CBD is available everywhere and is often advertised as a miracle medication that can treat numerous conditions. Chronic pain is a common condition that CBD is recommended to treat, but is CBD effective for treating pain? This article discusses everything you need to know about using CBD oil for pain.
Cannabidiol (CBD) is a phytocannabinoid derived from the cannabis plant but lacks the mind-altering properties of THC.
CBD topical creams are effective in the treatment of back pain and osteoarthritis of the knee.
It is too early to recommend the use of CBD in children for the treatment of pain.
CBD is not a benign drug and has many drug interactions and should be discussed with your doctor before starting.
What is CBD?
Cannabidiol (CBD) is a phytocannabinoid commonly extracted from the cannabis plant; however, it is also available as a synthetic (lab-made) ingredient in many products. It is extracted in the oil form and added to the many available products, like gummies, creams, vapes, and others.
The process of CBD extraction differs significantly and results in the production of three spectrums of CBD oil, ranging from a full spectrum, which contains THC and other cannabinoids, to an isolate that is pure CBD oil. Due to the differences in preparations, it is often difficult to determine the actual effects of CBD, as there are some reports of an "entourage effect." This refers to the increased effectiveness of CBD oil when it contains tetrahydrocannabinol (THC), terpenes, flavonoids, and other cannabinoids.
CBD has pain-relieving and anti-inflammatory properties, which has sparked interest in using CBD to treat painful conditions and inflammation. One reason for CBD's popularity is that it does not have the mind-altering effects associated with THC.
What is CBD used for?
The only U.S. Food and Drug Administration (FDA) approved CBD medication is Epidiolex. It is used to treat rare seizure disorders. However, other non-prescription CBD preparations have been studied for other health conditions, including anxiety, chronic pain, and sleep disturbances. The uses for CBD continue to grow as scientists learn more about the compound and its possible benefits.
Potential CBD side effects
CBD products are generally well tolerated but are associated with side effects. The most common side effects experienced by users include dry mouth, drowsiness, fatigue, decreased appetite, and lightheadedness.
Is CBD oil good for pain?
The use of CBD for pain has had mixed results when evaluated in research studies. Nabiximols (Sativex), an oral spray that contains a 1:1 ratio of THC and CBD, have shown effectiveness in the treatment of pain and symptoms associated with multiple sclerosis. It is approved as a prescription medication in Canada and many other European countries due to its success.
The treatment of pain using CBD products is prevalent in today's society, but research has been unclear as to whether they are effective. Recent studies have shown pure CBD products to effectively treat peripheral neuropathy of the lower extremities and osteoarthritis of the knee.
Overall, there is reason to believe that CBD may be effective in the treatment of pain and is a reasonable alternative to other commonly used pain medications such as NSAIDs, acetaminophen, and opioids. However, due to the fact that CBD products are not regulated by the FDA, one must be careful when selecting a product to ensure it contains the labeled ingredients. Also, CBD is not without its risks, and you should always discuss it with your doctor or pharmacist to determine if the benefits outweigh the risks.
Acute pain is temporary (lasting up to six months) with a clear cause, such as a recent injury or surgery. CBD has shown a small benefit in reducing acute pain with most of the benefit associated with CBD injected directly into the muscle and a smaller benefit of oral CBD. When used as a topical cream, CBD showed no benefit when used after knee replacement surgery.
Chronic pain is defined as lasting for more than six months and is much more challenging to treat than acute pain. Due to the complexity of chronic pain, CBD is often considered an alternative or addition to current pain medication options. Although the research is limited, a discussion with your physician is reasonable regarding the use of CBD oil for the treatment of chronic pain.
Neuropathic pain results from damage to a nerve commonly caused by diabetes, chemotherapy medications, infections, and trauma. Similarly to chronic pain, this pain is challenging to treat and requires multiple medications to successfully relieve it. Therefore, CBD can be an option for neuropathic pain in the right patient.
Can all forms of CBD be used for pain?
The two most common forms of CBD are oral formulations (pills, sprays, drops) and topical formulations (creams, oils). Both can be used for treating pain. However, topical formulations can provide a much better option, especially in people on multiple medications.
The oral form produces higher levels within the blood than the topical forms. These higher levels can result in more side effects and interactions with other commonly used medications. The low blood levels seen with topical forms make them safer and a better option if you have multiple medical conditions.
How to use topical CBD
When applying a topical CBD product, start with a low dose/strength and slowly increase the amount as your body adjusts. Before applying, the area should be cleaned and free of other creams or lotions. The CBD topical should be applied directly to the skin above the source of pain and rubbed in until it is absorbed. Finally, it is important to wash your hands after use. Make sure you pick a quality CBD product for massages and topical use.
How to use CBD oil for back pain
When using CBD oil for back pain, a topical cream can be an effective option with minimal side effects and drug interactions. Although there are no specific dosage recommendations for the use of topical CBD for back pain, there has been some questionable success using a cream with 400 mg of CBD per 1.7 ounces. When using this strength, it can be applied once to twice a day to the affected area.
How to use CBD oil for knee pain
Many different causes of knee pain make it difficult to determine if CBD oil is helpful. Knee osteoarthritis is the most common cause of chronic knee pain and has been shown to be receptive to topical CBD creams. By using a dosage of 125 mg twice a day (250 mg total per day), significant relief can be obtained when used for at least 12 weeks.
Can it be used for pain in kids?
Currently, no scientific evidence supports the use of CBD oil in children for pain. The only FDA-approved CBD product, Epidiolex, can be used in children with rare seizure disorders that do not respond to other medications. Also, there are some indications that CBD may help treat behavioral issues in children with autism spectrum disorders.
CBD has not been studied sufficiently in children to recommend appropriate dosing and which products are safe for kids. Many CBD products on the market are not FDA-regulated, making it difficult to ensure accurate dosages, ingredients, and purity. In addition, CBD can interact with other medications that children are taking, which could cause adverse effects.
Overall, it is too early to recommend the use of CBD oil in children for the treatment of pain.
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- Osteoarthritis and Cartilage. Synthetic transdermal cannabidiol for the treatment of knee pain due to osteoarthritis.
- Therapeutics and Clinical Risk Management. Cannabinoids in the management of difficult to treat pain.
- The Journal of Arthroplasty. Topical Cannabidiol (CBD) After Total Knee Arthroplasty Does Not Decrease Pain or Opioid Use: A Prospective Randomized Double-Blinded Placebo-Controlled Trial.
- Cannabis and Cannabinoid Research. Cannabinoids in the Management of Acute Pain: A Systematic Review and Meta-analysis.
- Journal of Opioid Management. Cannabidiol (CBD) as a treatment of acute and chronic back pain: A case series and literature review.