Cannabis has been hailed as the “aspirin of the 21st century,” a moniker that is well deserved. The pain-alleviating properties of cannabis have mainly been attributed to the cannabinoid delta-tetrahydrocannabinol (THC), but does CBD work for pain as well?
It turns out that CBD for pain can work wonders! Using CBD oil for pain could be an almost side effect free (and natural) way to relieve symptoms of arthritis and joint pain, nerve pain, and chronic pain.
CBD Oil for Pain Relief
Pain and inflammation are feelings that originate from neurotransmitter signals sent from a receptor in the body. CBD can activate or deactivate neurotransmitter receptors. Through that regulation, there may be a reduction in symptoms of pain and inflammation.
Cannabinoids are compounds found in the cannabis plant. They mimic natural endocannabinoids present in the human body. Cannabidiol (CBD) is one of the most abundant cannabinoids and does not produce intoxicating effects like THC.
Cannabinoids and endocannabinoids influence the body through the endocannabinoid system. Research has shown that the endocannabinoid system can regulate the perception of pain, and inflammation that can contribute to pain.
Many people are interested in CBD oil for pain relief because it will not have the intoxicating effects of medical marijuana. This effect means that you can learn how to use CBD oil for pain management and still be able to work or go to school without being impaired.
Using CBD for pain relief is also a good option because hemp extract is natural and has few bothersome side effects. Unlike opioid painkillers, CBD users are not prone to addiction or dependence. Additionally, no toxic dose of CBD has been observed, even at doses as high as 1500mg per day.
CBD Oil for Chronic Pain
Chronic pain, neuropathic pain, and other pain conditions are hard to treat, and opioid options have proven to be harmful and addictive. States with medicinal cannabis laws have seen an almost 25% reduction in opioid overdose deaths compared to states without medical marijuana laws. CBD is legal under the 2018 Farm Bill and may be freely transported between states without issue.
Chronic pain is one of the most common reasons for using medical marijuana. In one study’s patient group, up to 72.8% of chronic pain suffering participants had replaced opiate medications with medicinal cannabis. While CBD may be legal, that doesn’t mean it is approved by your pain doctor. To avoid confrontation with pain management doctors, many patients will research CBD drug testing articles before deciding to take CBD.
Chronic pain can be nociceptive. They may also be neuropathic. Nociceptive pain is one of the most common types of pain. Tissue damage and inflammation cause this type of pain, which is characterized by throbbing, aching, and sharp pain.
Damage to the nervous system causes neuropathic pain, which can feel like stabbing, burning, or tingling pain. Studies have shown that products manufactured with CBD oil for pain may alleviate symptoms of both types of pain.
CBD Oil for Joint Pain and Inflammation
Inflammation itself plays a significant role in pain. CBD can help alleviate symptoms of arthritis, joint pain, and pain from inflammation in other areas like the GI tract. The anti-inflammatory action of CBD for pain is becoming better understood.
CBD does not act on the anti-pain pathways controlled by the CB1 endocannabinoid receptor. However, it does take other routes to alleviate painful symptoms by influencing neurotransmitter signaling and modifying the kinds of immune cells and compounds that respond to inflammation.
Here are some highlights of how the anti-inflammatory activity of CBD for pain works:
- Adenosine A2A receptors regulate overactive immune cells resulting in tissue protection. When CBD enhances adenosine signaling, reductions of inflammatory compounds like TNF-ɑ and IL-1β occur.
- TNF-ɑ and IL-1β are two major inflammatory factors involved in arthritis, making CBD a good option for alleviating arthritis pain. By dialing down overactive immune system activity, inflammation is reduced, which may also lead to a reduction in pain.
- CBD also reduces some other inflammatory factors. These include other inflammatory cytokines and cyclooxygenase (COX) molecules, which play a significant role in pain and inflammation. These molecules are often the target of NSAIDs like aspirin and ibuprofen, but CBD can also suppress them. Through COX inhibition, CBD can reduce swelling.
Pain and inflammation reactions are complex and involve many biological molecules that mediate cellular responses. Tumor necrosis factor α (TNFα) is a secretion from cells in the immune system known as a cytokine.
Cytokines, like TNFα, plays a significant role in pain and inflammation responses. TNFα can trigger a cascade of reactions with other cytokines that lead to increased production of the protein cyclooxygenase-2 and the cytokine prostaglandin E2 (PGE2).
CBD vs. THC for Pain
So what is the difference between CBD and THC for pain? CBD will not be as helpful as THC for the relief of muscle spasticity, like in multiple sclerosis (MS). This lack of assistance is because those symptoms are more strongly associated with CB1 receptors that are activated by THC.
Inflammatory pain in joints and muscles may be relieved by CBD and other non-psychoactive cannabinoids because CB2 and CB2-like receptors can mediate inflammatory factors in the body. CB2 and CB2-like receptors do interact with CBD but have less affinity for THC.
Cannabinoids as Analgesics
Pain is a symptom perceived through the nervous system. It has multiple complex physiological pathways that can make it challenging to treat. The endocannabinoid system acts through receptors to help regulate the nervous system.
Since pain-sensing is a nervous function, cannabinoids can affect many of the pathways that lead to pain sensation.
Analgesia is the inability to feel pain. Medicines like ibuprofen are considered analgesics because they provide pain relief. Since animal experiments in 1899, there is strong evidence to suggest that cannabinoids have analgesic properties.
By the 1960s, researchers found that cannabinoids can reduce reactions to acute pains like pinpricks. Today, pain and chronic pain are among the most common symptoms motivating people to use medical marijuana or CBD for pain management.
How to Take CBD Oil for Pain Management
Oral consumption of CBD oil for pain can result in some loss of potency due to the first-pass metabolization in the digestive system. CBD oil capsules and edibles are still useful for increasing homeostasis in the endocannabinoid system.
CBD oil tinctures and vapes will release more CBD into the circulatory system faster than other methods. Due to this, these delivery methods could be more helpful for acute symptoms, or when a strong dosage is needed quickly.
There is no standard CBD oil for pain dosage. Consumers should start low and gradually increase until symptoms of pain decrease.
CBD creams and salves are gaining popularity for alleviating pain in a particular joint or area. Topical preparations of CBD for joint pain, arthritis, and muscle soreness can provide hours of relief.
CBD bath bombs are an excellent new delivery method for easing body pain and soreness. Soothing CBD baths help relax muscle tension and may have added benefits for relieving skin problems like acne and dermal allergies.
CBD Oil for Pain Dosage
Research has suggested that CBD oil for pain dosage can be anywhere from five to forty milligrams of CBD per kilogram of body weight. Individuals can find their best CBD oil for pain dosage by starting low and gradually increasing until the pain is relieved.
CBD dosage can differ based on delivery methods. Inhaling CBD vapes will provide faster CBD effects and deliver more CBD to the bloodstream than taking oral CBD supplements. For example, taking CBD gummies for pain is far less effective than taking a CBD tincture for pain.
CBD Oil for Pain Side Effects
CBD is not psychoactive, so it avoids the bothersome side effects of THC. CBD has very few side effects attributed to it. The most common side effect of CBD is an upset stomach. Some reported side effects of CBD are similar to the side effects of ibuprofen. These side effects include stomach upset, dizziness, and constipation.
If a person experiences side effects, they should lower their dose of CBD and consult a physician to make sure they are using the supplement safely. There is no lethal dose of CBD in humans or animals, but if something doesn’t seem right, always consult a licensed medical practitioner.
Endocannabinoid and Cannabinoid Role in Pain Sensation
The body’s natural endocannabinoids like anandamide play a significant role in sensing pain. Endocannabinoids, and cannabinoids that mimic them can reduce the sensation of pain through the central nervous system (CNS), and peripheral nervous system (PNS), especially in a part of the brain called the amygdala.
There are two main types of endocannabinoid receptors – CB1 receptors and CB2 receptors. The endocannabinoid system runs all through the body, and different kinds of receptors can concentrate in particular areas.
CB1 receptors are very abundant in the brain and central nervous system where CB2 receptors are less concentrated. CB2 receptors are more abundant through the peripheral nervous system that runs throughout the body.
THC act mainly through CB1 receptors and CBD indirectly influences endocannabinoid receptors and has some interaction with CB2.
CB1 Activation Reduces Pain
Many pain conditions are related to parts of the spine called dorsal root ganglia (DRG). Pain sensory neurons activate these large neurons. Between pain-sensing neurons and the DRG, there is a significant presence of CB1 receptors that can reduce signals of pain from being sent to the DRG.
When THC or anandamide activate CB1 receptors, the receptors block pain signals from reaching the DRG. This blockage can result in a reduction of inflammation and an overall analgesic effect.
Biological Pathways of CBD for Pain
CBD has a slight affinity for the CB2 receptor, which may contribute to its anti-inflammatory effects, but more so CBD interacts with a multitude of ion channels, enzymes, and other receptors such as TRPV1, 5-HT1A, and GPR55. Some research has even shown that CBD oil acts similarly to capsaicin in reducing pain through TRPV1.
Historical use of CBD Oil for Pain
While there are few CBD exclusive pain studies, historical data sheds some light on this prospect. The prominent British herbalist Nicholas Culpeper (1616-1654) wrote that hemp extracts like CBD oil “allayeth Inflammations in the Head … eases the pains of the Gout … Knots in the Joynts, [and] the pains of the Sinews and Hips.”
Hemp preparations have been used for ailments including pain from ancient China and India and became popular in Europe in the 1800s. Hemp extracts were popular medicines in the US too, up until the 1940s.
These historical hemp preparations were not from modern cannabis plants bred to enhance THC. They were home-brewed hemp-based CBD oil tinctures, teas, and topicals. Considering historical usage and laboratory research into how CBD works for pain, we now know that there is excellent evidence of CBD oil for pain relief.
- Baker, D., Pryce, G., Giovannoni, G., & Thompson, A. J. (2003). The therapeutic potential of cannabis. The Lancet Neurology, 2(5), 291-298. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/12849183
- Baron, E. P., Lucas, P., Eades, J., & Hogue, O. (2018). Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort. The journal of headache and pain, 19(1), 37. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968020/
- Burstein, S. (2015). Cannabidiol (CBD) and its analogs: a review of their effects on inflammation. Bioorganic & medicinal chemistry, 23(7), 1377-1385. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/25703248
- Costa, B., Trovato, A. E., Comelli, F., Giagnoni, G., & Colleoni, M. (2007). The non-psychoactive cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain. European journal of pharmacology, 556(1-3), 75-83. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/17157290
- Garcia, A. G. M. (2017). Hemp: a Composition Review plus. Food Science and Nutrition Department California Polytechnic State University. San Luis Obispo, CA. Retrieved from: https://digitalcommons.calpoly.edu/fsnsp/10/
- Grotenhermen, F., & Müller-Vahl, K. (2012). The therapeutic potential of cannabis and cannabinoids. Deutsches Arzteblatt international, 109(29-30), 495-501. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442177/
- Hartsel, J. A., Eades, J., Hickory, B., & Makriyannis, A. (2016). Cannabis sativa and Hemp. In Nutraceuticals (pp. 735-754). Retrieved from: https://www.hindawi.com/journals/bmri/2018/1691428/
- Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139-154. Hosking, R.D., Zajicek J.P. 2008 July 1. Therapeutic potential of cannabis in pain medicine, BJA: British Journal of Anaesthesia, Volume 101, Issue 1, 59–68. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442177/
- Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333-49. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/
- Russo, EB. (2018). Cannabis Therapeutics and the Future of Neurology. Frontiers in integrative neuroscience, 12, 51. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200872/