Anyone who has experience with neuropathy knows that it’s a uniquely unsettling experience. The electric tingling, burning, stinging, and pinprick sensations tend to happen in the extremities, but can occur anywhere in the body. Nerve pain is unique in that it is caused by damage to the nerves themselves (be it from a slipped disc, a compressed nerve, chronic conditions like multiple sclerosis, or damage sustained in an injury) and not the surrounding tissue. Therefore, neuropathic pain is the result of a misfiring of your body’s pain perception system..
Because the damage is done to the nerve cells, the cells your body uses to relay signals to and from the brain, neuropathic pain can produce strange and unnerving sensations that make sleeping, eating, and other day-to-day activities difficult — or even impossible. Nerve damage is notoriously difficult to heal (though much research is devoted to the topic), and many conventional painkillers are of little help.
Cannabidiol, or CBD, has been shown to impart neuroprotective, anti-inflammatory, analgesic, antioxidant, and antispasmodic effects that may be successfully applied to a neuropathic pain management regimen. Derived from hemp and known for its effectiveness without risk of addiction or dependence, CBD can be consumed orally, inhaled, or applied topically for relief from neuropathic pain.
Because of their ability to manipulate sensations in the skin and body, many people find CBD topical products to be particularly helpful at soothing and alleviating neuropathic pain. Topicals offer faster relief than oral dosing methods, as well as a greater degree of customizability. Supporting ingredients like cinnamon, ginger, peppermint, and capsaicin can change the way nerve cells fire, reducing or eliminating nerve pain when applied to the skin.
While these supporting ingredients open many doors for more effective pain relief, they also raise the risk of adverse reactions, especially in people with sensitive or allergy-prone skin. CBD topicals have a place in neuropathic pain management, but the wrong supporting ingredients for your skin type can reduce (or even entirely negate) their benefits.
Here, we’ll illustrate the physiology of neuropathy before discussing the role of topical CBD in alleviating it. Then, we’ll talk about the best carrier and supporting ingredients to soothe neuropathic pain, including how they work, what they’re best for, and any risks associated with them. Finally, we’ll close with a short note on sustainable ingredients.
What Causes Neuropathic Pain?
Your nervous system is made up of a couple of different key players: neurons, myelin, and glial cells. Neurons are like your body’s electrical wiring, carrying signals to and from your brain. They’re long, branching cells that use charged molecules to move signals down the length of the cell before relaying it to the next one.
Some neurons are covered with a substance called myelin, a protective coating that helps accelerate the movement of chemical messages. Cells called glia help to support the nerves and keep them functioning normally. In a healthy nervous system, these different types of cells work together and ionic messengers flow smoothly across synapses (the gaps between neurons that facilitate chemical communication between them).
Neuropathy occurs when any of these nerve cells are damaged. This damage can result from many different causes. While injuries like herniated discs or nerve compression can cause physical strain and injury to neurons, they aren’t the only possible cause. Chronic conditions like multiple sclerosis, diabetes (even pre-diabetes), and cardiovascular disease can lead to nerve cell damage by changing the body’s chemical environment or causing immune cells to mistakenly attack neural tissue.
So, why is nerve damage such a big deal, and why does it cause such strange and severe pain? Think of your nerves and their myelin like an electrical wire coated with rubber. If that rubber coating is damaged, electricity will no longer flow neatly down the wire, but can cause short circuits, sparks, or even stop altogether. Your neurons work very similarly, and a damaged neuron is more likely to send errant pain signals in the absence of a problem; the more severe the damage to your nerves, the more intense neuropathy is likely to become.
How Can CBD Help to Manage Neuropathic Pain?
This may sound a bit bleak so far, but stay with us. It’s true that the science of repairing nerve damage is still a ways out, but that doesn’t mean that relief is out of reach. While the research is still preliminary, current studies suggest that CBD possesses neuroprotective and antispasmodic properties that may help to calm frazzled neurons and ease neuropathic pain.
The exact mechanisms of this action are still being studied, but what we do know is that CBD has a positive regulatory effect on many of the body’s systems, including the nervous system. This means that CBD can help to reduce the frequency and intensity of neuropathic pain signals by quieting overexcited neurons and reducing inflammation and pain often associated with them. It may also reduce the tingling, burning, stabbing, and prickling sensations common in neuropathy, as well as spasms and involuntary contractions often associated with the condition.
Ongoing research suggests that topical CBD may more effectively manage neuropathy than traditional therapies, including opioid pain relievers. Because of the higher number of supporting ingredients relative to oral CBD, however, topicals carry a relatively higher risk of adverse or allergic reaction. Their effects can also vary substantially from product to product depending on the carrier and supporting ingredients it contains.
Topical CBD Carrier Oils for Nerve Pain
Carrier oils and other base ingredients have a significant impact on the overall effect of the finished product, and especially its sensory effects. Because sensation is so important to effectively addressing and calming neuropathic pain, we feel that a bit of education around carrier ingredients can help our readers more easily navigate the baffling variety of topical CBD products available and find the best formula for their needs.
Because CBD is a nonpolar molecule, it doesn’t dissolve in water, a polar molecule. This makes it hard for our bodies to absorb and metabolize — we are over 70% water, after all, and it’s the solute for many of our biological processes. While it isn’t readily soluble in water, CBD does bond well to lipids like oils, fats, and plant butters. When it’s attached to these compounds, CBD is much more readily absorbed by the body, improving its effectiveness drastically. This applies to both topical and oral CBD products. Because of their oily composition and emollient properties, these ingredients tend to support soothing and warming sensations best.
Lipids aren’t the only type of molecule that can help make your CBD dose more bioavailable, though; other molecules with a relatively weak polar charge can also be effective. These compounds might include things like aloe vera gel, different types of alcohol, or glycerol. In contrast to the heavy, oily feel of lipid products, these “polar lite” molecules tend to evaporate more readily, making them ideal for supporting cooling, tingling, or numbing effects.
If your nerve pain tends to feel like burning, stinging, or pinpricks, a cooling product might help to regulate the firing of the damaged nerves, reducing pain. We suggest choosing products made with aloe vera, glycerol, or cetyl alcohol where possible. This is because other alcohols, such as isopropyl, stearyl, or ethyl, can cause damage to the bonds between skin cells over time, increasing dryness and triggering discomfort. Cetyl alcohol, by contrast, is a fatty alcohol derived from coconut that may be less damaging (though it should be avoided by those allergic to coconut).
If you desire something with more warming, relaxing properties to help ease spasms, we recommend opting for products formulated with oils, waxes, or plant butters. Oils from plants like olive, avocado, safflower, argan, jojoba, grapeseed, almond, and coconut can be used alongside plant butters like shea, cocoa, and mango for creamy formulas, while carnauba or beeswax can lend a firmer, more salve-like consistency. We find that more emollient formulas keep warming ingredients like ginger, cinnamon, and capsaicin active for longer periods, extending symptom relief.
If you prefer to refrain from using products that manipulate your sensation and perception, that’s okay! There are plenty of helpful CBD topicals out there that produce no thermal sensation whatsoever. We suggest selecting a carrier based on your skin type and avoiding ingredients that tend to produce changes in tactile sensation. These tend to be things like menthol, capsaicin, cinnamon, and ginger, but can sometimes include milder extracts like lavender or arnica, so listen to your body on this one.
If you want to try topical CBD for nerve pain but have very sensitive skin that balks at most mainstream ingredients, don’t lose hope just yet. Instead of reaching for a topical formula with a lengthy ingredient list, try using an unflavored CBD tincture made with only CBD and a suitable carrier oil. You can apply it safely to your skin without worrying about hidden allergies while still reaping the analgesic, anti-inflammatory, and antispasmodic benefits of topical CBD. If you decide to try a topical formula, we suggest a salve or balm, which tend to contain fewer common allergens than cream, lotion, or roll-on formulas.
Topical CBD Supporting Ingredients for Nerve Pain
- Capsaicin – The chemical that gives chili peppers their signature spice (and pepper spray its notorious burn), capsaicin certainly has the potential to cause inflammation. However, in small doses, the fiery compound can actually act as an anti-inflammatory, encouraging circulation and reducing pain and swelling. It also causes a warming sensation when applied to the skin (again, well-diluted) that may be beneficial in alleviating some types of nerve pain. Researchers believe that this analgesic effect may be due in part to this sensation, which helps to desensitize the skin and, therefore, the sensation of pain. Capsaicin is used in very tiny doses in topical CBD pain relief products and is generally well-tolerated. However, those with an allergy to peppers should take care to avoid it.
- Clove – While it may not be as effective for deep-seated neuropathy in the fascia, clove oil works very well to soothe the sensation of neuropathic pain in the skin and superficial tissues. Clove is a small but mighty spice with surprisingly powerful analgesic properties. Clove oil has been demonstrated to be as effective as benzocaine at relieving pain when applied topically. There is also some evidence to suggest that clove may have a positive regulatory effect on nerves, helping to regulate their firing and, potentially, reducing the intensity and sensation of pain. Clove has an autumnal, spicy scent and is generally well-tolerated, but should be avoided by those with a clove allergy.
- Eucalyptus – Eucalyptus is widely used for its analgesic and anti-inflammatory properties (and its ability to clear stuffy noses). The extract of the fragrant tree native to Australia, eucalyptus may have a role to play in alleviating neuropathic pain. While the precise mechanism is not yet understood, two factors appear to be at work. Eucalyptus shows analgesic properties when applied topically and may help to reduce the sensitivity of damaged nerves, regulating their firing. Second, the aroma of eucalyptus may have an effect on the central nervous system’s processing of pain signals, reducing pain perception. Those with asthma should be advised that eucalyptus can trigger attacks in some people (though it may be helpful to others).
- Feverfew – The name of this plant comes from its traditional use in treating pain and inflammation. Also known as bachelor’s button, feverfew leaves and flowers produce compounds that reduce muscle spasms and the burning, tingling, pins-and-needles feeling associated with neuropathic pain. It has been demonstrated to possess analgesic and antispasmodic properties when applied to the skin, though it isn’t fully understood how these effects are produced. Emerging research suggests that this may be due to the terpenes, flavonoids, and other bioactive compounds within feverfew extract. If that is the case, these terpenes and other phytochemicals could help to support the dose of CBD in a topical pain reliever.
- Ginger – A piquant favorite in cuisine, ginger’s use as an anti-inflammatory, analgesic, and antiemetic has been well-documented throughout history. Extract from the root of the plant may help to alleviate neuropathic pain and soothe inflamed nerves when applied topically. It can also induce a gentle warming, tingling sensation in the skin, which may help to numb neuropathic pain while desensitizing damaged nerves, regulating their firing. These benefits are also apparent when ginger is consumed (though a separate supplement should be used), indicating that it may be beneficial to the diets of people struggling with neuropathy as well. Those with a ginger allergy or certain sensory integration issues should exercise caution before using topical CBD products made with ginger.
- Lavender – A perennial favorite in aromatherapy and home fragrance, lavender has long been understood to possess anxiolytic, anti-inflammatory, analgesic, and hypnotic properties. When applied to the skin, it acts as an antifungal and antibacterial as well as an analgesic, making it a potentially good option for [recovering from injury]. Research indicates that lavender can help to reduce migraine pain and may work to alleviate the severity and intensity of neuropathic pain. The calming effects of aromatherapeutic lavender may also help to dull pain perception in the central nervous system. Those allergic to lavender should be cautious, as it is a popular component of many topical CBD products targeted at pain relief.
- Peppermint – Peppermint (and other members of the mentha genus like spearmint) contains menthol, a popular ingredient in topical pain products for the cooling sensation it produces when applied to the skin. Some people may find menthol in particular to be helpful in managing their neuropathic pain. This may be due to menthol’s effect on receptors in the skin, sensitizing them to cold sensations and, therefore, potentially alleviating burning or stinging types of pain. Limonene and carvacrol, two other primary components of peppermint extract, have also been shown to help relieve pain and inflammation when used externally. To receive the full therapeutic benefit, look for products that list peppermint extract rather than just menthol among their ingredients — and keep any substance containing peppermint or menthol far away from mucous membranes. Exercise caution with peppermint (and other mints) if you are allergic or have especially sensitive skin.
- Rosemary – A culinary darling popular in cuisine traditions across the globe, rosemary is a shrubby herb rich in terpenes, flavonoids, and other phytochemicals that may be effective against neuropathy. The plant has historically been used against pain, fever, and seizures, and current research suggests that it may possess antispasmodic properties. One study showed rosemary to be effective at relaxing smooth muscles (the muscles you don’t have conscious control over; they contract involuntarily and can cause debilitating pain due to their proximity to organs and bones). This characteristic may make rosemary a soothing antispasmodic addition to topical CBD products for neuropathic pain.
- Turmeric – A brightly-colored root popular in Southeast Asian cuisine, turmeric is exceedingly high in a compound called curcumin. Curcumin has been utilized to combat pain, fever, and inflammation, and research suggests it may be helpful against neuropathic pain as well. While further study is needed, curcumin acts on receptors that can help block neuropathic pain signaling, relieving pain. When applied topically, curcumin may be able to regulate the activity of damaged neurons, reducing the frequency and intensity of neuropathic pain. It’s generally well-tolerated, but should be avoided by those with a turmeric allergy.
A Note On Sustainability
Our goal at Key to Cannabis is to help our readers find CBD products that support their health and wellness goals, largely through consumer education. This includes not just the science behind CBD products, but their environmental impact as well. As our society grows more conscious of our relationship with (and dependence on) our planet and the ecosystems it supports, sustainability of ingredients is increasingly important to many people (ourselves included).
We recognize that, while there is value in making better buying decisions, “better” doesn’t really ever mean “perfect.” Our intent is not to shame anyone for making the decisions that they feel are best for them (in fact, those are exactly the decisions we want to support), but to encourage conscious consumption where possible. What that looks like to you is fully up to you, and we always want to empower you to define that for yourself.
Wherever possible, we prefer to select plant-based ingredients for CBD topicals, particularly over petroleum products. This is for two primary reasons: first, petroleum is a finite resource with a massive environmental impact at every stage, from extraction to refining to transportation to consumption. Second, a connection has been established between long-term use of some topical petroleum products and cancer later in life.
We also prefer plant products to those derived from animals, though we recognize that not everyone feels the same way. Some animal products, like beeswax, lanolin, and gelatin, are important components in the wellness lifestyles of many of our readers, and that’s valid. While it’s true that there are vegan alternatives to these ingredients, they aren’t viable options for everyone. Also, there’s some nuance to the label “vegan.”
The vegan description on a product label indicates that the product contains no animal products. However, it doesn’t necessarily denote a more sustainable product. Microplastics, pleather, plastic fur, polyester, and petroleum products are considered “vegan,” but aren’t exactly more environmentally friendly than their animal-derived counterparts. We don’t mean to imply that the vegan label is meaningless, but we are suggesting that it isn’t the sole criterion by which to measure a product’s sustainability.
Neuropathic pain is notoriously difficult to treat, but CBD may be able to provide relief where other treatments have failed. Topical CBD may be especially beneficial for peripheral neuropathy, soothing the tingling, burning, stabbing pain often associated with nerve damage. While CBD has strong therapeutic potential for neuropathic pain, the right ingredients can make a world of difference to your wellness experience. We encourage you to be choosy about what’s on the label of your go-to CBD topicals — when in doubt, reach out to the manufacturer with any questions or concerns.