Cannabidiol (CBD) has become a promising complementary remedy for various health issues, including anxiety, epilepsy, and pain management.
There are endogenous and exogenous cannabinoids. Endogenous cannabinoids are naturally occurring lipids that the body produces. Two of the most well-known endogenous cannabinoids are anandamide (AEA) and 2-arachidonoylglycerol.
The body does not produce exogenous cannabinoids — these compounds are part of the cannabis plant. Examples of exogenous cannabinoids include:
- Cannabichromene (CBC)
- Cannabigerol (CBG)
Cannabinoids, both endogenous and exogenous, bind to endocannabinoid receptors attached to cells. These include cannabinoid 1 and cannabinoid 2 receptors. This binding action stimulates different cell responses that influence pain signaling pathways.
CBD does not bind very well to endocannabinoid receptors. However, one study on mice found that it may interact with neurological receptors in the spinal cord that suppress chronic inflammatory pain. CBD may also increase levels of AEA, an endogenous cannabinoid that reduces pain.
According to a small 2018 study, researchers evaluated CBD’s pain-relieving effects in seven people who experienced chronic pain after having kidney transplants. Six of the seven participants reported improvements in pain. One of the participants experienced more pain at higher CBD doses but achieved the best pain control at lower CBD doses.
While more research, such as large-scale, high-quality clinical trials, is still necessary, these preliminary studies suggest CBD may help manage pain. A 2021 study also notes that participants in the research have positive attitudes toward CBD treatment options and report positive outcomes when using the substance for pain-related conditions.
There are various advantages and disadvantages of using CBD products for pain relief:
- They may provide pain relief.
- They are available in many forms to help treat different types of pain.
- Different dosages are available to suit a person’s needs.
- It can include ingredients that soothe the skin or provide heating or cooling effects.
- More research is still necessary to confirm the effectiveness of CBD for pain relief.
- There can be potential side effects of CBD such as gastrointestinal distress or liver injury.
- CBD products may vary in quality and safety.
We should choose products that meet the following criteria:
- Ingredients: Products contain safe and high-quality ingredients, and their labels state all ingredients clearly. They should also confirm they are free from pesticides, heavy metals, and mold.
- Dosage: Products contain or recommend a serving size of a safe CBD dosage. The label also clearly states the dosage.
- Third-party labs: Products undergo third-party testing for contaminants by an ISO 17025-compliant laboratory.
- Available certificate of analysis: The company demonstrates transparency and shares a product’s certificate of analysis (COA) following lab results.
CBD comes in several different forms, including:
- oils and tinctures
- oral capsules or pills
- creams, balms, and salves
- topical patches
CBD gummies and capsules are for oral ingestion. On the other hand, topical CBD products are for external use only. People can apply these products to specific body areas, such as sore muscles or aching joints.
CBD oils and tinctures are more versatile than other forms and usually come in tinted glass bottles with a dropper. People can either add a few drops of CBD oil to food or beverages or place them under their tongue, where they can hold the oil for up to 1 minute before swallowing. However, people may not feel the effects of CBD oil for one or more hours after using it.
Individuals should follow the directions and dosage information on the CBD product label.
The Food and Drug Administration (FDA) only regulates one CBD-containing drug, called Epidiolex, for treating rare forms of epilepsy in children aged 2 years and older.
This means that the FDA does not regulate commercially available CBD products. People should look for high-quality products from reputable manufacturers and retailers when shopping for CBD. These companies test every batch of their products via an independent third-party lab for purity, showing that the product does not contain harmful metals or toxins.
High-quality products undergo third-party testing by laboratories without affiliations to the manufacturer. They test CBD products for:
- heavy metals
- harmful chemicals
Products that undergo third-party testing will have a certificate of analysis, a document containing information about the product’s CBD potency, THC and other cannabinoids, and safety test results.
A person can also consider the following when buying a CBD product for pain management:
- Strength: CBD products come in a range of strengths. People who have not used CBD products before should start with a low-strength product and build up until they get the needed effects.
- THC content: Hemp products with less than 0.3% THC are legal on a federal level. A person should check the THC content before making a purchase.
- Hemp source: People can consider CBD products from companies that responsibly source their hemp. Many companies use hemp that is grown in the U.S.
- Form: CBD products can come in oils, ointments, creams, patches, or gels. People can consider how convenient their chosen product will be to apply, whether it suits different skin types, and how long it will last.
- Cost: Some CBD products can be expensive. People should consider how often they will need to use their CBD product and choose a product that will fit their budget and be cost-effective.
- Unproven medical claims: A person should research the medical claims made by CBD manufacturers. The FDA has only approved one CBD prescription drug for medical use. The FDA states that people who buy CBD products claiming to treat serious conditions such as cancer, mental health conditions, diabetes, and Alzheimer’s disease should not delay receiving care from a healthcare professional.
- COA: A person should consider products from companies that provide a certificate of analysis (COA) detailing the ingredients in their CBD products. A person can find COAs on a brand’s website or by contacting the brand directly.
Risks And Side Effects Of CBD
Side effects of CBD include:
- changes in appetite
- weight changes
More severe side effects include:
- liver damage
- fertility problems in males
- potentially severe interactions with alcohol and certain medications
Manufacturers of CBD products say they may help relieve muscle, joint, and nerve pain. However, there is limited scientific evidence to confirm these claims.
Some alternative treatments for pain include:
- a warm or cold compress for stiff, aching muscles
- light physical activity for joint pain
- corticosteroid injections for nerve pain and inflammation
- over-the-counter (OTC) pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen
- topical pain relievers that contain NSAIDs, capsaicin, or menthol
- therapeutic massage
People who experience persistent or worsening pain despite trying OTC and at-home treatments may wish to discuss alternative treatment options with a doctor.
A person should see a doctor to understand their pain and get advice on managing it.
A doctor can help pinpoint the reason behind the pain and suggest workouts, and strengthening exercises, or prescribe medication that can help minimize or eliminate the pain.
While there is supporting research that CBD can help with pain, scientists need more evidence to understand its long-term effects and the appropriate dosages a person should take.
A person should not use CBD products to replace support from a doctor, especially if they have health conditions that cause pain.
If people react to topical CBD products or experience side effects, they should stop using them and talk with a medical professional for advice.
Below are answers to the top frequently asked questions about CBD for pain management.
What Is The Best Method Of CBD For Pain?
The best method of CBD for pain depends on the type of pain a person has.
A CBD salve or balm may be more appropriate for targeted relief, such as if a person has aching joints. People can apply these products directly onto the skin.
However, a gummy or CBD oil may be a better option if a person is seeking relief from more widespread pain, such as fibromyalgia. These products may have a more widespread effect than topical options.
Do Doctors Recommend CBD For Pain?
The United Kingdom’s National Health Service (NHS) states that while there is some evidence that CBD can help relieve pain, there is not enough to recommend it.
People who wish to use CBD for pain relief should do so after contacting a doctor. There may be other, more effective treatments available.
Is CBD Better Than Pain Meds?
Early research suggests CBD may offer pain relief like opioids without addictive properties. A survey of over 1,000 people found that the average daily opioid use was reduced by 78%, with similar reductions in other prescription pain medication use. The participants also reported improvement in quality of life within six months.
However, it is important not to discontinue pain medication without talking with a healthcare professional.
How Quickly Can It Provide Pain Relief?
Many variables, such as the underlying health condition, CBD product, and dosage, can affect how quickly CBD can relieve pain. For example, the American Arthritis Foundation suggests that a person may feel the effects of a CBD spray or tincture in 15–45 minutes.
What Conditions Can CBD Help With?
Ongoing research is still investigating what conditions CBD can help. Some health issues that CBD may help with include:
- arthritis and joint pain
- sciatica and back pain
While preliminary clinical studies and animal studies suggest CBD may help relieve pain, more research is necessary to evaluate these findings.
CBD is generally safe but can lead to side effects, such as tiredness and appetite changes.
Precision Pain Care and Rehabilitation has two convenient locations in Richmond Hill – Queens, and New Hyde Park – Long Island. Call the Queens office at (718) 215-1888 or (516) 419-4480 for the Long Island office to arrange an appointment with our Interventional Pain Management Specialist, Dr. Jeffrey Chacko.