Millions use CBD products to ease pain and treat symptoms of a wide range of diseases. What are the pros and cons of CBD? Learn more… The science behind CBD oil for pain is still lacking, but what we do know is promising. Here’s how to use CBD oil for back pain and other types of chronic pain.
Pros and Cons of CBD for Medical Conditions
Coping with a serious illness is hard. Of course, everyone wants to be as healthy as possible, with as few side effects from treatments as possible. In an effort to improve their health, many patients turn to complementary and alternative medicine (CAM). This post provides information on the pros and cons of CBD for medical conditions.
I strongly encourage you to read the first post in the series for important general information on CAM treatments. Additionally, read my other posts to learn about the pros and cons of additional common CAM treatments:
It’s important to realize that CBD and other CAM treatments come with some degree of risk (as do all other medical treatments and medications). So before you try CBD, do some research, talk to your doctor, and be realistic about potential outcomes. And don’t ignore traditional treatments while pursuing CAM therapies.
CBD – cannabis plant extracts
CBD, formally known as cannabidiol, naturally occurs in cannabis plants. The CBD extract does not get you high but may provide health benefits. On the other hand, THC is the component in marijuana that makes you high.
What’s the difference between hemp and marijuana?
Hemp is the common, legal term used for cannabis that has less than 0.3% of THC. Conversely, marijuana is the common, legal term for cannabis that contains more than 0.3% of THC.
What kinds of conditions can CBD help?
Nobody knows for sure. But a 2018 World Health Organization (WHO) report team determined that CBD has “been demonstrated as an effective treatment for epilepsy” for adults, children, and animals. Furthermore, the WHO report states that there is “preliminary evidence” that CBD could help Alzheimer’s disease, cancer, psychosis, Parkinson’s disease, and other serious conditions.
What about pain relief?
There is some evidence that CBD may help relieve pain – for some patients. But the evidence is inconclusive.
For instance, in 2021, an international group of researchers analyzed dozens of studies evaluating the pain relief provided by non-inhaled medical cannabis. (Note: the studied cannabis likely contained varying levels of THC and CBD.)
The researchers concluded there is not enough evidence to say that medical marijuana helps relieve chronic pain. They found the “use of medical cannabis or cannabinoids probably results in a small increase in the proportion of patients experiencing an important reduction of pain”.
Additionally, they found that medical cannabis or cannabinoids led to a “very small increase” in the number of patients experiencing an important improvement in physical functioning.
What about other studies?
Other studies provide some hopeful information. A 2018 report reveals that a combination of THC and CBD provided some pain relief for cancer patients. And one study with rats found topical CBD application relieved arthritis pain-related behaviors and reduced inflammation without any evident side-effects.
Other research found that CBD might reduce inflammation, which is often related to pain. Additionally, some small, preliminary human trials found there is a chance that CBD may help alleviate neuropathic pain (pain caused by nerve damage).
What do customers say?
In 2018, results of a survey of CBD users found that almost 62% of CBD users reported using CBD to treat a medical condition – the top three were pain, anxiety, and depression. About 36% of respondents stated that CBD treats their medical condition(s) “very well by itself”. In contrast, only 4.3% stated that it treated their conditions “not very well”. It’s worth noting that 1/3 of users reported a non-serious adverse effect.
Is CBD legal?
Not necessarily. Last year, the US government legalized hemp and the extract CBD as part of the 2018 Farm Bill. But it’s all a bit confusing.
Hemp is now legal, but the government has not created a system which allows people to freely grow hemp. Furthermore, the government still considers marijuana illegal, and since CBD comes from marijuana, it’s a very gray area.
To make the matter even more confusing, all 50 states and Washington, D.C., have different laws regarding hemp and marijuana. Wondering what the laws are in your state regarding CBD and marijuana? Look your state up here.
Is CBD safe?
Probably. But not certainly.
The 2018 WHO report on CBD found no adverse health outcomes, or any potential for addiction or abuse. However, because marijuana has historically been illegal in the US, it’s been hard for researchers to study the impact.
Therefore, there are still a lot of unknowns, including appropriate dosing, how it gets absorbed, and how CBD interacts with other medications.
Additionally, this is a widely unregulated industry right now, with new products and online stores regularly entering the market. And some manufacturers are more trustworthy than others.
For instance, some manufacturers use chemicals such as butane and hexane to extract the CBD, which can leave unwanted residue in the product. In contrast, others use “green” techniques which extract the CBD using CO2, which is considered safer.
Another major concern is that labels on CBD products can be inaccurate. Findings of a 2017 study should cause alarm – researchers tested 84 CBD products and determined that 70% were mislabeled.
Why does that matter? You cannot be certain what dosage you are getting. For example, if a label says the product contains 100 milligrams of CBD, in reality it might have 5 mg or even 200 mg.
What’s the FDA think about CBD?
The FDA is in the beginning stages of supporting CBD products. In 2018, the FDA approved the first CBD drug. The medication, made by a British pharmaceutical company, is for the treatment of severe epilepsy in children. I expect we’ll see more pharmaceutical companies making CBD products in the coming years.
It’s important to understand that the FDA is not regulating production of CBD products, so you don’t always know what you’re buying. However, even though the FDA isn’t regulating production, they are trying to make sure companies don’t make “unsubstantiated advertising claims”, such as claiming a cure for cancer or Alzheimer’s.
Where can you get CBD products?
Here, there and everywhere.
There is a huge industry around CBD. Note that some products only contain CBD, while others contain CBD and THC.
You can buy CBD products almost anywhere – at your local gas station or pharmacy (including some CVS and Walgreens stores) and at a wide range of other stores. Additionally, there are countless online stores selling CBD products.
What kinds of products contain CBD?
You name it, you can find it. Products with CBD include lotions, oils, creams, shampoos, candies, cookies, beers and makeup.
Buyer’s beware – you don’t always know exactly what you’re getting!
Since the FDA isn’t regulating CBD products, it’s a bit of the wild west out there. You might unknowingly buy a CBD product with THC, or who knows what else, in it. And, as discussed above, you might not get the dosage you expect.
If/when the pharmaceutical industry starts making more CBD products, we will likely see an increase in FDA-approved CBD products. This will likely give customers a sense of security regarding the purity of FDA-approved CBD products.
How popular is CBD?
Very! Results of a consumer survey indicate that around 7% of US adults use CBD products – that means there could be as many as 15 – 20 million people using CBD.
There’s been a lot of positive information flowing about the benefits of CBD, but there has not been a lot of scientific study. So, it’s a good idea to talk to your doctor before starting CBD and definitely do your research!
What to Know Before You Try CBD Oil for Pain Relief
The science behind CBD oil for pain is still lacking, but what we do know is promising.
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Cannabidiol, better known as CBD, is having a major moment. Most commonly consumed as an oil, the marijuana compound doesn’t give you that floaty feeling of being high—but it does have its own set of uplifting properties. CBD oil users say it melts away anxiety, eases sleep issues, and relieves depression. And last month, the U.S. Food and Drug Administration approved CBD to treat two severe forms of epilepsy, making it the first marijuana-derived drug approved at the federal level.
But the CBD oil use that might be most intriguing—and could perhaps be the biggest game-changer—is for pain relief. As the United States grapples with the opioid epidemic and struggles to treat the 50 million plus Americans who struggle with chronic pain, CBD oil has emerged as a nonaddictive alternative that people are applying as a topical oil, ingesting as a pill, or smoking through a vape pen.
But does CBD oil for pain really work—or is it just a passing fad amplified by the placebo effect? Here’s what we know so far.
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CBD oil as a painkiller just hasn’t been studied much
There has been lots of anecdotal proof for CBD and pain relief, so researchers have often focused on finding out whether that’s due to the placebo effect, says Rebecca M. Craft, PhD, H. L. Eastlick professor of psychology and director of the experimental psychology doctoral program at Washington State University.
Currently, the U.S. National Library of Medicine lists just 25 clinical studies involving CBD and its effects on pain. Only a handful of those have been completed so far, but there are more in the works. Many of these trials involve pain in people with advanced cancer, and while some show positive pay-offs, others demonstrate that cannabis treatment doesn’t provide any more relief than a placebo. The catch: Most of this science involves both CBD and THC (or Δ9-tetrahydrocannabinol, the part of cannabis that does give you a high).
There are a few other drawbacks to studies on CBD. First off, many involve rats rather than humans (including one that focuses on arthritis-related ache relief). Also, the science that does involve people doesn’t often include a large test group, Craft says. Finally, as Craft notes along with a review of CBD studies, there’s not much research out there about the long-term effects of cannabis-based meds.
In the end, science just needs to catch up with the draw toward CBD, at least in terms of easing aches.
CBD oil for pain relief boils down to your brain
It likely comes down to neurotransmitters in the brain. “One mechanism of action is that it de-sensitizes a particular receptor known to be involved in pain, called TRPV1,” Craft explains. TRPV1 creates that sort of burning sensation pain you might feel from something like nerve damage. As Craft points out, that’s only one particular form of pain that CBD could affect—and one in which scientists are still trying to learn more about.
Trying CBD oil for back pain and other run-of-the-mill aches probably won’t hurt you
None of this is to say trying CBD is off limits. “Cannabidiol is generally well-tolerated, which gives it a distinct advantage over other medications currently available for pain, including (and especially) opioids, non-steroidal anti-inflammatory drugs, steroids, anticonvulsant, and antidepressant medications,” says Seth Waldman, MD, anesthesiologist and director of the pain management division at the Hospital for Special Surgery. “I have seen a number of patients with difficult neuropathic pain syndromes who found it helpful.” (There’s also a study on this neuropathic pain—that burning-like sensation that affects the nervous system as Craft mentioned earlier. Research showed, though weak, it had a positive effect.)
Also, while using it topically as an oil is probably safer, more promising results come from taking it orally, Dr. Waldman notes. So you’ll want to be extra careful going the ingested route.
Your biggest concern should be making sure you’re not getting the THC along with the CBD, Craft says, and that can be difficult to ensure. “Very low doses are unlikely to have side effects,” she says. “But if you have higher concentrations and you’re pre-disposed for mental illness, it could actually make it worse.”
CBD oil for chronic pain has pros and cons
A strong draw to CBD: There’s no record of severe side effects. You might feel a little drowsy—and probably shouldn’t operate a vehicle while on it—but otherwise, you’re likely in the clear.
The bad news: CBD, just like any other supplement sold in the U.S., isn’t regulated. That means you can never be totally sure of the amount of CBD you’re getting. “If you and I go into a local cannabis shop, even a shop with a lot of experience of people coming in for medical reasons—unless you’re in Canada or Netherlands, where they have federally-produced drugs—we can’t trust that what’s on the label is what we’re actually getting,” Craft says. That means you could be getting more or less of CBD, as well as THC (which has its own set of side effects).
Using CBD oil for pain: The takeaway
“If it’s safe and you feel it works for you, then that’s great,” Craft says. “As far as helping the general public make a decision, we just want to know if it’s going to work for more people,” and that calls for more research.
Dr. Waldman says it is worth trying, at least for that neurological pain, but you’ll want to follow a few precautions considering dosage is hard to decipher. “Try only one new treatment at a time, so that any effects or side effects can be attributed to the right one,” he says. Then, “start low and go slow. That is, begin with the lowest dose, used once daily, and if tolerated and necessary, the dose could be increased slowly and deliberately. It is more difficult to gauge the effects of a new treatment if it is used irregularly.” One last important note is, of course, talk to your doctor first before trying.
This type of pain treatment, “is trendy and may have legitimate medicinal properties that are incredible—or it could go by to the wayside in a few years,” Craft says. “We just have to wait and see.”
Mallory Creveling, an ACE-certified personal trainer and RRCA-certified run coach, joined the Runner’s World and Bicycling team in August 2021. She has more than a decade of experience covering fitness, health, and nutrition. As a freelance writer, her work appeared in Women’s Health, Self, Men’s Journal, Reader’s Digest, and more. She has also held staff editorial positions at Family Circle and Shape magazines, as well as DailyBurn.com. A former New Yorker/Brooklynite, she’s now based in Easton, PA.