Cannabis has been used to help people manage pain since ancient times. But it’s only recently that medical cannabis and CBD oil are gaining traction in the modern medical world as a potential medication for dealing with chronic pain. CBD oil is of particular interest to the medical community since it doesn’t come with the psychoactive effects of THC, which some people have to or prefer to avoid.
Pain is complex and is often managed using medications that carry a risk of dependence. While these medications are often required to manage intense or chronic pain, CBD oil may be a useful supplementary treatment, with the added benefit that it is non-addictive and usually tolerated well.
Some of the conditions that CBD oil might help manage include fibromyalgia, arthritis, cancer pain and neuropathic pain. But how solid is the evidence so far, and how exactly is CBD oil used for pain?
What is Pain?
Pain, especially chronic pain, is complicated and difficult to treat. Everyone’s perception of pain is different, and it can be influenced by our mood, biology, past experiences and environment. Finding the right treatment can be challenging, and will often depend on the type of pain being treated.
Some common types of pain include neuropathic pain, nociceptive pain and radicular pain.
Neuropathic pain is pain in the nerves and can occur as a result of nerve damage.
Nociceptive pain is caused by tissue damage and is activated by nerve fibres called nociceptors.
Radicular pain can arise when a nerve root is compressed or inflamed and can be a symptom of health conditions such as sciatica.
Pain can also be either acute or chronic. Acute pain usually results from an injury or disease, can be sudden and intense and serves as a warning that the body is under threat.
Acute pain will usually resolve once the disease or injury has healed.
Chronic pain is pain that lasts for over 3 months, and may be there all the time or come and go. Acute pain from an injury or disease can linger and turn into chronic pain, but sometimes the cause of chronic pain is unknown. Sometimes stress or anxiety can cause or contribute to chronic pain, which is referred to as psychogenic or psychosomatic pain.
The Benefits of Using CBD Oil For Pain
If you experience chronic pain, or know someone who does, you’ll know how challenging it can be to live with. CBD’s use in managing pain is a growing research area – while still early days, the results so far are promising and CBD could offer unique benefits when compared to more traditional pain medicines.
For instance, CBD oil is non-psychotropic, meaning you won’t experience the “high” that you might get from a THC product. CBD oil is also non-addictive, and side effects tend to be rare and minor. Some pain medication can be addictive and carry the risk of more serious side effects, so CBD oil may be a useful alternative or supplementary treatment for some people.
How Does CBD Oil Help With Pain?
The endocannabinoid system is involved in regulating several bodily functions, including your metabolism, immune system, inflammation and pain. When you use CBD oil, the phytocannabinoids from the cannabis plant affect your own endocannabinoid system in various ways, such as potentially providing pain relief. CBD could also have some anti-inflammatory properties, which may help reduce some pain.
While some CBD oils contain only CBD, full-spectrum CBD oil is extracted from the whole cannabis plant, meaning it also contains low amounts of THC. There’s some evidence that CBD products that contain other cannabinoids and terpenes may be more effective due to the entourage effect.
The entourage effect is the theory that certain cannabinoids, terpenes and flavonoids work together to achieve a greater therapeutic benefit.
What Types of Pain Can CBD Oil Help Manage?
Although no CBD products have been approved by the Therapeutic Goods Administration for treating pain, there have been some promising early results from preclinical and some clinical studies. Some of the types of pain CBD oil might be able to help manage are fibromyalgia, cancer pain, arthritis and neuropathic pain.
CBD Oil For Fibromyalgia and Endometriosis
Fibromyalgia is a chronic condition that can cause musculoskeletal pain, meaning pain in the muscles and bones. It can also lead to fatigue, anxiety and depression. It’s a complex condition that can be difficult to identify and treat. A 2021 survey of 2,701 people with fibromyalgia found that CBD use was generally effective at reducing pain, however more rigorous studies are required to better understand if this is a consistent effect.
Endometriosis is another chronic condition that can cause pain around the pelvis. Endometriosis is caused by tissue that normally lines the inside of the uterus growing outside of the uterus. Cannabinoid receptors have been found inside the endometrium, suggesting CBD may act on these receptors and potentially reducing inflammation and pain related to endometriosis.
CBD Oil For Cancer Pain
People with cancer may experience different types of pain from the disease itself and from treatment. Tumours can cause cancer pain by pressing on nerves, organs and bones, and also by releasing chemicals into the body that cause pain. Chemotherapy, radiation and surgery can also cause pain that can range from mild to severe.
The research on CBD oil for cancer pain is promising, with one review stating that the evidence suggests CBD may be a useful option to reduce cancer pain and ease chemotherapy side effects. However, the review emphasises the need for more human studies and randomised controlled trials on CBD use for people with cancer.
CBD Oil For Arthritis Pain
Arthritis is a condition that causes swelling and tenderness in one or more joints in the body. The term “arthritis” broadly refers to joint pain or joint disease, and there are more than 100 types of arthritis. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
So far, the research on CBD for arthritis is limited, but there have been some positive early findings. One 2018 study tested how effective a CBD gel might be for those with knee pain caused by osteoarthritis. Of the 320 people treated with CBD, there was initially no statistically significant difference in knee pain compared to placebo. However, closer inspection of the participants who responded well to CBD treatment revealed a statically significant change in pain compared to placebo.
Studies such as these are promising, but most of the evidence for using CBD for arthritis is anecdotal. Some people who have arthritis report a noticeable improvement in pain after using CBD oil, but more high-quality human studies are needed on CBD’s potential role in managing arthritis pain.
CBD Oil For Neuropathic Pain
Neuropathic pain is a type of pain that affects the nerves. Nerve pain can occur when a health condition damages nerves anywhere in the body, and can resemble an electric shock or a sharp burning sensation.
CBD may have some use in treating neuropathic pain. A small placebo-controlled study with 29 patients found that topical CBD oil provided “statistically significant” relief from neuropathic pain, and that treatment was well-tolerated.
However, most reviews of the evidence for CBD oil and neuropathic pain stress the need for more high-quality studies with higher sample sizes. Although, some reviews do state that CBD may be an effective and safe treatment for neuropathic pain despite the limited clinical evidence.
How to Use CBD Oil For Pain
The best way to use CBD oil for pain depends on your condition and the method of delivery you’re most comfortable with. Some people prefer inhaling CBD using a vaporiser and CBD oil cartridges. Vaping has a fast onset, which may benefit you if you need immediate relief.
On the other hand, you can also simply drop CBD oil onto or under your tongue, or ingest CBD via a capsule, lozenge or topical cream. Oils, capsules and lozenges can take between 30-90 minutes to take effect. The effects can last from 8-12 hours, although the exact length of effect will vary from person to person.
CBD topicals might suit you if you experience localised pain. The ability to apply the cream or lotion directly to the painful area may offer faster or more pronounced relief, but the evidence for this is so far mostly anecdotal.
Does CBD Oil Have Any Side Effects?
CBD oil can have some side effects, but they are rare and usually minor. CBD oil’s side effects can include drowsiness, dry mouth, dizziness and diarrhoea. Thankfully CBD oil is usually tolerated well, and most side effects occur at high doses.
A good rule is to start low and go slow, so that you can see how CBD affects you individually. Your doctor will determine the best starting dose to help you feel as comfortable as possible.
You may have also heard that CBD can be harmful for the liver, but recent research suggests that this may not be the case. Regardless, speak to your doctor if you experience any liver issues before starting any new medication, including CBD oil.
How Does CBD Oil Interact With Other Medications?
CBD oil is generally safe to take alongside other medications, but it does have some interactions you should be aware of. It’s also important to understand how your body processes medication and how CBD oil might affect this.
Since CBD oil is metabolised in the liver, taking other medications that are metabolised the same way can sometimes lead to complications. Enzymes in the liver can be less effective at breaking down certain medications when the same enzymes are simultaneously metabolising the cannabinoids in CBD oil.
This isn’t usually a serious problem, but sometimes your body will be unable to properly process other medication if CBD is competing with liver enzymes. This can potentially cause you to have too much or not enough medication in your system, increasing the risk of side effects or the medication not working.
If you’re taking certain heart medications, blood thinners or other medications processed by the liver, taking CBD at the same time may pose risks – but speak to your doctor for the details.
There’s also a risk of doubling up on side effects. Drowsiness is a potential side effect of CBD oil and many other medications. Some other medications that may cause drowsiness include benzodiazepines, some antidepressants, antipsychotics or certain antihistamines. Certain herbal supplements such as St. John’s wort can also cause drowsiness. If you’re taking any of these medications, ask your doctor if it’s safe for you to take CBD at the same time.
How Do I Get Started With CBD Oil?
Pain management poses a unique challenge for healthcare providers in that pain is a personal experience that can vary depending on an individual’s psychology, circumstances and physiology. Emerging treatments such as CBD oil are in high demand, and with further research, CBD oil could further help those affected by pain or chronic pain.
As always, speak with your doctor before making any changes to your treatment plan. If you’re interested in CBD oil for pain, book an appointment with your GP or with a dedicated medical cannabis clinic to work out a treatment that is best for you.