How Does Cannabis Help With Pain?

The reality is that pain will affect everyone at some point in their life. Many people unknowingly turn to prescription medications, while others seek natural alternatives that may help. The use of a natural remedy is especially important for those suffering from neuropathic pain and chronic pain, or pain that lasts for more than a few months. Chronic pain affects more than 3 million people in the United States every year – and the worst part? It can’t be cured. 

However, we may soon see a rise in chronic pain treated with hemp-based supplements. It’s no secret that THC is effective against pain, but preliminary research shows the potential of CBD for pain, especially chronic discomfort. Some studies show CBD to be more effective against pain than opioids like hydrocodone and oxycontin, and researchers are expected to continue to expand this research in hopes of establishing a safer alternative to these common medications.

The irony is that in the United States, the most common medical treatments are nerve blocks, steroids, and narcotics (opioids) – many of which carry a significant risk of side effects and addiction. On top of these side effects, many of these medications have little to no effect against chronic pain. 

Even over the counter non-steroidal anti-inflammatory drugs (NSAIDs) like Aspirin and ibuprofen can be dangerous when used regularly. These “safe” medications end up hospitalizing over 100,000 people each year and killing approximately 15,000. Fortunately, narcotics and NSAIDs are not your only option for pain relief. 

In addition to physical therapy and self-care, many people incorporate CBD into their treatment regimen for natural, plant-based pain relief. CBD is fundamentally different than most prescribed painkillers, as it’s not addictive, non-toxic, and has very minimal (if any) side effects.

Whether the chronic pain is in your back, neck, hands, feet, or elsewhere – there may be a natural option. Preliminary research and anecdotal evidence show that CBD for pain can help manage discomfort in a similar manner to the most common analgesics, by binding with neuroreceptors to block signals that communicate pain to the brain. This helps to reduce pain perception while easing the inflammation and overactivity that often sit at the root of persistent pain. Of course, more evidence is needed to substantiate these claims, but researchers are consistently moving in that direction.

In order to understand CBD for pain management, we turn to a series of medical studies that have been conducted over the past ten years. These studies evaluated CBD’s medical efficacy in treating those who suffer from various types of pain. We will address the results below.

What Studies Support the Use of CBD for Pain?

Specific studies regarding the use and pharmacokinetics of cannabinoids for pain management date back over a decade. To date, multiple research efforts have taken aim at explaining the way that cannabidiol may work to help provide pain relief. This broad range of studies explores the use of CBD for pain in different forms—on its own, when combined with THC, and in the form of cannabinoid-based pharmaceuticals. 

In general, research suggests that cannabidiol could be useful for managing pain due to a variety of conditions, including neuropathic pain, like pain related to multiple sclerosis. Studies also suggest that CBD may be a suitable therapeutic option for pain caused by inflammation, like pain due to arthritis or muscle injury. Research even suggests that cannabinoid-based therapy may be suitable for managing intractable cancer-related pain. 

Research related to the use of CBD for pain is still only at its start, but researchers have outlined a clear interest in the anti-inflammatory and neuroprotective properties of CBD, as well as in its use for managing pain related to a variety of neurological and physical conditions. These studies suggest that a variety of different dosing methods, ranging from oral doses to transdermal application, may be appropriate for managing pain related to one or more of these conditions. 

1. Cannabinoids in the management of difficult to treat pain.

A 2008 article reviewed a variety of research on cannabinoid analgesia and the function of the endocannabinoid system regarding pain mechanisms, as well as multiple clinical trials concerning the use of cannabinoids to manage pain. The articled concluded that “Cannabinoid analgesics have generally been well tolerated in clinical trials with acceptable adverse event profiles. Their adjunctive addition to the pharmacological armamentarium for treatment of pain shows great promise.

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2. Meta-analysis of cannabis based treatments for neuropathic and multiple sclerosis-related pain.

A 2007 study looked at the effects of cannabinoids on treating the debilitating pain experienced by 50-70% of multiple sclerosis (MS) patients. The double-blind placebo-controlled study concluded that “cannabinoids including the cannabidiol (CBD)/THC buccal spray are effective in treating neuropathic pain in MS.”

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3. Oromucosal delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial. 

Another 2007 study evaluated the long-term tolerability and effects of a THC/CBD pharmaceutical known as Sativex. The study concluded that “THC/CBD was effective, with no evidence of tolerance, in these select patients with CNP and MS who completed approximately 2 years of treatment.” 

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4. Cannabinoids for neuropathic pain. 

A 2014 study stated that “The endocannabinoid system has been elucidated over the last several years, demonstrating a significant interface with pain homeostasis. Exogenous (plant-based) cannabinoids have been demonstrated to be effective in a range of experimental neuropathic pain models, and there is mounting evidence for therapeutic use in human neuropathic pain conditions.” 

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5. Neuropathic orofacial pain: cannabinoids as a therapeutic avenue. 

Another 2014 study suggested that “Analgesia is one the principal therapeutic targets of the cannabinoid system and many studies have demonstrated the efficacy of cannabinoid compounds in the treatment of neuropathic pain.” 

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6. Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT(1A) receptors without diminishing nervous system function or chemotherapy efficacy. 

A 2014 study investigated CBD’s therapeutic potential in treating chemotherapy-induced neuropathic pain (CIPN). Scientists concluded that “adjunct treatment with CBD during PAC chemotherapy may be safe and effective in the prevention or attenuation of chemotherapy-induced neuropathic pain.” 

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7. Antihyperalgesic effect of a Cannabis sativa extract in a rat model of neuropathic pain: mechanisms involved. 

A 2008 study found, “that a controlled cannabis extract, containing multiple cannabinoids, in a defined ratio, and other non-cannabinoid fractions (terpenes and flavonoids) provided better antinociceptive efficacy than the single cannabinoid given alone…” This is why the use of full-spectrum CBD oil is more effective in treating pain than taking CBD isolate alone – you want the beneficial terpenes and flavonoids contained in the plant.

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8. Non-psychoactive cannabinoids modulate the descending pathway of antinociception in anaesthetized rats through several mechanisms of action. 

A 2011 study evaluated the effects of two non-psychoactive cannabinoids, cannabidiol (CBD) and cannabichromene (CBC), on pain management. The study concluded that “CBD and CBC stimulated descending pathways of antinociception and caused analgesia by interacting with several target proteins involved in nociceptive control. These compounds might represent useful therapeutic agents with multiple mechanisms of action.” 

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9. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. 

A 2012 study reported that, “systemic and intrathecal administration of cannabidiol (CBD), a major nonpsychoactive component of marijuana, and its modified derivatives significantly suppress chronic inflammatory and neuropathic pain without causing apparent analgesic tolerance…These cannabinoids may represent a novel class of therapeutic agents for the treatment of chronic pain and other diseases…” 

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10. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. 

A 2010 study looked at the efficacy, safety, and tolerability of THC:CBD extract in patients with intractable cancer-related pain. “This study shows that THC:CBD extract is efficacious for relief of pain in patients with advanced cancer pain not fully relieved by strong opioids.” 

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Which CBD products help with pain?

When formulating a regimen of CBD for pain (like chronic or neuropathic pain), it’s important to understand that CBD has not been proven to treat pain. Still, anecdotal reports of success encourage many people to try the plant-based alternative by incorporating regular doses. It may be best used as a preventative first – it can also be used to manage acute flare-ups, but preventative maintenance is most important! Think about it like any other dietary supplement, you want to establish a baseline concentration in your system.

There are a variety of different products made with CBD for pain, but we recommend ingesting full spectrum CBD oil daily in the form of Tinctures or Gel Capsules

The ingredients in the two products are the same; the only difference between the two is the form factor and dosage – pills vs. sublingual tinctures. The best CBD tinctures and gel caps will combine the power of CBD for pain with a high-quality MCT oil—a key ingredient needed for your body to break down and absorb cannabidiol. 

Many people find they still need a safe way to manage acute flare-ups in addition to using the products outlined above for daily pain management. Depending on your preference, there is a couple of suitable option for managing sudden pain flares.

Whether it’s caused by a recent injury, cold weather, or general aggravation  – we recommend vaporizing CBD isolate to combat these acute pain flare-ups. The benefit of vaporizing or dabbing CBD isolate is that the relief can be felt almost instantaneously. CBD isolate is 99% pure CBD and provides a wave of relief that can be felt throughout the whole body. 

Certain CBD topicals may also provide quick relief from pain flares. Topicals, like CBD salves and creams, penetrate the skin to help manage pain in the bones, muscles, joints, ligaments, and at the skin’s surface. 

Often, the best way to manage moderate to severe pain, recurring pain, or pain caused by a number of chronic conditions is to combine different CBD products for all-day preventative and therapeutic coverage. 

What is the correct dosage of CBD for pain?

The correct dosage for you depends on a number of factors, like the type and severity of the condition you hope to treat, as well as biological factors like weight and tolerance to cannabinoid-based products. 

We suggest starting with with 5-10mg per day of CBD for pain. If relief is not felt at this dosage, we suggest increasing by 5-10mg until the desired effects are achieved. One easy way to do this is with a CBD tincture, which makes it easy to measure accurately metered doses as needed each time. 

Other products, like CBD gel capsules, come in pre-measured doses, so starting with the lowest dose (like a ten-milligram capsule) is a great way to understand how much CBD you need to reach the desired level of relief. 

Then, you can increase your dose as needed, but keep in mind that these ingestible products provide sustained relief for several hours – many people find they provide relief for the whole day! The one thing to keep in mind with ingestible CBD products is the delayed onset time – it can take up to 90 minutes for the full effects of the tinctures or capsules to be felt.

Dosing for CBD topicals is a bit different, and you should use as much of the product as you need to cover the affected area. Topical products typically work fast, and relief can be felt within 15 minutes and lasts several hours. Simply re-apply as necessary.

Dosing for CBD vaporizers is also slightly different since it can be difficult to properly meter doses with certain vaping devices. Starting with a low-dose cannabidiol vape or CBD additive can help you smoothly experience the fast-acting effects. Because the therapeutic effects of vaporized CBD for pain kick in so quickly, you can easily “stack” doses as needed until the desired effects are reached. Simply increase your dose one “puff” at a time, waiting about 10-15 minutes in between to monitor the effects. 

A Note About CBD and Drug Interactions

Although CBD has been generally labeled as safe by numerous studies and even the World Health Organization, it is important to note that CBD may interact with certain medications. In the same manner that grapefruit interacts with some medications, CBD may affect the absorption of medications that are metabolized by the cytochrome P450 enzyme group. That’s because CBD also relies on this group of liver enzymes for absorption, so there’s a significant opportunity for interaction when medications and CBD are taken simultaneously.

Interactions could include many of the prescription medications taken for pain, like opioids, which often utilize cytochrome P450 pathways for absorption. These interactions are not necessarily dangerous but can cause the effects of the medication to falter, which can be dangerous if the medication is meant to treat severe symptoms or a chronic condition. 

The effect CBD has on these liver enzymes is temporary. Often, putting some space between your dose of CBD for pain and your medication may resolve this issue, but it’s always best that you talk to your doctor about CBD before using it, especially if you already take prescription medications or have a chronic illness.