Using CBD Oil for Pain Management: Does It Work?
Cannabidiol (CBD) is a type of cannabinoid, a chemical found naturally in cannabis (marijuana and hemp) plants. CBD doesn’t cause the “high” feeling often associated with cannabis. That feeling is caused by tetrahydrocannabinol (THC), a different type of cannabinoid.
Some people with chronic pain use topical CBD products, in particular CBD oil, to manage their symptoms. CBD oil may reduce:
- overall discomfort related to a variety of health conditions
The research on CBD products and pain management has been promising.
CBD can offer an alternative for people who have chronic pain and rely on medications, such as opioids, that can be habit-forming and cause more side effects. However, more research is needed to verify the pain-relieving benefits of CBD oil and other products.
Epidiolex, a drug prescribed for epilepsy, is the only CBD product on the market that the Food and Drug Administration (FDA) has approved.
There aren’t any FDA-approved, nonprescription CBD products. They aren’t regulated for purity and dosage like other medications.
Keep reading to learn more about the potential benefits of CBD use for pain. You can also talk with your doctor to see if it’s an option for your condition.
Everyone has a cell-signaling system known as the endocannabinoid system (ECS).
Some researchers think that CBD interacts with a core component of the ECS — endocannabinoid receptors in your brain and immune system.
Receptors are tiny proteins attached to your cells. They receive signals, mostly chemical ones, from different stimuli and help your cells respond.
This response creates anti-inflammatory and pain-relieving effects that help with pain management. This means that CBD oil and other products may benefit people with chronic pain, such as chronic back pain.
One 2018 review assessed how well CBD works to relieve chronic pain. The review looked at studies conducted between 1975 and March 2018. These studies examined various types of pain, including:
Based on these studies, researchers concluded that CBD was effective in overall pain management and didn’t cause negative side effects.
A 2016 study looked at CBD use in rats with arthritis.
Researchers applied CBD gel to rats for four days in a row. The rats received either 0.6, 3.1, 6.2, or 62.3 milligrams (mg) per day. The researchers noted reduced inflammation and overall pain in the rats’ affected joints. There were no obvious side effects.
Rats who received low doses of 0.6 or 3.1 mg didn’t improve their pain scores. The researchers found that 6.2 mg/day was a high enough dose to reduce the rats’ pain and swelling.
In addition, rats who received 62.3 mg/day had similar outcomes to the rats that received 6.2 mg/day. Receiving a substantially larger dosage didn’t result in them having less pain.
The anti-inflammatory and pain-relieving effects of CBD gel could potentially help people with arthritis. However, more human studies are needed.
Some people with cancer also use CBD. Research on mice has shown that CBD can lead to the shrinking of cancerous tumors. However, most studies in humans have investigated the role of CBD in managing pain related to cancer and cancer treatment.
The National Cancer Institute (NCI) has pointed to CBD as a possible option for reducing chemotherapy side effects, such as:
- lack of appetite
In a 2010 study on cancer-related pain, study subjects received oral sprays of a combination THC-CBD extract. The THC-CBD extract was used in conjunction with opioids. This study revealed that using the extract provided more effective pain relief than using the opioids alone.
A 2013 study on THC and THC-CBD oral sprays had a similar finding. Many researchers from the 2010 study worked on this study as well. More evidence is still needed.
Studies on CBD and migraine are limited. The studies that currently exist also look at CBD when it’s paired with THC, not when it’s used alone.
However, results from a 2017 study indicate that CBD and THC can lead to less acute pain and less intense pain for people with migraine.
In this two-phase study, some participants took a combination of two compounds. One compound contained 9 percent CBD and almost no THC. The other compound contained 19 percent THC. Doses were taken orally.
In phase I, there was no effect on pain when the doses were under 100 mg. When the doses were increased to 200 mg, acute pain fell by 55 percent.
In phase II, participants who received the combination of CBD and THC compounds saw the frequency of their migraine attacks fall by 40.4 percent. The daily dose was 200 mg.
The combination of compounds was slightly more effective than 25 mg of amitriptyline, a tricyclic antidepressant. Amitriptyline reduced migraine attacks by 40.1 percent in study participants.
Participants with cluster headaches also found pain relief with the combination of CBD and THC compounds, but only if they’d had a childhood history of migraine.
CBD doesn’t pose significant risks for users, and most topical CBD products don’t enter the bloodstream.
However, certain side effects are possible, such as:
- changes in appetite
- changes in weight
- certain over-the-counter (OTC) drugs
- prescription medications
- dietary supplements
Proceed with caution if any of your medications or supplements contain a “grapefruit warning.” Grapefruit and CBD both interfere with enzymes that are crucial to drug metabolism.
Like other drugs and supplements, CBD may also increase your risk of liver toxicity.
One study on mice concluded that CBD-rich cannabis extract increased their risk of liver toxicity. However, some of the mice had been force-fed very large amounts of the CBD-rich cannabis extract.
While there isn’t conclusive data to support CBD or CBD oil as the preferred method of pain management, researchers agree that these types of products have a lot of potential.
CBD products might be able to offer relief for many people who have chronic pain, all without causing drug intoxication and dependence.
If you’re interested in trying CBD for chronic pain, talk to your doctor. They can help you determine a starting dosage that’s right for you.
Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level, but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and may be inaccurately labeled.
Cannabidiol (CBD) oil, made from cannabis, is sometimes used for chronic pain. We’ll review the research on whether CBD oil is effective.
Medical Marijuana for Back Pain
Elizabeth I. Molina Ortiz, MD, is board-certified in family medicine. She is a primary care provider with Atrius Health in Boston and was the medical director of Charles River Community Health.
Our understanding of the risks and benefits of medical marijuana use has been increasing in recent years. Although as of 2016, not all the questions have been answered, a handful of states have set up dispensaries and passed laws protecting patients who use this drug from prosecution. These programs are far from complete. But the good news is some spine conditions and types of chronic neck or back pain are included by a few of the more forward-leaning states as conditions for which medical marijuana can be prescribed.
Find out where your state stands in the medical marijuana for back and neck pain issue.
About Medical Marijuana
Marijuana is the leading cash crop in the US and a Schedule I drug under the Controlled Substances Act of 1970. This designation means it has a lot of potential for abuse (i.e. addiction), and no medicinal value.
Yet, Marinol, a synthetic marijuana-based medication approved by the FDA, is classified as a Schedule III drug. Marinol contains a synthetic version of THC, which is the active ingredient in marijuana. As a Schedule III drug, Marinol is regarded as medicinal, with less potential for abuse. The FDA approved Marinol to help stimulate the appetite in people with AIDS and to treat nausea and vomiting due to chemotherapy.
Cannabinoids and Pain
According to the Americans for Safe Access Foundation (ASAF), a pro-medical marijuana advocacy group in Oakland, California, the natural form of marijuana contains many more cannabinoids (in addition to the THC) than does the synthetic Marinol, and consequently delivers more therapeutic benefits. Cannabinoids are naturally occurring chemicals in the cannabis plant. The University of Washington says over 480 cannabinoids exist, and these can be further sub-divided. Some of the sub-divided compounds are more psychologically active than others. THC, which is perhaps the best known of the cannabinoid sub-classes is very psychologically active. Others are not as active as THC but are nonetheless valuable for treating certain medical conditions, for example, seizures in children.
As far as pain is concerned, ASAF reports that taking a combination of cannabinoids yields more pain control than taking THC alone. Americans for Safe Access says that cannabis has at least two roles to play in the management of chronic pain, including neck and back pain.
First, it can relieve the pain itself—either alone or in combination with other pain-relieving drugs. And second, it can control nausea associated with long-term pain and also with taking opioids, a narcotic pain reliever.
ASAF also says that because inhaling leads to better absorption and fewer complications, it is the most common and preferable way to take cannabis.
Medical marijuana for back pain relief may show some promise. Find out what's going on in this industry for people who live with pain.