Can CBD oil help with pain?
CBD oil is an increasingly popular natural remedy used to treat a wide range of ailments. Also known as cannabidiol, the active ingredient CBD is one of numerous compounds called cannabinoids found in the hemp or cannabis plant. But unlike the psychoactive cannabinoid THC, CBD won’t get you high.
Can CBD oil provide relief from pain? People who take it certainly think so. A 2018 survey of CBD users found that general pain and arthritis pain were the two conditions it was most commonly used to treat, and that pain was also the symptom users most often said had been treated “very well” or “moderately well” by CBD alone.
A number of scientific studies appear to back this up, providing evidence for the pain-relieving potential of cannabinoids such as CBD in relation to chronic pain, arthritis, cancer-related pain, migraines and more (see the Evidence section below for more details).
Due to its low-level of side-effects and apparent lack of addictive qualities, CBD is also seen as a good prospective alternative to opioids and other traditional pharmacological treatments that may be habit forming.
How does CBD work to help pain?
Some of the beneficial effects of CBD on pain are likely due to its interaction with the body’s Endocannabinoid System (ECS). The ECS produces molecules called endocannabinoids that bind to ECS receptors, signalling cells to produce anti-inflammatory and analgesic (pain-relieving) responses.
Cannabinoids such as CBD that occur in hemp plants can also influence the ECS and it’s believed they may slow the breakdown of endocannabinoids, thus prolonging their effects.
CBD may also reduce pain through its interactions with other receptors, including opioid receptors which are involved in pain relief, serotonin (5-HT) receptors, which influence mood, and a receptor known as TRVP1, which is responsible for producing the sensation of scalding heat.
Evidence that CBD can help with pain
A 2011 review of studies examining the effect of cannabinoids including CBD on chronic pain showed them to have significant success in reducing symptoms and found them to be a safe alternative to existing medications. A follow-up study came to the same conclusions and also reported cannabinoids to be well tolerated in terms of their side-effects.
A variety of further research has looked at how CBD may help pain related to more specific conditions.
CBD for arthritis
There’s a huge amount of interest in CBD oil among people suffering from pain and inflammation caused by arthritis.
A recent survey of more than 2,600 arthritis patients by the Arthritis Foundation found that 79% were either currently using CBD, had used it in the past or were considering using it. Of those using CBD, 94% reported that the primary reason was to relieve pain and 3 out of 4 said that it was either “effective” or “very effective” in relieving symptoms.
Along with the general scientific evidence that CBD can help with chronic pain, there is initial research suggesting it could be effective specifically for some forms of arthritis. A trial on rats with arthritis concluded that treatment with a CBD gel demonstrated “therapeutic potential for relief of arthritis pain‐related behaviours and inflammation without evident side‐effects”.
However, little investigation has so far been done with human arthritis patients and one study of osteoarthritis patients given a CBD gel for knee pain was inconclusive, although it did appear to indicate a more beneficial effect on men than women.
When considering using CBD oil for the relief of arthritis pain, it’s important to remember that there are many different forms of arthritis that act in varying ways, so what may work for one may not work for another and vice versa. For rheumatoid arthritis, conventional prescription medicines are recommended since they are known to help prevent permanent long-term damage to the joints.
The Arthritis Foundation says that anyone interested in trying CBD should first consult the health care professional responsible for their arthritis treatment.
CBD for cancer pain
Several studies have shown a combination of CBD and THC to have a therapeutic effect on patients suffering from cancer-related pain.
One study of 177 cancer patients found that a combination of the two compounds boosted pain relief in subjects who had gained insufficient benefit from opioid pain killers. It also concluded that THC and CBD together showed a greater effect than THC alone and that CBD may help temper the potential unwanted psychoactive side-effects of THC. A follow-up study came to similar conclusions.
Meanwhile, a review of 18 trials on cancer patients found that a combination of CBD and THC “demonstrated a significant analgesic [pain-killing] effect of cannabinoids”.
The drug Nabiximols, marketed under the trade name Sativex, contains CBD and THC. It was originally prescribed to combat spasticity – muscle-stiffening – in multiple sclerosis patients but in Canada has been approved as a treatment to help boost pain relief in both MS and cancer sufferers. The US Food and Drugs Administration is also investigating its use for this purpose.
A 2018 review of research by the scientific journal Headache concluded that there was an increasing amount of evidence that CBD and THC may be effective in relieving pain, including the symptoms of migraines and headaches.
The results of one study into the treatment of migraines and cluster headaches with CBD and THC were reported at the 2017 European Academy of Neurology Congress. They showed that migraine attacks were reduced by 40.4%, and that pain intensity was reduced by 43.5%. Similar results were found in those suffering from cluster headaches but only if they had also experienced migraines in childhood. The researchers concluded that “cannabinoids are an alternative to established treatments in migraine prevention.”
The main symptoms of fibromyalgia are widespread chronic pain and an increased sensitivity to pressure on the surface of the body, so in theory it could be a good subject for the analgesic properties of CBD.
Specific studies into the use of cannabinoids for treating fibromyalgia are rare, however, and tend only to have involved the whole cannabis plant.
A study of three strains of pharmaceutical grade cannabis taken by fibromyalgia patients through inhalation showed a reduction for a significant number of subjects in the pain caused by an electrical stimulus, as well as an increase in their thresholds for pain caused by pressure – but only in varieties of cannabis containing THC as well as CBD.
One of the reasons CBD is popular as a natural remedy, and seen as worthy of investigation as a potential medicine, is its relative safety compared with some traditional medications. A large proportion of CBD users experience no negative side-effects at all and the consensus among researchers is that CBD is ‘well tolerated’, meaning few patients drop out of clinical studies due to adverse effects.
However, it’s worth being aware that some people do notice low-level side effects, the most common being dry mouth, experienced by 11% of those who took part in a 2018 study of over 2,400 CBD users. Tiredness / fatigue is also regularly reported and some people experience appetite changes, nausea, diarrhoea or irritability.
A report by the World Health Organization said CBD had "a good safety profile" and found no evidence that it is addictive or can lead to social problems. “In humans, CBD exhibits no effects indicative of any abuse or dependence potential,” said the report. “To date, there is no evidence of recreational use of CBD or any public health related problems associated with the use of pure CBD.”
As a precaution, the UK Food Standards Agency advises that pregnant and breastfeeding women do not use CBD and that healthy adults refrain from taking more than 70mg a day (around 28 drops of 5% strength CBD oil), unless advised by a doctor. It also warns against using CBD alongside medication.
If you are on medication or supplements, you should talk to your doctor before taking CBD. That's because it can inhibit enzymes that are responsible for the metabolisation of certain drugs, slowing their breakdown and potentially leading to unsafe levels in the body. This in turn may exacerbate any side-effects of the drugs.
One of the enzymes that CBD interacts with is also inhibited by the ingestion of grapefruit and some related citrus fruits so you should avoid taking CBD with drugs that carry a 'grapefruit warning' unless otherwise advised by a healthcare professional. However, some drugs that CBD may effect do not carry warnings, which is why you should always consult your doctor.
How to use CBD oil for pain – products and methods
There are a variety of CBD products on the market, including e-liquids used in vaping devices, capsules, chewable ‘gummies’ and topical creams. However, one of the most popular – and arguably the best in terms of efficiency and safety – is bottled CBD oil, a solution using oils such as hemp seed or olive as a carrier for the active ingredient.
CBD oils usually come with an integrated dropper, allowing you to drop a measured dose directly into your mouth to be swallowed, or into food and drink. But for maximum absorption and the fastest effects, CBD oil is best taken sublingually – under the tongue. Hold the oil there for a minute or two before swallowing. This allows it to be absorbed through the sublingual membrane and more quickly into the bloodstream.
Swallowing CBD oil directly or in food and drink is also popular but it will take longer to get to work, and digestive processes will destroy more of the CBD before it can be absorbed. It’s also worth noting that CBD may be better absorbed when taken with higher fat foods and that CBD in a solution can start to break down at heats above 71°F, meaning adding it to a hot coffee could reduce the effect.
Topical creams are another way of using CBD and there is some evidence that they may help with localised complaints such as arthritis pain.
How long you’ll have to wait to experience any benefits of CBD depends to a great extent on how you take it.
Directly inhaling CBD from e-liquids using a vaping device is the fastest way to get it into your bloodstream and you may feel the effects within a matter of minutes. However, the general safety of vaping is still open to question.
The next most efficient way to consume CBD oil is sublingually, that is by placing a few droplets under the tongue and holding them there for a minute or two before swallowing. This allows the CBD to be absorbed through the blood vessel-rich membrane beneath the tongue and sends it rapidly into the bloodstream. You could start to notice the effects of CBD oil taken sublingually within 15 to 25 minutes.
CBD oil swallowed without sublingual application will take longer to work, probably hours rather than minutes, and more of it is likely to be lost during digestion. There are a number of factors that can influence the precise amount of time you may have to wait before it takes affect, including what you have eaten and how recently. Capsules or soft gels that dissolve before releasing the active ingredient could take longer again.
Chewable CBD ‘gummies’, which spend some time in the mouth before being swallowed, may provide some sublingual absorption but the majority of the CBD will still have to go through the digestive system.
Age, weight, individual body chemistry, severity of symptoms and any adverse effects you might experience can all have a bearing on what is the right dosage of CBD oil for you.
It’s also important to choose a reliable brand of CBD oil (one that uses independent lab tests to verify the levels of CBD in its products) and to decide on a consistent method of consuming the oil – preferably sublingually (see How to use CBD oil for pain and How long does CBD oil take to work?) – so that you get the same dosage each time.
The best way to decide on an optimum dosage is to start small and work your way up. Begin by taking oil containing perhaps 5-10mg of CBD. Try this for a few days and make a note of how you feel after each dose, in terms of benefits and any side-effects. If you decide you need more, increase the amount by the same increment again. Continue this process until you find the most beneficial dosage for you.
If you suffer from chronic pain, you might also want to consider taking a number of smaller doses throughout the day rather than a single daily dose.
Remember that CBD oils differ in strength, as indicated by their percentage. Here's how to calculate the amount of CBD in mg in any given oil.
To get a general idea of the amount of CBD oil you might require, use the Jersey Hemp dosage calculator.
What’s the best CBD oil for pain?
When using CBD oil to help manage pain, it’s important to choose a product that delivers a consistent level of CBD content. A recent report by the Centre for Medical Cannabis found that 11 of 29 products tested in the UK had less than 50% of the advertised CBD content and one high street pharmacy product contained no CBD at all.
Jersey Hemp was granted the first licence in the British Isles for harvesting hemp for CBD production. All the hemp used in its products comes from its own fields and every batch of CBD oil is tested by an independent laboratory – with results available to view on the website – making it one of the most trustworthy CBD brands in the UK.
The Centre for Medical Cannabis called Jersey Hemp “one of the most compliant, high quality and accurately labelled products that we tested.”
Main image by Tumisu from Pixabay
The author of this article is not a medical expert and nothing in this article constitutes medical advice or gives rise to a medical practitioner/patient relationship. You should seek specialist medical advice where required. Never disregard professional medical advice or refrain from seeking it because of something you have read here.