For many people experiencing chronic pain, cannabidiol (CBD) oil has steadily gained popularity as a natural approach to pain relief. A compound found in the marijuana plant, cannabidiol is sometimes touted as an alternative to pain medication in the treatment of common conditions like arthritis and back pain.
The use of cannabis for pain relief dates back to ancient China, according to a report published in the journal Cannabis and Cannabinoid Research. It’s thought that CBD oil might help ease chronic pain in part by reducing inflammation. In addition, CBD oil is said to promote sounder sleep and, in turn, treat sleep disruption commonly experienced by people with chronic pain.
It’s important to note that many CBD oil products do not contain tetrahydrocannabinol (or THC, the compound responsible for producing the “high” associated with marijuana use). Unlike THC, cannabidiol is non-intoxicating and does not have psychoactive effects.
Why People Use CBD Oil
According to the Institute of Medicine of The National Academies, 100 million Americans live with chronic pain. Along with drastically reducing quality of life, chronic pain can increase healthcare costs and have a negative impact on productivity at work.
Common types of chronic pain include:
- Cancer pain
- Irritable bowel syndrome (IBS)
- Low back pain
- Multiple sclerosis pain
- Neuropathic pain
- Temporomandibular disorder (often referred to as “TMJ”)
Over-the-counter and prescription pain medications are often recommended in the treatment of chronic pain, but many people seek out alternative forms of relief (such as herbs, nutritional supplements, and products like CBD oil).
Some of these people wish to avoid the side effects frequently associated with standard pain medication, while others have concerns about becoming dependent on such medications. In fact, some proponents suggest that CBD oil could provide a solution to opioid addiction as concerns over opioid overdoses continue to escalate.
Potential Benefits of CBD Oil
Scientists are still trying to determine how CBD oil might alleviate pain. However, there’s some evidence that cannabidiol may affect the body’s endocannabinoid system (a complex system of cell-to-cell communication). Along with contributing to brain functions like memory and mood, the endocannabinoid system influences how we experience pain.
So far, much of the evidence for CBD’s effects on pain management comes from animal-based research. When taken orally, CBD has poor bioavailability. Topical CBD application to localized areas of pain is said to provide more consistent levels of CBD with less systemic involvement.
This research includes a study published in the journal Pain in 2017, in which scientists observed that treatment with topical CBD helped thwart the development of joint pain in rats with osteoarthritis.
Another study, published in the European Journal of Pain in 2016, found that topical CBD gel significantly reduced joint swelling and measures of pain and inflammation in rats with arthritis.
In a report published in Pediatric Dermatology in 2018, scientists reported three cases of topical CBD (applied as an oil, cream, and spray) use in children with a rare, blistering skin condition known as epidermolysis bullosa. Applied by their parents, all three people reported faster wound healing, less blisters, and improvement of pain. One person was able to completely wean off oral opioid analgesic pain medication. There were no adverse effects reported.
While very few clinical trials have explored the pain-relieving effects of CBD oil, a report published in the Cochrane Database of Systematic Reviews in 2018 examined the use of a variety of cannabis-based medicines and found they might be of some benefit in the treatment of chronic neuropathic pain. A type of pain triggered by damage to the somatosensory system (i.e., the system responsible for processing sensory stimuli), neuropathic pain often occurs in people with conditions like diabetes and multiple sclerosis.
In this report, researchers reviewed 16 previously published studies testing the use of various cannabis-based medicines in the treatment of chronic neuropathic pain and found some evidence that cannabis-based medicines may help with pain relief and reduce pain intensity, sleep difficulties, and psychological distress. Side effects included sleepiness, dizziness, mental confusion. The authors concluded that the potential harm of such medicines may outweigh their possible benefit, however, it should be noted that the studies used a variety of cannabis-based medicines (e.g. inhaled cannabis and sprays and oral tablets containing THC and/or CBD from plant sources or made synthetically), some of which are more likely to result in these side effects than products without THC.
Side Effects and Safety
The research on the side effects of CBD oil is extremely limited. In addition, due to the lack of regulation of many products, there is inconsistency in the content and purity. The amount of CBD in products may not be consistent and products can contain varying amounts of the psychoactive component THC.
While CBD is considered the major non-psychoactive component of cannabis, in studies using varied doses, routes of administration, and combination or whole products with THC, a number of side effects have been reported, including anxiety, changes in appetite and mood, diarrhea, dizziness, drowsiness, dry mouth, low blood pressure, mental confusion, nausea, and vomiting.
There’s also some concern that taking high doses of cannabidiol may make muscle movement and tremors worse in people with Parkinson’s disease.
What’s more, CBD oil may interact with certain medicines, such as medications changed by the liver (including chlorzoxazone, theophylline, clozapine, and progesterone) and sedative medications (including benzodiazepines, phenobarbital, fentanyl, and morphine).
When smoked, cannabis has been found to contain Aspergillus (a type of fungus). People with suppressed immune systems should be aware of the risk of fungal infection when using this form of cannabis.
Topical CBD application may cause skin irritation.
CBD oil should never be used as a substitute for standard care. In the case of chronic inflammatory conditions like arthritis, for instance, chronic inflammation can lead to joint damage (causing destruction and disability) if the condition is not effectively managed.
The Availability of CBD Oil
As more and more states across the U.S. legalize the use of marijuana, CBD oil has become more widely available. CBD oil is now sold in a range of forms, including capsules, creams, tinctures, and under-the-tongue sprays.
While many companies now sell CBD oil online and in dispensaries, use of the oil isn’t legal in every state. Because state laws vary greatly when it comes to cannabis products, it’s crucial to confirm that use of CBD oil is legal in your state.
Chronic pain is the most common reason for medicinal cannabis use, according to a recent survey. If you have a chronic pain condition and have not been able to manage it with standard treatment (or wish to avoid the adverse effects of other medications), you may be considering CBD oil for pain relief.
Preclinical animal research suggests that CBD may have moderate pain-relieving effects for neuropathic pain without the cannabinoid-like side effects, however, there is currently a lack of large, well-designed clinical trials (the type of research you want to see to put full stock in a treatment) confirming these effects.
If you’re thinking of trying CBD oil for pain relief (and it is legal where you live), talk to your doctor to discuss whether it’s appropriate for you and the safest way to incorporate it into your pain management plan. Keep in mind that due to the lack of regulation, the purity and content of CBD oil products can vary.
If you live with chronic pain, you may have experienced how it can disrupt sleep and, in some cases, can contribute to anxiety and depression. Natural therapies, including exercising and taking up mind-body practices like meditation and yoga, and following an anti-inflammatory diet may help improve quality of life for some people who experience pain regularly.