CBD and pain

CBD and pain

Last updated: 07.07.2021

We all experience physical pain at some point or other. For so many people, pain is a significant, ongoing or recurring problem.

Often, many conventional medications do not provide the relief that's needed, or the body becomes immune to its effects, has risk of addiction or the negative side effects outweigh the benefits.

CBD may well be an alternative that can help with pain management. The anti-inflammatory and pain-relieving effects of CBD are being reported to help may sufferers of pain.

The jury is still out on clinical trials related to CBD and its effect on 'pain'. However, there are some promising early results showing CBD's relationship with reduction in different kinds of pain is a positive one that does deserve more research.

CBD and pain

CBD and pain... in a nutshell

  • Comprehensive scientific studies are still missing. However, there is some promising evidence of the effectiveness of CBD in neuropathic and inflammatory pain.
  • CBD has anti-inflammatory and antispasmodic properties and could therefore help treat pain.
  • CBD has the advantage over opiates that there are hardly any proven side effects and it does not lead to addiction.

Can CBD help with pain?

Acute pain can occur in various forms and can actually fulfill an essential function in the body so far as it provides warning and aids protection.

In contrast, chronic pain is more complex - pain signals can be sent out even though the injury or illness has already healed. Sometimes, the pain or accompanying infammation can actually impede complete healing.

Millions of people suffer from severe restrictions in life due to chronic pain. Doctors sometimes prescribe strong medications that are often associated with side effects, sometimes including addiction. One need only look across the Atlantic at the opioid crisis in US healthcare for a warning of what strong but poorly managed medications can lead to.

The question we will seek to answer here is whether, CBD, which is not addictive and has few side effects, could be a serious alternative for managing pain?

We have looked at pioneering US scientific research and evaluated hundreds of customer experiences.

How does pain arise in the body?

Firstly, though, it's worth having a rudimentary understanding of how pain is actually felt.

There are pain sensors (called 'nociceptors') distributed throughout the human body. These pain sensors can be thought of as receiving stations: if it is too warm, too cold or there is too much pressure, the pain sensors register this. They then send out an electrical impulse that registers the pain.

There is a risk of over-simplifying things here, so please do research as much detail as you find useful. Pain is an extremely complex mechanism. The most important pain systems are nociceptive (i.e. neurons in the body), neuropathic (i.e. nervous system), psychogenic (i.e. psychological reasons). You can also experience mixed pain, which is a combination of neuropathic and nociceptive.

Pain is important for the body. They signal that something is wrong and that we should take care of our body or intervene.

The classic example is touching something extemely hot: the body registers the pain, electrical impulses are sent out and the hand is pulled back. The pain can therefore be compared to an alarm bell.

Athlete-holding-his leg-clearly-in-pain.
Exercise can often result in pain, CBD may be able to help.

Acute and Chronic pain

Acute pain

The physical alarm bell explained above works perfectly for acute pain. The body registers a wound, inflammation or irritation.

The pain makes us aware of a problem and we can quickly ensure that the damage does not spread any further. Everyone has experienced acute pain.

The most common causes are:

  • Acute headache
  • Burns
  • Abrasions or cuts
  • Muscle strains
  • Acute arthrosis
  • Broken bones
  • Toothache 
  • Postoperative pain
  • Menstrual cramps

When the physical cause is cured or eliminated, the acute pain subsides regularly.

Chronic pain

However, chronic pain is more problematic. Pain is considered 'chronic' when it persists for more than three months, often past the normal healing time. Therefore, chronic pain lacks the acute warning function of physiological nociception.

A major review carried about by the NHS found that nearly half of all adults in the UK are affected by some type of chronic pain. It really is a common problem.

The causes of chronic pain are often much more difficult to identify than acute pain. This is because chronic pain does not always have a clearly defined physical cause.

The pain then no longer fulfills a warning and protective function. So the alarm bell rings for no reason.

Common types of chronic pain include:

  • Back pain
  • Chronic headaches, such as migraines
  • Chronic joint pain, e.g. arthrosis or arthritis
  • Tumour pain
  • Nerve pain
  • Fibromyalgia
  • Mouth and face pain
  • Phantom pain

Woman sits on a chair, soothing her painful foot.
Pain can have a massive effect on your life, and cause a great deal of stress.

Pain can also be a result of psychological reasons

Pain can be a subjective sensation - everyone perceives pain differently. It can also vary from day to day. There are days when pain is not too severe. Then there are days when it seems unbearable.

For some types of pain, the underlying causes remain unclear. These include, for example, nerve pain, back pain, headache, phantom pain or psychological pain. Treatment for these types of pain are considered difficult and lengthy.

The Pain Memory

Science also assumes that our central nervous system has a so-called pain memory.

Basically this means that a damaged nervous system can continue sending pain impulses even if the injury or illness no longer exists.

An example of this is phantom pain following amputations. In these cases there is no physical cause for the pain from a neurological point of view.

Once a pain memory is in place, medication is usually not enough to provide relief. The psyche is part of the pain and must be considered during treatment.

The patient must learn to erase the pain memory. There are approaches here that incorporate Cognitive-behavioral therapy into the treatment.

Chronic pain often reduces the pain threshold in patients. The fear of pain can make the sufferer react sensitively to even the smallest of external influences.

In this way, the nerve cells send pain signals to the central nervous system, although there is no physical cause. External circumstances that can promote chronic pain include:

  • Disputes
  • Stress
  • People in the area who also suffer from pain
  • Negative thinking
  • Painful past experiences
  • Tension
  • Fears
  • Lack of pain treatment
  • Unhealthy lifestyle
CBD-cream-garnished-with-marijuana-leaf
Cream is just one way to take CBD. One benefit of cream is that it can be rubbed directly into the affected area.

Can CBD help with pain?

First of all, the use of CBD and THC, as well as other cannabis extracts for pain, is nothing new. The cannabis plant has a very long tradition around the world as a natural herbal pain reliever.

It is reported that the Chinese were already using cannabis around 2,900 BC for a variety of diseases, such as joint pain or muscle cramps, gout or malaria.

CBD is particularly interesting in relation to pain relief because, unlike THC, CBD does not get you high and is not addictive. Side effects have been shown to be very mild, if any. Most people experience almost no side effects. An important extra consideration is that CBD products are legal in the UK, unlike THC and cannabis (except for medical purposes)

There is promising evidence that CBD can be used for chronic pain. According to our research, there are already clear indications from science regarding the possible effectiveness of CBD, particularly in the case of neuropathic and inflammatory pain.

In the next couple of sections we really get into the scientific research on CBD and pain relief. This isn't for everyone so we've kept it light, but we do encourage people to read further around the subject to really understand what is available to help.

A quick reminder... what is CBD?

CBD, the shorthand for cannabidiol, is one of the many active ingredients in the cannabis plant, also known as the hemp plant.

CBD, a natural substance from the Cannabis sativa plant, will not get you high,

Unlike the better-known substance THC (tetrahydrocannabinol), CBD is not psychoactive, does not lead to physical dependence and produces no psychoactive effects, i.e. it does not get you ‘high’ and will not lead to addiction.

The World Health Organisation confirms this in its 2018 report where it states CBD is a safe substance.

CBD can actually be used for a wide variety of medical conditions, such as epilepsy and and anxiety, as well as for general wellness. Much like vitamins. In addition to this people sometimes use CBD to keep calm and relaxed, for example when public speaking.

What's more, CBD is legal in the UK, but be sure of the contents of the specific CBD product you purchase.

a-mix-of-cbd-products

There are a number of ways to take CBD, but the most common appears to be CBD oil, this may be due to its strength and to the fact that it is one of the most fast-acting methods. CBD oil tinctures normally come with a pipette, the CBD oil is administered under the tongue and should take effect within a few minutes.

Other methods include CBD topical cream, CBD vape liquid, CBD gummies and CBD chocolate. But the list is rapidly growing in line with CBD's popularity.

A note of exercise caution, however, when venturing into the world of CBD products. Given the fact over the counter CBD products are not FDA approved, it is wise to check the label thoroughly.

It can be quite difficult to know which is the best CBD to buy. Some companies can be misleading, and some products may not contain CBD at all! We generally advise to choose products from a company that openly shares it's third party lab reports.

Make sure you are buying high quality forms of CBD. Again, look at the lab reports, but also look for reviews and customer feedback. High quality doesn't necessary mean it has to be the most expensive, shop around - and always look for discount codes and offers!

There is strong evidence to suggest that when CBD is mixed with other cannabinoids, flavonoids and terpenes, that the effect on the body is greater. This is known as the entourage effect. Products that offer the entourage effect are known as full-spectrum cbd.

Interesting scientific research on CBD and pain

Neuropathic pain occurs regularly in people with diabetes or multiple sclerosis. Common chronic inflammatory diseases include rheumatoid arthritis (rheumatism), but also some types of headache, muscle cramps and pains, and Crohn's disease

In a 2018 report from America's National Academies of Sciences, Engineering and Medicine, a scientific committee concluded that there was "conclusive or substantial evidence" that cannabis or CBD could be effective in treating chronic pain in adults. The result was based on an evaluation of 10,000 scientific studies.

As early as 2003, a small study came to the conclusion that cannabis substances such as THC and CBD could help with pain. The background was in particular neuropathic pain due to multiple sclerosis. CBD and THC were administered in a 1:1 concentration.

In 2006, another study concluded that CBD could help treat cancer pain . The background here was a combination of CBD with THC.

The study concluded that "(Cannabis extracts) open a new line of promising treatment to mitigate pain that fails to respond to the pharmacologic treatments available, especially for neuropathic and inflammatory pains. "

A study published in 2010 also found that THC / CBD extracts are effective for advanced cancer pain, even when strong opiates could not completely relieve the pain.

In 2008, scientific studies from the past 20 years were evaluated to see if CBD could relieve chronic pain.

The scientists came to the conclusion that CBD could be effective in pain relief without adverse side effects.

Incidentally, this study also concludes that CBD may help with chronic pain related sleep disorders.

Woman-affected-by-pain-in the-knee.
Many sufferers of arthritis benefit from using CBD cream

Further results on CBD in pain in Experimental Animal Studies

In 2016, researchers had very good results in an animal study regarding CBD in arthritis pain. The scientists were able to prove that CBD effectively alleviated the inflammatory pain in the animals' joints.

A separate animal study by the Journal of Experimental Medicine also supports these results. It has been suggested that the use of CBD can relieve pain and inflammation.

Researchers therefore believe that cannabinoids like CBD could represent a new class of therapeutics for the treatment of chronic pain.

Also the fact that cannabinoids bind with both CB-1 and CB-2 cannabinoid receptors (this is explained on our one of our science heavy pages) on immune cells suggests that CBD could play an important role in regulating the immune system.

How does CBD work for pain?

It's important to reiterate that CBD is considered safe by the World Health Organization (WHO) and, unlike opioids and THC, there is no risk of addiction or abuse.

CBD acts by influencing the body's endocannabinoid system (ECS for short), a rather complex communication system between the cells. And it is precisely this system that also influences the sensation of pain.

One way in which CBD is thought to relieve pain is by preventing the cells from breaking down anandamides. This is a messenger that is involved in reducing pain. Incidentally, anandamide is chemically very similar to THC and is therefore also referred to as ‘natural marijuana’.

Another way CBD could help is by docking with the CB-2 receptor in the human body, which is known to be a key receptor in relation to nociception (i.e. pain).

Caution should be exercised when taking other medications at the same time, such as blood thinners. Always medical advice from your doctor before taking CBD.

Could CBD really be an alternative to pain relievers?

Whilst further study is really needed, there does appear to be scope for CBD relieving pain. Unfortunately, studies on CBD are not in the interests of the large pharmaceutical companies.

Strong, synthetically produced chemical medications are big business, and, it cannot be denied that these medications do help lots of people. Unfortunately, these drugs are often accompanied by severe side effects.

Pain relievers don't heal, relief is temporary

The problem is that classic pain therapy cannot 'cure' chronic pain. Only pain relief can actually be provided for pure chronic pain.

Therefore, long-lasting pain requires ongoing pain relief, that with traditional mediation can mean prolonged exposure to drugs that can cause side effects.

In the worst case scenarios, the (over) consumption of pain relievers can also lead to the pain intensifying. The body is burdened by taking painkillers permanently. The kidneys and liver, which break down the chemical substances, are particularly at risk of being affected by long term medication.

Woman-holding-a glass-and-painkillers-about-to-consume.
Painkillers do not cure the problem, but offers temporary relief.

What are the classic medicines for pain?

Painkillers are called analgesics, with a distinction made between non-opioid and opioid analgesics. For reference, the defition of an opioid is a compound resembling opium in addictive properties or physiological effects.

If the pain is mild to moderate, non-opioid pain relievers are often prescribed, such as:

  • Acetylsalicylic acid ("aspirin")
  • Ibuprofen
  • Paracetamol
  • Diclofenac
  • Metamizole

With severe pain, opioid pain relievers often come into play, such as:

  • Tramadol
  • Codeine
  • Morphine

The potential side effects of opioids are numerous, including constipation, nausea, vomiting, dry mouth and loss of appetite.

Also, psychiatric disorders such as dizziness, headache, tiredness, sleepiness, confusion, anxiety, euphoria, dysphoria and small pupils (miosis) can occur.

Opioids are considered very reliable pain relievers. However, there is a real risk of abuse and these drugs can intoxicate and leave users feeling dependent (i.e. addicted).

This is particularly problematic in the USA, which is witnessing an “opioid crisis”. In 2017 there were over 11 million people who abused opiates.

Of course, many people partake in recreational cannabis use to self-medicate. Typically, recreational marijuana contains a much higher amount of THC than CBD products, which is what makes it illegal.
Not everybody wants or enjoys the intoxicating effects of THC.
CBD can be a great alternative which offers legality and the benefits of CBD without getting 'high'

Which CBD product should I use for pain?

CBD, sometimes referred to as cannabis products, can be bought in different forms.

CBD oils are probably the most common. There are numerous variants here, but 5% and 10% CBD oils are most regularly used. There are also higher doses available.

CBD oils are dripped under the tongue. No uniform information can be given about dosing, since every person reacts differently.

The intensity of the pain also plays a role here. Many users recommend starting with low doses and increasing it gradually if necessary.

In addition to CBD oils, CBD products are also available as capsules or foods, such as CBD gummy bears, CBD chocolate or CBD hemp teas . You can of course also buy CBD liquids for vaping or crystals.

A topical CBD lotion or CBD cream would also be ideal for joint and muscle pains.

There are also special CBD gels that could be used for example for osteoarthritis or arthritis. These products can then be applied precisely to the painful area. Here, too, there are different concentrations of CBD.

What are the experiences with CBD for pain?

We have evaluated hundreds of customer experiences. Most come from the United States and Canada, where CBD is already being used increasingly by people with chronic pain.

Of course, these are highly subjective and there is absolutely no reason to assume that these experiences will apply to you, but it is often useful to read other people's firsthand accounts.

We summarise our impressions from these experience as follows:

  • CBD is said to be more effective for mild to moderate pain, but less so with severe pain.
  • Side effects are hardly reported. From our own experience, we know that CBD oil can sometimes make you sleepy. Therefore, it is recommended by some users to make it easier to fall asleep in chronic pain.
  • In some cases, reference is also made to the fact that THC in connection with CBD could work even better for pain.

Conclusion

In recent years, CBD has developed as a trend towards chronic pain relief, especially in North America.

Many people now use it every day. For example, approximately 54% of arthritis patients in the United States report using CBD or THC to combat arthritis pain. The overwhelming majority report good experiences of this.

In the United States, alternatives to the powerful opioid drugs that have driven millions of Americans into addiction are urgently needed. However, whether CBD could deliver this is still uncertain.

Numerous studies show that CBD could have an analgesic, antispasmodic and anti-inflammatory effect. It remains to be seen whether CBD is a real alternative to strong painkillers or whether it could be used as a supplement in pain therapy.

Further clinical studies are necessary here, which both shed light on the interaction with other drugs, but also prove the long-term consequences of CBD consumption.

Success Stories with CBD and pain

Our success stories come from social media, other CBD websites or through people we know personally. Some people are comfortable sharing their names and products, others prefer to remain anonymous. We feel hearing other people's positive experiences are a vital part of learning about how CBD can help, although it is important to remember that not all CBD products work the same for everyone. Don't be disheartened if one product/dosage doesn't work for you... keep trying!

We'd love to hear your success stories! If you would like to share yours, please get in touch at greenandsimple@mail.com

"I suffered with an ACL torn ligament and cracked knee and conventional medication just wasn't helping. I mostly suffered when laying down so sleeping was an issue. After using a CBD roll on my leg felt completely normal after about 30 minutes"
- anonymous

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