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CBD & Pain – Managing Pain with CBD

Nearly 50 million people in the United States struggle with chronic pain and are desperate for help. Now Cannabis research is indicating that CBD and other components in hemp extracts may hold the keys for helping to turn down the volume of pain in the body, ease inflammation, and calm the mind so that you can stop focusing on pain and get back to living.

Pain is something that most people deal with on a regular basis.  In the United States it is estimated that approximately 50 million people are impacted by chronic pain¹.  That is 16.7% of the US population!  And this may be an underestimate.  Some estimates indicate that it could even be as many as 40% of the population that struggle with chronic pain.  One of the primary ways that people treat chronic pain is through the use of pain killing opiods or benzodiazipenes, which can be addictive and can cause severe health problems with chronic use.

So, does CBD affect pain?

Pain is a difficult thing to measure in a laboratory.  This is for many reasons.  One issue is that pain is a subjective experience.  Measuring brain activity and other variables can help understand whether someone should be in pain or not, but it tells you very little about what the person is actually experiencing.  Additionally, pain can be caused by different things.  For instance neuropathic pain, or nerve pain, is quite different than pain caused by inflammation, like in arthritis.

There is preclinical and clinical evidence that suggests that CBD might be an effective pain reliever for some people, especially when combined with other compounds from the Cannabis plant².  It should be noted that there is a pharmaceutical available in several countries called Sativex which contains both CBD and THC and is used for chronic pain.  There are no pharmaceuticals currently available for chronic pain that contain only CBD – which limits the amount of human clinical data that there is available to better understand how CBD affects pain.  That being said, there are a number of preclinical rodent studies, as well as other animal studies, anecdotal reports, and case studies that provide hope that CBD and CBD-rich hemp extracts could be a useful tool for some people suffering from chronic pain. 

CBD-rich hemp extracts may be able to influence pain in several ways – by modulating the way the brain signals to tell you that you are experiencing pain, by reducing inflammation which can cause or exacerbate pain sensations, and by distracting the mind away from focusing on the sensation of pain.

Pain Signaling

One way that CBD can affect the experience of pain is by modulating the “volume” of pain signaling in the brain.  This is particularly important for people experiencing neuropathic pain.  It does this by manipulating glutamate and GABA signaling.  Glutamate is an excitatory compound while GABA is an inhibitory compound.  In healthy subjects CBD tends to decrease glutamate signaling in the brain, which is associated with excitability and heightened pain signaling, and increased GABA signaling in the brain, which is associated with relaxation and decreased pain signaling³.

Inflammation Reduction

Additionally, CBD has been demonstrated in pre-clinical research to be a potent anti-inflammatory compound in some regards.  CBD appears to influence a wide variety of anti-inflammatory effects on a lot of different types of tissues in the body.  This indicates that CBD may hold promise in reducing the sorts of inflammation that can lead to chronic pain – particularly as seen in various forms of arthritis.  However, more human clinical research is encouraged.

Distraction

Another way that CBD might help address the experience of pain is by reducing anxiety associated with pain, and by taking one’s mind off of the pain.  This is more likely to occur with CBD products that feature additional compounds from the hemp plant, including THC (as long as the concentration is less than 0.3%).  Additionally, many chronic pain sufferers are depressed, and it has been shown that mental health states can influence the subjective experience of pain.  When people are depressed, pain is often felt more intensely than when they are happy.  If CBD can help relieve anxiety and improve mood, it may indirectly then reduce the experience of pain.

CBD Products and Pain

It is also important to note that the method of consuming CBD will influence how it acts on pain.  Topical CBD products will typically only provide localized relief in the area where the product is applied.  This is because our skin is very effective at its job – keeping things out of your body and away from your blood vessels.  Then skin consists of alternating oily and watery layers that prevent many things from passing through – including cannabinoids.  Now, this is not necessarily a problem because there are plenty of cannabinoid receptors, vanilloid receptors (another type of chemical receptor that CBD interacts with that is associated with sensations of pain and heat), and nerves in the upper layers of the skin which CBD can manipulate to affect pain.  However, transdermal products are designed specifically to deliver CBD past those upper layers of skin (the epidermis) to get the CBD down into the lower layers of the skin (the dermis) where blood vessels reside.  Once CBD reaches the dermis, it can enter the blood stream and be distributed all throughout the body.

Final Thoughts

It may be best to tackle pain with CBD from multiple approaches – a localized topical approach near the area in pain, while also consuming CBD orally or sublingually so that the CBD can interact with the brain and help address pain from that angle as well.

A Dual Approach – Relief from the Inside, Out

Formulations that complement each other – Wildflower Relief Stick, designed to unknot tired muscles and provide relief from aches and pains, and Papa & Barkley 900 mg drops, formulated to help reduce inflammation and support whole body relief.

¹ Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6736a2-H.pdf
² Boyaji S, et al. The role of cannabidiol (CBD) in chronic pain management: an assessment of current evidence. Current Pain and Headache Reports. 2020. 24:4
³ Pretzsch CM et al. Effects of cannabidiol on brain excitation and inhibition systems; a randomized placebo- controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorder. Neuropsychopharmacology. 2019. 44: 1398-1405

Please use this as a guide and not medical advice.  Written in collaboration with Jason Wilson, MS – a science educator, natural products researcher, an expert on cannabis and cannabinoid science, and creator of the Curious About Cannabis Podcast.