How does CBD work in pain management?
Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.
Are you currently feeling the effects of pain? Maybe you are seeking an all-natural solution? Then welcome – you have come to the right place! Using CBD as a pain reliever is actually an ancient practice, with the first documented use of cannabis as a medicine dating back to 2737 BC. Chinese Emperor Sheng Nung drank a cannabis-infused tea to help him manage a range of conditions such as malaria, gout, memory, and rheumatism. This article will consider how CBD oil can help to manage your pain, through the examination of specific condition led research. What’s more, we will outline the various methods of administration, so that you can make an informed decision on how best to incorporate CBD oil into your healthy lifestyle.
What is pain and why do we feel it?
Pain is a universal feeling, and it’s pretty much impossible to go through life without knowing what it feels like. The feeling of pain can be classed as an uncomfortable sensation and is signalling to you that something isn’t right. Pain can be a steady feeling or it can ache, pinch, throb, or stab. Pain can also cause a whole host of additional physical symptoms, such as weakness, drowsiness, feeling sick, shakiness, and dizziness. These physical symptoms can lead to a declined mental state, as they can negatively impact your mental health. Physical pain can lead to feelings of anxiety, depression, anger, and cause mood swings. This can lead to trouble and strife in your relationships, friendships and professional life. Pain can be categorised as acute or chronic, acute is a type of pain that doesn’t last long and has a minimal impact on your daily life, for example a headache or injury. Chronic pain is a pain that persists for longer than 12 weeks despite medical intervention, like prescribed medication or surgery. This pain can be mild or severe, and it is often related to a chronic, long-term condition, such as arthritis or fibromyalgia.
So, why do we feel pain? Your central nervous system is made up of the brain and nerves located in the spine. Your spinal nerves can carry and send messages/signals from the body and send them to the brain. Your brain almost acts as a control hub for these messages and decodes them, then deciding if it needs to take any further action by interpreting and reacting to the signal. Think about it this way: when you trap your finger in a door it’s an automatic reaction to quickly pull it out, this is because your brain has sent out signals of pain. Pain is actually an extraordinarily complex process, and not everyone will feel the same level of pain from the same accident or illness. Pain tolerance and thresholds will vary from person to person, and this is important to keep in mind. Medications can be taken to help manage pain, as currently this is the best way to treat pain – treating the symptoms.
Different types of pain
Pain types can be classified in many different ways, but here we will explain the three main ways it's often categorised:
- Inflammatory pain: this can be a throbbing pain and is often linked to a spontaneous incident that causes tissue damage and then inflammation. This is usually due to an injury, but it can also be linked to diseases like arthritis or hyperalgesia. The latter is a condition that causes hypersensitivity to pain.
- Neuropathic pain: this type of pain can feel like an electric-shock and is then followed by numbness. It transmits a message of severe trauma to the peripheral nervous system, connecting the spinal cord and the brain to the body.
- Central pain: this type of pain can be caused by disease in the spinal cord or brain, such as tumours or haemorrhages. This pain can be mild or severe, and it can cause a pressing, burning or aching sensation.
What is CBD?
Now let us answer one of the most commonly searched for questions when it comes to CBD: ‘what is CBD oil’? The full name of the compound is cannabidiol, but it’s more commonly referred to as CBD. CBD oil is derived from the cannabis plant, Cannabis sativa and it’s one of 113 other compounds located in the plant. One of the other most researched compounds is Tetrahydrocannabinol (THC), and this is the main psychoactive cannabinoid in cannabis. Consuming it can cause the individual to feel a “high” or intoxicating effect. CBD contains no psychoactive properties, hence its rise in popularity in the health and wellness world. It’s also great news for people seeking an all-natural solution to their pain. So, how is CBD oil made? It needs to be extracted from the cannabis plant and then diluted with a carrier oil, such as coconut, hemp seed, or avocado oil. CBD oil can be consumed in many different forms, such as vaping, spray, edibles, creams, and capsules.
Different types of CBD oil
There are three main types of CBD oil that you can choose from, but first it’s important to understand the distinctions between them in order to make an informed choice.
- CBD Isolate: this type of CBD is pretty self-explanatory, as it’s CBD in its pure form without any additives. It is a popular choice among first-time users of CBD, due to the complete removal of THC. What’s more, some people find it easier to dose considering the exact amount of CBD can be quantified. However, when it comes to pain management, a study published in 2015 reported that to feel the pain relieving effects of CBD, people may need to consume higher doses of CBD isolate.
- Full-spectrum: this type of CBD contains all the compounds that naturally occur in the cannabis plant, including up to 0.3% THC. Some people prefer to consume full-spectrum CBD due to the potential benefits of the entourage effect. This is referring to all of the compounds that work in synergy to allow you to get the most out of your experience. What’s more, some individuals regard this as the most natural form of CBD, as there is less change and processing.
- Broad-spectrum: this kind of CBD oil contains the naturally occurring compounds found in the cannabis plant, apart from THC. Individuals can also benefit from the entourage effect from this type of CBD.
Is CBD oil a painkiller?
CBD oil can certainly be regarded as having the potential to be a natural painkiller. Why is this? Well, it interacts with the human body through something called the endocannabinoid system, which consists of molecules known as endocannabinoids. Endocannabinoids are vital for cognitive function and memory in the brain, as well as the function and health of your organs. It all contributes to keeping your body and mind centred and balanced. CBD can have a positive influence on the receptors of the primary inhibitory neurotransmitters GABA and can increase their activity. This results in a reduction of pain signals when the signals reach the brain.
The naturalness of CBD is also one huge reason for people using CBD as a painkiller. You see, people dealing with regular pain often need to purchase over-the-counter pain remedies. Analgesics can come with a range of side effects, as well as worry over long-term effects and damage to organs. For example, the National Kidney Foundation reports that long-term use of ibuprofen can cause chronic kidney disease, otherwise known as chronic interstitial nephritis. Furthermore, some individuals hold concerns over becoming addicted or dependent on their pain medication, in particular opioids. The body can stop producing its own opioids when narcotic analgesics are absorbed into the blood, and this can lead to addiction. There’s also a risk of developing withdrawal symptoms after taking opioids for a prolonged amount of time. They can also lead to severe health issues, such as hypertonia due to the dilation of blood vessels. This can lead to your body retaining water and consequently increase arterial pressure. This can cause heart attacks, blood clots, and renal impairment. They can cause nasty side effects such as drowsiness, constipation, temporary euphoria, confusion, nausea, and slow breathing. Misuse of the drug can cause something known as hypoxia, which results in not enough oxygen reaching the brain. This is extremely dangerous, and can cause long-term psychological effects, coma and death. Conversely, CBD is an all-natural compound with no literature claiming that it is addictive - quite the opposite in fact. A study published in 2017 reported that even higher doses of CBD (1,500mg per day) were well-tolerated by the participants. While CBD is tolerated well by most people, there have been noted short-term side effects such as tiredness, dry mouth, and diarrhoea.
CBD for pain – what conditions can it help?
There’s a wealth of research into CBD for pain and pain management, and it’s an area of research that’s going to carry on building and expanding. Current research looks promising for the use of CBD oil as a treatment to help manage the symptoms of pain for a range of health conditions. Here we will examine some of the key pieces of research.
CBD oil for arthritis pain
In the UK alone, rheumatoid arthritis affects more than 400,000 people. While the condition can begin at any age, it is far more common in individuals aged 40 and over, with women more likely to develop the condition than men. The two most prevalent types of arthritis are rheumatoid arthritis and osteoarthritis. The latter is a degenerative illness that spreads to the bones and joints, particularly in the knees, hips, and thumbs. This can lead to stiffness and pain. Rheumatoid arthritis is classed as an autoimmune condition, as the immune system begins to attack the joints leading to inflammation, pain, swelling, and stiffness. This type of arthritis typically affects the feet and hands, making everyday tasks impossible for some people suffering from severe cases. There have been a number of animal studies conducted to examine the effectiveness of CBD as a pain reliever for arthritis. A 2016 study examined the effects of CBD gel on rats with arthritis. This study took place over four days and the rats received either a dose of 0.6, 3.1, 6.2, or 62.3 mg of CBD per day. The rats who received the low doses of CBD (0.6 and 3.1 mg) didn’t see an improvement in their pain. However, those that received 6.2 mg per day was a high enough dose to reduce both pain and swelling. Furthermore, there were no negative side effects of CBD to report. They conclude the study by stating that CBD application holds the therapeutic potential to treat arthritis pain and inflammation of the joints. A further rat study published in 2017 concluded that CBD is a safe and useful treatment for osteoarthritis joint pain. More human studies need to be conducted for conclusive results, however a 2006 study shows promise. It examined the effects of Sativex (a cannabis mouth spray containing both CBD and THC) on patients suffering from rheumatoid arthritis. 58 patients took part and 27 received a placebo, over a five-week course of treatment. The spray was administered once per day and the outcomes were assessed by measuring sleep, pain while resting, and stiffness in the joints. The spray group saw “significant improvements in pain on movement, pain at rest, quality of sleep” in comparison to the placebo group.
CBD oil for cancer pain
‘CBD oil for cancer pain’ is a commonly searched phrase online, as people are looking for a natural relief to their pain, especially if current treatment is not working effectively for them. The side effects of chemotherapy can be extremely challenging to live with. The NHS notes that these effects can include tiredness, sore mouth, pain, hair loss, feeling and being sick, and a lack of appetite. The National Cancer Institute reviewed the current literature and noted that “Cannabinoids may have benefits in the treatment of cancer-related side effects.” One study published in 2010 examined the effects of an oral spray containing both CBD and THC, alongside opioids. They concluded that the combination of opioids and the oral spray worked more effectively to manage pain. A further study published in 2013 (essentially an extension of the previous investigation) found further evidence that the oral spray of CBD and THC was an effective pain reliever. It was also reported that the spray caused no negative side effects and it was generally well-tolerated. Furthermore, there was no evidence to suggest that the pain-relieving effects would be lost or minimised with long-term use, as patients who carried on using the spray had no need to increase their dosage as time went on. There is also an area of research pertaining to CBD and its ability to minimise cancerous tumours. For example, a 2019 review of the current literature (both vitro and in vivo studies) with a focus on pancreatic cancer demonstrates this. It reported that cannabinoids can help to reduce tumour invasion, stimulate the death of tumour cells, and slow the growth of tumours. Although further research is needed into the specifics (dosing and effectiveness) things look promising for the use of CBD in the treatment of cancer and the management of pain.
CBD oil for period pain
Dysmenorrhea is the medical term for period pain, with primary dysmenorrhea referring to the menstrual cramps that return every month. Pain can begin a few days before your period begins, and the pain can appear in your back, thighs, lower abdomen, or stomach. Other common symptoms include diarrhea, fatigue and sickness, not to mention the hormonal and mood changes. The cramps occur due to the uterus contracting thanks to the chemical prostaglandin. During menstruation the uterus can contact too strongly, and this can result in the supply of oxygen being cut off to the nearby muscle tissue. Once the oxygen is lost, you then feel the pain. Many women reach for the pain killers during this time of the month; however some scientists now believe that CBD is more effective. This is because CBD can also inhibit the enzyme that produces prostaglandin, much like the over-the-counter NSAIDs painkillers (ibuprofen, paracetamol). However, due to the manner in which CBD inhibits COX-2 over COX-1 to stop inflammation, it results in no negative gastrointestinal side effects, unlike NSAIDs. CBD oil can also help to relax muscles by targeting the receptors in the muscle tissue. This can lead to a decrease in pain, as it will allow the body to relax its contractions. What’s more, CBD is also recognised for its ability to increase blood flow, and this can help to prevent the oxygen supply being cut off. Cannabinoids (both THC and CBD) can desensitise the nerves that cause us to feel pain. CBD targets the TRPV1 nerve, and this can lessen the pain associated with cramps. Even better, CBD has the power to also produce soothing effects for the other surrounding pain receptors, contributing further to the pain relief. CBD is also a known anti-inflammatory, and this can help women to manage the other symptoms that occur alongside their monthly cycle. For example, using CBD oil can help to alleviate digestive issues, nausea and cramps. This can help to improve the quality of life for some individuals, and allow them to carry on with their professional work life, as well as enjoy leisure activities with minimised pain. It is common knowledge that hormonal changes can cause some women to experience feelings of anxiety, sadness, depression, and worry during their monthly cycle. Keep reading to discover how CBD oil can be considered a natural mood booster, and how it can help to combat the negative emotional impact of pain.
CBD oil for mental anguish
As we already know, pain can take a toll on our mental health. The internet search ‘CBD oil for anxiety’ has increased exponentially during recent months, and we can safely assume that’s due to the COVID-19 pandemic, as people adjust to the ‘new normal’ of working from home and not being able to see their loved ones. More and more people are turning to CBD to calm and soothe their anxious thoughts, and this can directly relate to individuals suffering from pain. There have been numerous studies undertaken into the potential benefits of CBD oil for anxiety disorders. One such study was published by the National Institute on Drug Abuse, as they report that CBD can reduce stress in animal models for generalised anxiety disorder (GAD). The physical symptoms of anxiety improved, such as an elevated heart rate. There is also evidence to suggest that CBD oil can aid in reducing anxiety related insomnia, and this is extremely useful for people suffering from pain, as a healthy sleep cycle is vital to healing and general wellbeing. CBD can interact with the CB1 and CB2 receptors, located in the cemental nervous system and your peripheral nervous system. It can positively interact with serotonin signals and this can naturally improve your mood. Serotonin is a neurotransmitter and low levels of it are intrinsically linked to depression. Individuals are often prescribed a selective serotonin reuptake inhibitor (SSRI) or Cognitive Behavioural Therapy (CBT), or a combination therapy approach. However, both can produce negative side effects; SSRI’s can make you feel sick, dizzy, cause weight changes, and cause an increase in anxious and worried feelings. One study found that 40 percent of people that have CBT experience negative side effects, such as uncontrollable crying or a worsening of the original symptoms. This has some people reaching for the CBD oil for a much-needed mood boost.
CBD oil for migraine relief
There’s a growing body of research into CBD oil that indicates it could provide relief from migraine pain, in particular the neurological pain that accompanies it. A migraine is classed as a severe headache that can last between 4 and 72 hours, and the pain is described as throbbing, often on one side of the head. It can also cause dizziness, changes in vision, sensitivity to light, and sickness. Migraines are an extremely common and debilitating health condition, as they typically affect 1 in every 5 women and approximately 1 in every 15 men. The American Migraine Association reported that although further evidence is needed, CBD should be regarded as a viable option for individuals suffering from muscle and joint pain linked to migraines. Further research has demonstrated that CBD is an effective way of managing chronic pain, as well as helping individuals suffering from intense pain to get some much-needed restorative sleep. Furthermore, some individuals suffer from migraines as a result of low serotonin levels in the brain, as this can cause blood vessels to expand and induce a migraine. As we have discovered, research into CBD demonstrates its ability to influence and increase the level of serotonin in the brain, and therefore could act as a preventive measure.
Methods of administration
The phrase ‘how to take CBD oil’ comes up often when people begin researching the benefits of CBD. There are a variety of options open to you, and this can feel overwhelming at times. Let’s break down the key ways that you can consume CBD oil for pain.
Oral drops/ tinctures
Don’t worry if you thought CBD oil was the only method of consumption, as it’s an easy mistake to make! It remains one of the most widespread and popular ways of adding CBD to people’s lifestyles, particularly in the UK. You simply put a few drops of the oil underneath your tongue onto the soft tissue and hold it there for 30 seconds before swallowing. There are many advantages to this method of consumption, for example it’s easy to dose thanks to the pipette, and they are easy to use. The range of flavours is also a huge drawing point, especially for those of you that don’t enjoy the natural tang/sharp taste of CBD. Businesses are only getting more creative with their flavours, you can now purchase lemon, blueberry, vanilla, peppermint, and so many more! Finally, they are fast acting thanks to the sublingual application as they reach the bloodstream quickly, typically within 10 to 15 minutes. This is where the term ‘bioavailability’ comes into play, as this refers to the amount of time it takes for the CBD oil to reach your bloodstream and for you to begin to feel the effects. There are a few disadvantages; some people would prefer a more discreet method of administration, as using them in public places isn’t always convenient. Additionally, although they are fast acting, other methods such as vaping can allow you feel the effects of CBD almost immediately.
CBD e-liquids can be consumed via a vaporiser. CBD is the active ingredient, but there are others included such as vegetable glycerin. There will also be additional flavourings added to make it pleasurable to consume. Contrary to what some people believe, they contain no nicotine or addictive substances. As previously stated, vaping CBD is the fastest acting method of consumption. The CBD is absorbed through the lungs, therefore it reaches the bloodstream extremely quickly. You can begin to feel the effects of vaping CBD in just two minutes. Like oils, they are also available to purchase in a range of favours, meaning that you are bound to find one that you like! Plus you can purchase them in a range of doses, meaning that you can tailor your experience to your exact wellness needs. Some of the stronger e-liquids can contain up to 1,000mg of CBD, and this can suit individuals suffering from severe pain. However, some people will prefer to avoid vaping CBD, especially first-time CBD users. What’s more, you will not be able to vape CBD everywhere you go, as some countries will have specific laws pertaining to vaping in public places. It's worth checking out the laws of the country you reside in before you embark on vaping your CBD out in the open.
When we refer to topical CBD oil, we are referring to a form of CBD that is absorbed via the skin. Topical CBD can come in a range of products, such as lotions, creams, balms, bath bombs, and so much more. The sheer range of products that you have to choose from is a massive advantage to using topical CBD. What’s more, they are easy and convenient to use, and you can combine them with your self-care routine. You could enjoy the calming benefits of a CBD bath and end up smelling divine! There’s no yucky medicine smells here. Topicals can also come with added benefits of softening your skin and helping to prevent premature skin aging. Plus, if you don’t like the sensation of swallowing capsules, then this is a viable alternative. It can take a long time for you to feel the effects of topical CBD, but the effects can last for a decent amount of time (up to six hours).
Both of these methods are self-explanatory. You consume CBD capsules with a glass of water (just like any other tablet), while CBD edibles are any food/beverages that include CBD oil. CBD capsules are simple to use (if you don’t mind swallowing tablets) and convenient for on-the-go consumption. They also have no taste, which some individuals prefer, and it’s super easy to adjust your dosage until you get it exactly right for you. CBD edibles are so easy to add to your lifestyle; after all, we all need to eat and drink, right? You could add some drops of CBD oil to your morning coffee or smoothie or purchase a ready-made snack like protein bars or dried fruits. They are an extremely subtle method of CBD consumption, so if you want to fly under the radar then capsules or edibles are probably your best bet. Both methods are slow-acting, however the effects can be long-lasting (up to eight hours).
So, there we have it – how CBD oil can help you to effectively manage, and kill, your pain. There’s no right or wrong way to consume CBD oil, and we encourage you to try out different doses and methods of administration to discover what best enhances your healthy lifestyle.