October 21, 2020

Can CBD oil relieve pain?

The popularity of CBD is booming. Most people use this oil to relieve pain caused by arthritis, multiple sclerosis, migraines and irritable bowel syndrome. But are these uses supported by science? And what type of supplement provides the fastest and most effective pain relief? This article will give you answers to these questions.

What is CBD oil?

CBD oil is a therapeutic oil made from the cannabis-derived compound cannabidiol, or CBD. Unlike THC, CBD is not intoxicating.

People commonly use medical cannabis containing CBD and THC for pain relief. In two surveys of over 3,500 people using these medications, over 50% reported suffering from various types of disease-related pain. The conditions most commonly treated with CBD - and other cannabis products - include

Arthritis (rheumatoid arthritis and osteoarthritis)
multiple sclerosis
Headaches (migraines, cluster headaches and drug-induced headaches)
Lower back pain
Cancer pain
Fibromyalgia
Nerve pain
Irritable bowel syndrome pain

Hemp-derived CBD oil is legal in many countries, while marijuana-derived oil can contain higher THC levels and is therefore more strictly regulated.

CBD oil for pain relief

How does it work?

Interactions with the endocrine system

The endocannabinoid system consists of two receptors: CB1 and VB2. The cannabinoids that the body produces itself - including anandamide - bind to these receptors. CB1 receptors are primarily found in brain cells, while CB2 receptors are most abundant in immune cells.

Cannabinoids in general - including anandamide and THC - reduce pain by activating these receptors. In fact, anandamide deficiency has been linked to painful conditions such as migraines, fibromyalgia and irritable bowel syndrome (1).

CBD is less likely to bind to CB receptors, blocking them rather than activating them. However, CBD indirectly increases the amount of cannabinoids in the body: it stops the breakdown and excretion of anandamide. This probably explains why it enhances the pain-relieving effects of THC (2, 3).

However, CBD and cannabis products are not the only way to increase your cannabinoid levels. There are at least 49 other pathways that we know of.

Anti-inflammatory mechanisms

CBD oil is a powerful anti-inflammatory, which probably explains why it can prevent and relieve pain. Looking at its effects on a cellular level, we see that it affects over a dozen anti-inflammatory mechanisms and molecules. Firstly, CBD activates receptors that reduce sensitivity to inflammation (TRPV1 and TRPA1) and nerve pain (5HT1A and glycine receptors) (4, 5, 6).

It also blocks the primary pain node NF-kB, activates anti-inflammatory PPAR-gamma and prevents the degradation of anti-inflammatory adenosine. In turn, CBD reduces the production of many pro-inflammatory messengers (IL-1beta, IL-6, TNF-alpha, IFN-gamma and prostaglandins (7, 8, 9).

In addition, CBD increases the levels of the anti-inflammatory cytokines IL-4 and IL-19 (10). Last but not least, CBD enhances the analgesic effects of opioids such as morphine (11).

Next, we'll look at whether CBD oil works for a range of pain conditions.

When does CBD work?

1) Multiple sclerosis

In multiple sclerosis, pain is caused by involuntary muscle contractions and damage to nerves, muscles and joints. THC, CBD and a combination of both were similarly effective in reducing involuntary muscle contractions and pain in a small study of 24 subjects with multiple sclerosis (12).

In mice with multiple sclerosis, CBD reduced inflammation and nerve damage, which slowed the progression of the disease. Its effects may vary when CBD is combined with other hemp-derived cannabinoids. THC provides additional relief while another compound (palmitoylethanolamide) blocked the positive effects of CBD (13, 14).

However, an oral spray containing similar amounts of THC and CBD called nabiximol is commonly used for this condition.

Summary: Extracts containing THC and CBD relieve pain caused by multiple sclerosis, while there is some evidence that CBD alone may also be effective.

2) Nerve pain (neuropathy)

CBD reduced nerve pain caused by brain injury, repeated nerve stimulation, cancer drugs and diabetes in rats and mice. It activated three receptors that reduce pain sensitivity (TRPV1, 5-HT1A and glycine receptors), lowered levels of pro-inflammatory cytokines and prevented T cells from attacking the nerves (15, 16, 17). In addition, CBD enhanced the analgesic effects of THC in mice (18).

As with multiple sclerosis, clinical trials for difficult-to-treat nerve pain often successfully tested a spray containing THC and CBD.

Summary: Extracts with CBD and THC reduce difficult-to-treat nerve pain. CBD alone may also help, but clinical trials are needed to confirm this.

3) Arthritis

Arthritis refers to damage to joint cartilage caused by wear and tear (osteoarthritis) or autoimmune reactions (rheumatoid arthritis). In a survey of nearly 3,500 people who used medical cannabis, 21% reported using it to treat arthritis and often reported good results.

Although the only clinical trial conducted to date examined a spray containing THC and CBD, a follow-up study is underway to examine the effect of CBD alone on joint pain in people with rheumatoid arthritis (19).

Both orally ingested and skin-applied CBD relieved pain and inflammation in dogs and rats with osteoarthritis. It was also effective in mice and rats with rheumatoid arthritis (20, 21).

Summary: CBD in combination with THC relieves joint pain. Studies to test the pain-relieving effects of CBD alone on arthritis pain are underway.

4) Fibromyalgia

Fibromyalgia can cause widespread pain, possibly due to the brain being more sensitive to pain signals (22).

In a clinical trial, a vape containing equal amounts of THC and CBD slightly reduced fibromyalgia pain. Vapes containing more of one or the other compound, however, were found to be ineffective (23).

CBD injected directly into the muscles may be more effective in treating fibromyalgia, as it relieved pain in rats with a similar disorder (myofascial pain) (24).

5) Irritable bowel syndrome and inflammatory bowel disease

Irritable bowel syndrome and inflammatory bowel disease cause pain, cramping and diarrhea or constipation. Although both conditions are similar, inflammatory bowel disease causes more inflammation and damage to the intestinal lining.

One survey showed that almost 4% of all medical cannabis users used it to treat irritable bowel syndrome and inflammatory bowel disease, and another survey of people with inflammatory bowel disease showed that 22% treated this condition with cannabis oil.

CBD has not yet been tested in people with irritable bowel syndrome. This disease is thought to cause pain by increasing the production of TRPV1 receptors in the gut. TRPV1 triggers inflammatory pain and stimulating these receptors with CBD (or other compounds such as chili pepper or capsaicin) reduces the sensation of pain, which could explain why CBD may provide pain relief in IBS (25, 4).

Inflammation of the intestine increases the permeability of the intestinal barrier, which aggravates irritable bowel syndrome. In a clinical study of 30 healthy men, CBD reduced the permeability of the intestinal barrier and prevented pro-inflammatory cytokines from entering the cells of the intestinal mucosa (26).

Alternatively, CB1 activation by anandamide and other cannabinoids reduced inflammation of the cells of the intestinal wall. Although CBD primarily binds to other receptors, it could indirectly activate the CB1 receptors and thus reduce intestinal inflammation by increasing anandamide levels (27).

Nevertheless, CBD showed little or no effect on symptoms of irritable bowel syndrome in 2 studies involving 80 subjects (28, 29).

However, CBD was more effective in rats and mice with irritable bowel syndrome. CBD relieved inflammation and tissue damage, reduced pain and enhanced the anti-inflammatory effects of THC (30).

Summary: CBD oil could increase natural cannabinoid levels and reduce inflammation associated with IBS. However, clinical studies are still lacking.

6. back pain

In a clinical study of 11 subjects suffering from back pain despite surgery, a cannabis oil containing CBD and THC as an adjunctive therapy reduced pain and improved quality of life. However, the oil contained more THC than CBD (31).

In another study of 200 people with chronic pain, 19% of whom suffered from lower back pain, medicinal cannabis (with THC and CBD) reduced pain and opioid use (32).

Summary: Only products with CBD and THC appear to relieve back pain. There are no studies to date with CBD alone, although there are reports of successful use.

7 Headaches and migraines

Cannabis is commonly used to treat all types of headaches. In a study of 100 migraine patients using medicinal cannabis, 85% reported reduced pain and reduced migraine frequency (33).

Although activation of the CB1 receptor by THC may be responsible for most of this effect, CBD may help prevent migraine attacks by stimulating the release of serotonin, which reduces migraine pain (34).

On the other hand, CBD may also trigger migraine attacks by activating the TRPV1 receptor and releasing CGRP (a protein that dilates blood vessels in the brain) (35).

Summary: CBD alone is unlikely to reduce migraines and headaches, whereas THC is more likely to help.

8. pain after medical procedures

HPV vaccination can cause a number of adverse side effects, including severe pain, fatigue and sleep disturbances. In a small study of 12 subjects who developed these symptoms after vaccination, a CBD-enriched hemp oil helped to relieve pain and increase vitality and well-being (35).

Chronic pain is a side effect of kidney transplants, which is usually treated with painkillers that can damage the kidneys. In a small study of 7 transplant patients, CBD reduced this pain in all but one patient (36).

Injected CBD reduced post-operative pain in rats. An oral cannabis product that contained more THC than CBD also reduced postoperative pain in a clinical trial (75).

Summary: CBD appears to reduce pain after medical procedures.

9 Other types of pain

Some case studies report successful pain relief with CBD (often in combination with THC) in people with

Endometriosis
Benign tumors in the nerves
Two types of rare inflammatory diseases of the skin (epidermolysis bullosa and pyoderma gangrenosum)

Limitations

Many of the human studies used CBD in combination with varying amounts of THC. However, animal studies suggest that CBD alone can also relieve pain.

CBD oil dosages for pain relief

The only clinical trial of CBD for pain relief after kidney transplantation used quite high dosages: starting with 100 mg per day and increasing the dosage to 300 mg per day over 3 weeks (38).

Unofficial doses are lower and are based on recommendations from manufacturers and users. The optimal dosage depends on the following factors:
Body weight: heavier people require a higher dosage to experience pain relief.
Type of pain: severe and chronic pain usually requires higher dosages than mild pain.
Habituation: people who use CBD regularly may develop a habituation effect over time, requiring higher dosages. With this information in mind, the recommended CBD dosages (taken one to three times a day) are as follows:
Light people (under 60 kilos): 10 to 17 mg
Medium people (60 kilos to 90 kilos): 15 to 25 mg
Heavy people (over 90 kilos): 22 to 45 mg

Start with the lowest dosage and observe your reaction. If you tolerate CBD oil well, you can gradually increase the dose until you achieve the desired effect.

How to take it

CBD oil is available in different dosage forms:

Oil tinctures
Capsules and tablets
teas
Oral sprays
Liquids for e-cigarettes
Lotions, ointments and creams for application to the skin
plasters

The choice of dosage form may depend on the type of pain:

Capsules and teas release CBD more slowly, but their effects also last longer. These dosage forms are well suited for chronic pain.
Liquids for e-cigarettes, mouth sprays and oil tinctures are absorbed more quickly and are therefore well suited for acute pain.
Dosage forms applied to the skin are mainly used for muscle and joint pain.

How long does it take for the effect to kick in?

The length of time it takes for you to feel pain-relieving effects depends on the method of delivery, which determines the rate at which CBD is released into your bloodstream (39, 40):

Liquid for e-cigarettes: 5-15 min
Oral sprays and oral tinctures that are absorbed through the mucous membranes: 15-30 min
Oral capsules and teas: 30-180 min
Forms applied to the skin: 30-120 min

Testimonials

Most people use CBD oil for painful conditions such as multiple sclerosis, arthritis, nerve pain, fibromyalgia, irritable bowel syndrome and back pain. Users are usually satisfied and most of them report pain relief.

In some cases, users have complained that the oil did not work for them. Depending on the type of product and the method of administration, some users have also complained about the bad taste.

Possible side effects of CBD oil:

CBD oil is generally well tolerated and has few, usually mild, side effects. The most common side effects reported by people using CBD for pain relief included (41):

Dry mouth
euphoria
hunger
dizziness
Drowsiness and fatigue
Nausea

Conclusion:

CBD oil can cause pain by increasing anandamide levels - the human body's natural cannabinoid molecule. Unlike THC, it does not act directly via the cannabinoid receptors and has no intoxicating effect.

CBD oil can help with mild multiple sclerosis pain, nerve pain, arthritis and irritable bowel syndrome. Its side effects are mild and most people tolerate CBD oil well.

If you need quick pain relief, use a liquid for e-cigarettes. For longer-lasting pain relief, capsules are better. For localized pain such as back pain or knee pain, you may benefit from creams or other CBD formulas to apply to the skin.

References:

Source: https://selfhacked.com/blog/can-cbd-oil-relieve-pain/

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