If you’ve heard or read about CBD oil, but aren’t sure what impact it has on pain, keep reading. We review ongoing research into conditions such as chronic pain, arthritis, and fibromyalgia to see how CBD could play a role in pain management.
As the impact of opioids and prescription painkillers continues to mount, more consumers are choosing to manage their pain with natural alternatives—such as CBD oil. The versatile cannabinoid has taken the wellness industry by storm, but is there any evidence to support its capabilities?
Before we dive into some of the scientific literature on CBD, it helps to understand the phenomenon of pain. While pain may sound like a simple concept in principle, how our body interprets pain differs significantly from one person to the next.
UNDERSTANDING PAIN AND WHAT CAUSES IT
How painful something is, or how much discomfort you experience, is a very individual phenomenon. This is because pain has to travel through several checkpoints in the body, and is as much an emotional response as it is a physical reaction. You see, even once the signal reaches the brain, it still needs to be sorted and organised by the thalamus, sensory cortex, and motor cortex for the body to act accordingly. In most situations, this usually manifests in yelling profanities while clutching the injured body part.
The type of pain described above is called nociceptive pain. It occurs when we step on a Lego brick, stub a toe, or break a bone. With nociceptive pain, nerve fibres at the site of injury identify inflammation, chemicals, or physical events—triggering our pain response. Cue more profanities.
Neuropathic pain, on the other hand, occurs when the nerves themselves are damaged. By disrupting how the body interprets pain, sensations can become chronic, exaggerated, or even muted entirely. Neuropathic pain is particularly challenging to treat because the cause isn't always apparent—that’s where CBD steps in.
CBD OIL FOR PAIN: HOW COULD IT HELP?
CBD’s potential influence on both nociceptive and neuropathic pain is broad. To help break it down, we’ve split the supporting research into common causes of pain.
• Chronic pain relief
A 2018 review published in Frontiers in Pharmacology examined the results of over 1,000 studies into medical cannabis and the treatment of neuropathic pain and fibromyalgia. It's important to point out that the term “medical cannabis” doesn’t just refer to the plant, but also its constituent parts—in this case, cannabinoids such as CBD, THC, and CBN.
The review highlighted several ways cannabinoids can influence pain, including inhibition of neurotransmitters, activation of pain pathways, and reduction of neural inflammation. It was concluded that “evidence from current research supports the use of medical cannabis in the treatment of chronic pain in adults”. The researchers did, however, point out that monitoring of patients using cannabinoids is mandatory, and that larger, long-term studies were still needed.
• Arthritis pain relief
Arthritis is a broad term covering over 200 conditions affecting joints and connective tissue. The most common form of arthritis is osteoarthritis, a degenerative disease that causes instances of both nociceptive and neuropathic pain.
In 2014, Spanish researchers explored the involvement of the endocannabinoid system in osteoarthritis pain. And although “compelling evidence suggests an active participation of the endocannabinoid system in the regulation of pain'', the researchers were quick to point out that the majority of evidence is from preclinical data. That didn’t, however, stop them from summarising that “promising results” have been “obtained in support of the therapeutic value of cannabinoids and osteoarthritis management”.
• Post-surgery pain relief
Managing inflammation post-surgery is essential to getting back on your feet and keeping pain at manageable levels. In 2016, Molecular Medicine published a study that found cannabidiol (CBD) to exhibit a protective effect in the face of inflammation and oxidative stress. These results appear to go hand-in-hand with an early review involving neuropathic pain, rheumatoid arthritis, and Alzheimer's disease.
• Headache and migraine pain relief
Migraines affect a staggering 1 in 7 people worldwide and are incredibly debilitating. Despite their prevalence, we know very little about what causes migraines, and this makes treatment difficult.
As part of a 2008 study, GW Pharmaceuticals proposed that there were “common clinical, biochemical and pathophysiological patterns” between conditions such as migraines, fibromyalgia and irritable bowel syndrome. One system, in particular, that’s involved in all three is the endocannabinoid system.
The endocannabinoid system (ECS) is a regulatory system that exists inside all of us, and is responsible for monitoring vital organs, parts of the brain, and the central nervous system. It can also encourage the production of beneficial enzymes and endocannabinoids when needed.
The results of the study highlighted that “migraine has numerous relationships to endocannabinoid function”. If the theory from GW Pharmaceuticals is correct, then CBD’s potential involvement in migraines appears to stem from its modulation of the ECS.
HOW TO USE CBD OIL FOR PAIN
CBD’s versatility doesn't just extend to the conditions outlined above. Once carefully extracted, the cannabinoid is found in the following:
• Topicals
• Tinctures
• CBD oils
• Softgel capsules
• Edibles
While we cannot give any specific advice on how to use CBD, or a recommended dose, if you plan to try CBD it's worth attempting to match the type of pain to the relevant consumption method. If you have a digestive disorder, for example, then CBD oil may be better to try than topical creams. However, if your pain is joint-related, CBD topicals may prove superior.
SHOULD YOU TAKE CBD OIL FOR PAIN RELIEF?
Although the research outlined above is encouraging, you should always consult your doctor before using CBD as part of a pain management programme. As we’ve pointed out, pain is interpreted differently in everyone, so no two cases are the same. Many of the studies into CBD are still in preclinical stages, with much more to learn about the cannabinoid's full potential.
However, it's easy to understand why CBD has a significant following—it appears to directly counter many of the disadvantages of pharmaceutical painkillers. The compound produces minimal side effects, has a good safety profile, and “exhibits no effects indicative of abuse”, according to the World Health Organisation (WHO). Just make sure you find a reputable producer who can verify the contents of their CBD oils if you do decide to try it for yourself.
