As CBD gets more and more popular, one of the most common uses among the general public has been to manage or reduce pain.
But popularity and anecdotal evidence doesn’t equal scientific fact. So what is the relationship between CBD and pain management?
We already took you through some of the research into CBD’s effects on inflammation in a recent post, so we recommend reading through that too if it’s of interest to you.
While that post primarily indicated positive results from several studies, there is more to effective pain management than simply reducing inflammation.
Does research suggest CBD can support other forms of pain unrelated to inflammation?
Considering that over 60% of CBD users are taking CBD in the hope of relieving symptoms associated with an ailment, and pain is one of the three most common of these complaints, it goes without saying that the anecdotal reports of the use of CBD for pain are everywhere.
But what does the clinical evidence say?
Let’s take a look at the current evidence
One of the earliest studies into CBD oil for pain was a 2008 study specifically looking at types of pain that have been difficult to treat with traditional methods.
This clinical trial looked at all cannabinoids instead of CBD specifically. Despite this, the results were highly positive, finding that cannabinoids do have a strong analgesic effect, also observing a lack of significant side effects.
Some of the side effects noted were also beneficial ones, with the study finding that both THC and CBD provided some antiemetic effects.
There have also been some studies into using CBD for neuropathic pain that, while less unanimous then the above mentioned trials, found evidence of more pain reduction of chronic pain than that caused by a placebo. Evidence regarding neuropathic pain is more limited than other forms of pain, yet still mostly suggests a beneficial result.
Of course, there are numerous studies into the effects of CBD on pain caused by inflammation too, many of which are relevant.
This includes a 2016 study into the effects of CBD on inflammation and pain-related behaviours in rats with arthritis. It concluded that CBD could reduce both swelling and pain symptoms, both when ingested and when used topically.
Bringing us up to date with more recent studies, a complete literature review in 2018 found relatively mixed results, with some cannabinoid delivery systems providing minimal benefits. Despite this, the study concluded that combining formulations could likely improve effectiveness, producing more “rapid systemic effects” and “long term analgesic outcomes”.
Equally pertinent is a 2019 trial that compared random strains of medical cannabis against each other in regards to their effect on pain in fibromyalgia sufferers. The conclusion was that the strain with the highest CBD content provided the greatest benefits in comparison to placebo. All of the CBD-dominant strains in the trial were found to hold greater benefits than the THC dominant or balanced strains.
While these studies are not numerous or comprehensive enough to represent a conclusive answer, almost all have found promising results and the future is looking to be an exciting time for cannabidiol.
Of course, if you find the existing evidence positive enough to give CBD a try, your next question is likely to be “how does it even work?”.
While the answer almost certainly lies in the endocannabinoid system (ECS), our understanding of this system and its interactions with the rest of our body are premature enough that the way CBD actually works is relatively unknown.
What we do know is that the ECS contains different cannabinoid receptors which interact with cannabinoids to send chemical signals around the body and encourage specific responses.
CB1 receptors are found in the brain and spinal cord and thought to help with pain management.
CB2 receptors are found all around the body and are considered a major part of the immune system, directing the body’s response to certain stimuli in order to regulate inflammation.
Based on this knowledge, researchers believe it is likely that both of these receptors play their own part in pain management. The existence of a CB3 receptor is theorised by some scientists, although this is as yet unproven.
Purchasing and using CBD oil can feel a little overwhelming with so many factors, but as CBD has been classed as safe by the WHO the complexity behind the ECS shouldn’t put you off.
Let’s take a look at the best methods of taking CBD oil.
From gummies to pills, from edibles to concentrates like crumble, and from e-liquid to topical ointments and creams, the question of how to take your CBD oil might at first seem a little intimidating.
However, it’s simpler than you might think.
Vaping CBD oil provides the highest bioavailability and therefore is likely to provide the most noticeable and immediate effects.
However, most CBD e-liquids only contain CBD isolate instead of full or broad spectrum CBD. This misses out on the entourage effect, meaning that many of the other beneficial ingredients from hemp such as other cannabinoids, terpenoids, flavonoids, vitamins and healthy fats are all missing.
This means that if you would prefer to vape your CBD oil, you are likely better off going for a full or broad spectrum concentrate infused with terpenes, for example CBD crumble.
In terms of other methods for people who don’t smoke or vape, pure full or broad spectrum CBD oil is generally preferred. Edibles, capsules, gummies and pills are usually just CBD oil in a different form anyway, whereas buying your own CBD oil allows you to make all of these things while maintaining full control over dosage.
Of course, this is only the case if you can get your hands on a high quality CBD oil.
Things to look out for include:
Having access to your own high quality, broad spectrum CBD oil allows you to take cannabidiol as and when you feel appropriate, with a complete understanding of dosage.
But that brings us to another question – how much should you be taking?
Unfortunately, there is no established guide to CBD dosage. This is because research is still relatively premature, along with the fact that the ideal dose is simply too different on a case-by-case basis.
Factors that can influence the ideal dosage a person should take include:
With all these factors changing in each case, it is entirely possible that a standard dose will never be established.
While this may sound worrying, side effects of CBD use are pretty rare, a problematic overdose has never been registered, and studies have trialled doses exceeding 600mg, which is a whole bottle of lower strength oil!
This means that for most people, it’s ok to simply find your own ideal dose by increasing the dosage every day until you find the optimum results.
Anecdotal reports of CBD oil use for arthritis are increasing.
However, since chronic arthritic pain is in part caused by inflammation, the way CBD interacts wit arthritis is still quite unknown. This is somewhat due to the different functions carried out by the CB1 receptors and CB2 receptors.
Studies into CBD’s effects on arthritis in humans are still painfully undeveloped too, although as mentioned previously, some trials into rats have been positive.
With uncertainty around which cannabinoids cause benefits via which receptors, research suggests it’s all the more useful that any CBD that is used as a supplement is full or broad spectrum.
This means that instead of containing cannabidiol alone, the product contains a variety of the 100+ cannabinoids in the exact natural ratios in which they exist in the hemp plant. This is thought to give a much wider range of benefits.
With CBD becoming the wellness product of the moment and studies increasing drastically, you can expect more findings on this topic in the very near future.
If anything major changes, we will keep you up to date, but in the meantime we recommend reading as many studies as you can in order to improve your own understanding.
Disclaimer: Views expressed here do not necessarily reflect those of Nature & Bloom and its staff. This article is not intended to provide medical advice, diagnosis, treatment, cure or prevention for any disease. Nature & Bloom products have not been evaluated by the MHRA.