychotic symptoms for people with schizophrenia, reduce diabetes induced pancreatic inflammation, and potentially even fight cancer. The National Cancer Institute (NCI) has suggested that CBD may even be an option for reducing the side effects of chemotherapy.
While more human studies are needed to better understand the role of CBD oil in combating pain, the studies show promise, and this area of research is sure to evolve in coming years.
CBD for Athletic Pain Recovery
For most athletes, muscle aches and pains are a part of life. Hard training sessions can leave you sore and fatigued, and minor injuries can happen to even the most experienced athletes. Rest is number one, but many people look for other ways to speed up recovery. After all, the faster you recover, the more progress you can make in the gym.
So, can CBD help with the typical aches and pains athletes so often experience? Many athletes find CBD oil offers them relief from temporary acute pain and systemic inflammatory pain. It can also relieve pain from bruises, abrasions, muscle strains, and sprains. Studies support this claim and have demonstrated that cannabinoid analgesics are well tolerated in clinical trials with acceptable adverse event profiles.
If you are considering buying CBD oil, where is the best place to start and what is the best CBD oil for your needs? Some prefer topical CBD products over ingested. What product is right for you?
CBD For Pain in Practice
So how does CBD oil for pain work for real people? Here’s how some world-famous athletes have used CBD products to reduce their sports-related pain.
Mike Tyson is one of the most famous boxers to date and a big-time advocate for CBD use. Tyson isn’t shy about his CBD use in training, as well as pre-and post-fight. He also owns his very own legal marijuana farm.
Kieran Kevan has found CBD products not only assist in post-workout recovery but also to help him relax after bodybuilding.
Megan Rapinoe is a world-famous female soccer player who believes CBD is a natural, healthy method to preserve overall wellbeing during training and competition.
Nate Diaz, a UFC fighter and Ultimate Fighter 5 champion, vaped CBD during a post-fight conference. When the press inquired, Diaz said he uses CBD oil to combat inflammation after fights and training sessions.
How to Take CBD
Before introducing CBD oil into your pain management routine, ensure you do your homework. Most CBD oils are not high potency or high purity. Make sure the CBD company you are buying from can back up each batch of product with Certificates of Analysis (COAs). Talk to your doctor before taking CBD oil to determine if CBD is a suitable treatment for you. It’s possible that CBD could interact with other medications you are taking, so don’t skip this step!
Bioavailability of CBD & Doses
Bioavailability is the percentage of an administered dose of a substance that reaches the systemic circulation. While it’s often forgotten, the bioavailability of CBD is an important factor to consider when determining the correct CBD dosage. In the same way that taking vitamin C with an iron supplement improves iron absorption in your body, the way you consume CBD can impact how your body responds to and absorbs the cannabinoids. CBD’s bioavailability is impacted by:
- Food: CBD edibles are best absorbed when taken with food, particularly foods that are high in fat.
- Habits: your sleep, stress, and food intake can also impact how your body absorbs CBD.
- Weight: CBD, like most supplements and medications, should be taken according to your body weight, with heavier people consuming a higher dosage.
- Marijuana use: People who have a history of heavy marijuana use may require a heavier dose.
Every body responds differently, and you may require more or less CBD than another person of similar size and stature. A good place to start is with a small dose, 10 mg, and increase by 5 mg over a period of weeks if necessary. If you notice any negative side effects, stop use immediately and consult a doctor.
Should You Use CBD for Managing Pain?
Whether you should use CBD is a decision best taken with your doctor. Pain is complex, and treatment that is effective for one patient may not work for another. But no one should have to live with constant pain or take addictive pain medications. Ultimately, finding relief from pain is important to your overall well-being and enjoyment of life.
Because of its non-psychoactive properties, low potential for dependence and abuse, relative safety, and encouraging results in animal studies, many people are finding that using high purity CBD for managing pain is a viable option that works for them.
If you find that conventional pain medication is not a good fit for you, CBD is worth trying. At Mojave RX we offer only high quality CBD oil products made from CBD isolate extracted from the Hemp plant (no THC).