Cannibidol (CBD) is one of the most talked about pain-relief methods of 2019. Whether you have joint aches and pains, chronic pain from hard work, headaches, CBD has been posited as a solution by some. With between 6-10% of the entire world estimated to suffer from neuropathic pain, there is a pressing need to explore other treatment options, especially those with different mechanisms of action in order to treat and reduce pain.
Preliminary research indicates that there is a strong correlation between CBD and pain relief, but the mechanisms behind this are still under investigation. Part of the problem has been the questionable legality of CBD until the 2018 Farm Bill made CBD legal at a federal level. However, CBD products are currently not approved by the FDA to treat any official medical condition. In other words, the FDA does not regulate CBD for purity and dosage, as it does with other medications.
With that said, CBD has gained popularity as a more natural form of pain relief, that many say is superior to the opioids causing a nationwide crisis. CBD is non-psychoactive, doesn’t produce a high, and is nearly impossible to abuse, considering it doesn’t produce dopamine, or dopamine signaling.
The numbers seem to support this assertion, with 80% of CBD users in a landmark 2018 study indicating CBD is a very, or extremely effective treatment for their symptoms. The study later went on to say that 43% of hemp-derived CBD users now use CBD instead of other medications to treat their conditions.
This study also indicated that 69% of hemp-derived CBD users found CBD products to be either more effective, or much more effective than over-the-counter products.
While we think it’s important to note that there is likely some bias in these figures due to how the study was sampled, the trend is clear: CBD seems to work for pain, at least according to the respondents.
But that raises another important question: does science support the idea of CBD working for pain?
What is pain?
According to the Mayo Clinic, pain is a complex interaction of nerves, the spinal cord, and the brain. Each person will feel pain differently, depending on what’s causing the pain, and the memories associated with it.
There are two primary categories of pain, which are acute (short-term) and chronic (long-term) pain. Acute pains tend to resolve themselves within a given period, while chronic pain is persistent, and can last for months or longer. While acute pain is usually a sign of a health problem, chronic pain is considered a health problem itself.
Pain is perceived through sensory nerve cells, which send small electrical transmissions through the network of fibers that carry information to the spinal cord, and then to the brain. Depending on the magnitude of the pain, specialized nerves prioritize the signals your body sends. This in turn causes you to react to the pain. For instance, you’d jerk your hand away from a hot stove immediately, however you might not feel the pain from a papercut until a few minutes later.
Your brain controls all these actions and can also signal the release of pain-suppressing chemicals, like adrenaline. This is where CBD potentially comes in.
One of these systems that sends messages to the brain is known as the endocannabinoid system, which cannabinoids can interact with. The mechanism is complex and still being understood, but the current hypothesis is that CBD can block certain signaling pathways which help limit pain.
CBD and Pain: The Research
Although CBD hasn’t enjoyed the same persecution as it’s high-inducing brother, THC, CBD has been widely understudied because of the illegality of cannabis over the last 40 years. With the law finally catching up to the times, more studies are being done as we speak. However, there is still a massive gap between the science that we currently have on hand and the results that many companies are claiming CBD can bring.
It’s important to understand that we are still lacking the “holy grail” type of study that would definitively prove once and for all that CBD is an effective pain blocker. There’s always that chance that CBD may be a powerful placebo effect in and of itself. Part of the hindrance is the difficulty in accessing CBD to study. The FDA makes is particularly difficult for researchers to get their hands-on CBD, with strict accounting and purchasing required from government approved sources. Of course, these laws will change with time, but now we urge you to carefully evaluate what you read prior to making any decisions.
That said, most of the research we have relates to using CBD for chronic pain. For instance, a 2008 review examined the research that had been done in the prior 20 years. The conclusion was positive, with the researchers noting that “Cannabinoid analgesics have been generally well tolerated in clinical trials with acceptable adverse event profiles”.
The review went on to say that numerous random clinical trials demonstrated the safety and efficacy of cannabinoids in central and peripheral neuropathic pain.
A similar review was published in 2018 that examined cannabis-based medicines and their efficacy in treating different pain profiles, ranging from minor to severe. The reviewers sought only randomized, double-blind controlled trials. The most effective studies are done double-blind and randomized in order to avoid any systematic bias in the results.
The primary body of evidence consisted of 16 studies with over 1700 patients. The authors concluded that these medicines may increase the number of people achieving 50% or greater pain relief as compared with the placebo. However, the authors also expressed uncertainty at the quality of some of the evidence, indicating that the sample sizes were too low in some cases to accurately come to a statistically significant conclusion.
Arthritis Related Pain
Cannabidiol may have therapeutic use as an arthritis treatment, as several studies have investigated this specific treatment arm.
A 2015 study on rats found that transdermal (application on the skin) applied for 4 consecutive days significantly reduced joint swelling, pain, and immune reaction without influencing rat behavior which indicates that there were limited cognitive effects, if any. The authors concluded that topical CBD application has the potential for relief of arthritis pain-related behaviors and inflammation while having minimal side effects.
A similar 2017 study looked at the relationship between pain and osteoarthritis in rats. The study went on to suggest that joint inflammation was reduced by a topical application of CBD, which corroborates the previous findings of the 2015 study. The study also found that proactive application of CBD prevented future joint pain. The study concluded that CBD may prove to be a useful therapeutic treatment for both treating active arthritis and preventing future occurrences.
It is important to note that this study was performed on rats, which doesn’t always transfer over to humans. It’s also important to note, that although there were no side effects on rats, this doesn’t always carry over seamlessly to humans.
Unfortunately, the side effects of CBD are not well researched, and even though animal profiles indicate tolerability, caution should always be used when choosing a CBD product. However, many studies of CBD also contain THC as a component, and many of the negative reactions to CBD are not actually from the CBD, but from the THC itself. By choosing a product that is made with CBD isolate, you can prevent negative side effects from THC.
There is also the possibility that CBD may interact with certain medicines, and as such we recommend that you always check with your doctor first!
With that being said, CBD is generally well tolerated, and the side effects are usually no worse than feeling a little bit sleepy!
Part of the problem CBD is facing is a lack of consistency. Many companies do not test their CBD or provide testing to indicate what is going into their products. Considering that the current research indicates that CBD is highly dose dependent, it’s important to understand what you’re taking.
We highly recommend you seek a CBD company who provides testing on the cannabinoid profiles found in their product to make sure you are getting what you are promised.
For example, a 2017 research letter published in JAMA showed that of 84 CBD products tested, 18 contained THC, and a quarter of them contained less CBD than labeled.
With that being said, the evidence presented here is a mixed bag. On one hand, while numerous anecdotal accounts of CBD reducing pain exist, the requisite science that backs them up is lacking. However, we feel that CBD has a ton of potential as an effective treatment. You may wish to consider CBD for pain relief, and the current research indicates that there is certainly potential. We recommend discussing incorporating CBD into your daily routine with your doctor.
When choosing a CBD product to use, we also highly recommend that you choose a product that has testing provided, which will help you make an informed choice.