What’s The Effective Dose of CBD For Neuropathic Pain?

When it comes to treating neuropathic pain — a notoriously difficult type of pain to alleviate — a higher strength of CBD is generally recommended. Most of the research showing benefits from CBD noted an abnormally large dose of the compound to achieve this success.

For this reason, it’s a good idea to work out the dose yourself to find out what’s best for you and your symptoms.

You can use our CBD oil dosage calculator to find the best dose based on your weight and desired level of effects.

Start small and increase the dose every day until you either experience relief from symptoms — meaning you’ve found your dose — or experience side effects. If you experience side effects, you may need to dial the dose back to the last side-effect-free dose.

If you’re still not getting any reduction in pain symptoms with this dose, you may need to combine CBD with other forms of pain management — after consulting with a doctor, of course.

CBD Dosage Calculator

What Are The Side-Effects of CBD?

Although CBD has been proven to be highly safe many times over, it’s important to know about the potential side effects it may produce.

Everybody is different, and what works for one person doesn’t always work the same way for another.

Here are some of the most common side-effects of CBD:

• Appetite suppression
• Diarrhea
• Drowsiness
• Dry mouth
• Lightheadedness
• Lower heart rate
• Sedation

Which Type of CBD Should I Use?

CBD comes in all different forms — not all are going to work for every condition.

1. CBD Oils & Tinctures

CBD oils and tinctures provide the easiest methods of taking CBD. All you need to do is measure out the desired dose (more on this later) and pop it into your mouth. You can choose to hold the oil/tincture under your tongue for faster absorption or swallow it right away — both will work well.

2. CBD Capsules

CBD capsules are another excellent dosing option you can employ. Capsules are small and easy to carry, deliver standardized CBD doses, and have great bioavailability. They’re also an excellent option for people who don’t want to taste the CBD oil — which can have an earthy, undesirable taste in some cases.

3. Topical CBD Products

Topical CBD is another good option, but only if the source of your neuropathic pain is close to the surface of the skin. It’s recommended that you use it alongside internal forms of CBD, such as capsules, edibles, or oils. This is because the cannabinoids in topical CBD products won’t reach the spinal cord and brain where most of the pain relief comes from when treating neuropathic pain.

4. CBD Edibles

CBD Edibles, including gummies or baked goods, are certainly a fun way of taking CBD — but they’re often inconsistent with dosing (with the exception of gummies). The dosages listed are estimates, and the actual CBD content inside can vary significantly.

For this reason, we don’t recommend relying on CBD edibles as your everyday maintenance dose of CBD for neuropathic pain.

What is Neuropathic Pain?

Neuropathic pain is a type of pain involving damage to or dysfunction of the nerves and somatic sensors found throughout the body.

Any damage to or dysfunction of the nerves and sensory tissues can send pain signals to the brain. These signals warn the body of real damage or dysfunction, but they can also be caused by false messages sent to the brain.

These messages warn the brain of damage that may or may not exist. This makes neuropathic pain difficult to treat, especially when the underlying cause can’t be identified.

1. Central Neuropathic Pain

The central nervous system is any part of the nervous system inside the brain and spinal cord. This is separated from the peripheral nervous system by a semipermeable barrier called the blood-brain barrier.

Central neuropathic pain, therefore, involves pain originating from nerves located inside the central nervous system.

It’s caused by conditions such as:

• Multiple sclerosis
• Strokes
• Spinal cord injuries

2. Peripheral Neuropathic Pain

The peripheral nervous system involves any part of the nervous system outside of the brain and spinal cord. This includes all the nerves in the limbs, abdominal cavity, legs, and face.

Often, when a nerve becomes damaged, the repair process may not go as planned. Instead of returning the nerve to the way it was before the damage, the nerve becomes unusually sensitive and will send pain signals to the brain when it shouldn’t.

The original damage can happen from many different causes, primarily traumatic injuries or specific viruses that target the nerve cells directly — such as herpes virus or shingles.

This type of pain is caused by conditions such as:

• Diabetes
• Metabolic syndrome
• Herpes zoster infection
• HIV infection
• Nutritional deficiencies
• Environmental toxin exposure
• Cancer
• Autoimmune disorders
• Traumatic injuries

3. Mixed — Peripheral and Central Neuropathic Pain

Mixed neuropathic pain involves pain stemming from nerves found both inside the central nervous system and inside the peripheral nervous system.

Causes for mixed neuropathic pain include:

• Cancer
• Chemotherapy treatments
• HIV and other viral infections
• Heavy metal toxicity

What Are The Causes of Neuropathic (Nerve) Pain?

Neuropathic pain is caused by damage or dysfunction of the nerve cells. There are many causes for nerve damage in the body, such as:

• Multiple sclerosis
• Varicella-zoster infection
• Epstein Barr Virus infection (EBV)
• Traumatic injuries
• Trigeminal neuralgia

Treatments for Neuropathic Pain

• Antidepressants (SSRIs, SNRIs, and tricyclic antidepressants)
• Opiate pain medications (morphine, fentanyl, tramadol, and methadone)
• Surgical nerve blocks (severe cases only)
• Capsaicin
• Topical analgesics (lidocaine)

Related: Does CBD Interact With Tramadol?

CBD For Spinal Cord Injury

Spinal cord injuries can have debilitating and life-altering consequences. Injuries can cause varying levels of paralysis, spasticity, loss of sensation, muscle weakness, and nerve pain that can persist for the rest of that person’s life.

There are some treatments available for this condition, most of which are supportive — helping those affected manage pain, depression, and other side-effects of the condition.

CBD cannot cure a spinal cord injury — however, it does likely offer a great deal of support for those affected by managing symptoms and promoting the repair of nerve cells in the damaged areas of the spinal cord.

There’s also some indication that CBD can support the recovery process — lowering the severity of side effects and improving motor function in the affected nerves [5].

The Benefits of CBD Oil For Spinal Cord Injury Includes:

• Managing chronic pain
• Relieving symptoms of mild to moderate depression
• Adjunctive treatment to prevent antibiotic resistance during lung infection
• Alleviating insomnia
• Promoting nerve regeneration
• Possibly reducing the extent of nerve damage from the incident

What is a Spinal Cord Injury?

The spinal cord is an extension of the brain. It contains high concentrations of nerve cell tracts that send and receive messages between the body and the brain. Any damage to the spinal cord can result in serious consequences, including paralysis, spasms, neuropathic pain, or loss of organ function.

The spinal cord contains millions of nerve “intersections” that distribute signals to every part of the body. The area of the spinal cord that is damaged will determine what side-effects develop and where.

For example, if the region of the spine containing the nerves that control leg muscles is damaged, it means that there will be a weakness or complete loss of function in those muscles and sensory deficits in one or both legs.

Spinal Cord Injury Symptoms

• Paralysis/Weakeness
• Motor deficits
• Sensory deficits (of pain, touch, temperature, location, and vibration senses)
• Bedsores from prolonged immobility
• Changes in mood
• Chronic pain
• Difficulty breathing
• Frequent infections
• Headaches
• Incontinence
• Infertility
• Muscle pain
• Nerve pain
• Pneumonia
• Poor libido

Types of Spinal Cord Injury

Depending on how severe the injury is, there are three main classifications that doctors use to describe the condition:

1. Incomplete spinal cord injury — involves damage that hasn’t completely inhibited nerve transmission past the site of injury.
2. Complete spinal cord injury — damage to the spinal cord is severe enough that no nerve signals can pass across the site of injury.
3. Brown Séquard Syndrome— damage to exactly one half section of the cord, either left or right hemisection.

There are also several other types of spinal cord injury such as dorsal column lesion, irregular lesions, small or large central lesion, tumor of the dorsal root, or tumor of the meninges or bone.

The Location of the Spinal Cord Injury Matters

Nerves leave the brain and head down the spinal cord in bundles and pairs. They branch off at various points along the way to go to their target organs, and some tracts will cross sides.

The location of the damage to the spinal cord will determine which areas of the body are affected.

Complete damage of the spinal cord will prevent all nerves below the damaged point to stop receiving or sending messages. Therefore, to classify the level of injury, doctors will assess the lowest levels of different sensations and functions of the nerves in the spinal cord.

There are four main divisions of the spinal cord — organized according to the vertebral column. The vertebral column starts at one at the base of the skull and goes all the way to the coccyx. The spinal cord, in fact, actually ends between vertebrae L1-L2, and is followed by a bundle of nerves called the cauda equina the rest of the way down.

Causes of Spinal Cord Injuries

• Car accidents
• Gunshot wounds
• Stab wounds
• Tumor growths
• Sports injuries
• Toxic exposure
• Ischemic damage

What the Research Says

In 2012, researchers conducted a study on the use of CBD for spinal cord injuries in rats [5]. Rats were either placed in the treatment group and given CBD, or into the control group where no treatment was given. At the end of the six-day study, rats in the CBD treatment group had significant improvements in motor function and reduced injury side-effects than rats in the no-treatment group. Therefore, the researchers conducting this study concluded that CBD might be a useful treatment option for spinal cord lesions (injuries).

Another study used a survey that was handed out to 10 spinal cord injury patients at the Spinal Cord Injury ward of the Miami V.A. Hospital who were using marijuana to treat their symptoms. The survey was kept confidential and involved questions about the most common symptoms of the condition and how marijuana use affected them.

Results of This Survey Listed:

THC has also offered benefits for spinal cord injuries. For this reason, a full-spectrum cannabis extract containing both CBD and THC is considered the best option.

Potential Benefits of THC for Spinal Cord Injuries

• Reduces muscle spasms involved with spinal cord injuries [6]
• Improves bladder control in spinal cord injuries [7]
• Reduces pain associated with spinal cord injuries [8]

THC remains illegal throughout most of the world, so it may be difficult to find products containing more than 0.3% THC concentration. Further robust studies will be needed to better characterize standard effects and determine efficacy.

Related: Best CBD:THC Ratio for Neuropathy.

Key Takeaways: Does CBD Oil Work For Neuropathic Pain?

The causes of neuropathic pain can range from neurological issues such as multiple sclerosis or a stroke to nutritional deficiencies and diabetes.

No matter what’s causing neuropathic pain, the benefits of CBD remain much the same.

CBD can support neuropathic pain in the following ways:

• Increases anandamide levels
• Activates the vanilloid receptors
• Inhibits inflammation that may be causing neuropathic pain
• Mildly activates the opioid receptors in the spinal cord and brain

When it comes to treating neuropathic pain, a higher dose is usually recommended — however, this can vary from person to person. Whenever using CBD for the first time, it’s wise to start low and increase slowly over time until you receive the benefits you’re looking for.

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References

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2. Leung, L. (2011). Cannabis and its derivatives: review of medical use. The Journal of the American Board of Family Medicine, 24(4), 452-462.
3. Grotenhermen, F., & Müller-Vahl, K. (2012). The therapeutic potential of cannabis and cannabinoids. Deutsches Ärzteblatt International, 109(29-30), 495.
4. Bisogno, T., Hanuš, L., De Petrocellis, L., Tchilibon, S., Ponde, D. E., Brandi, I., … & Di Marzo, V. (2001). Molecular targets for cannabidiol and its synthetic analogues: effect on vanilloid VR1 receptors and on the cellular uptake and enzymatic hydrolysis of anandamide. British journal of pharmacology, 134(4), 845-852.
5. Kwiatkoski, M., Guimaraes, F. S., & Del-Bel, E. (2012). Cannabidiol-treated rats exhibited higher motor score after cryogenic spinal cord injury. Neurotoxicity Research, 21(3), 271-280.
6. Hagenbach, U., Luz, S., Brenneisen, R., & Mäder, M. (2003, September). The treatment of spasticity with D9-tetrahydrocannabinol (D9-THC) in patients with spinal cord injury. In IACM 2nd Conference on Cannabinoids in Medicine (pp. 12-13).
7. Hagenbach, U., Gafoor, N., & Brenneisen, R. (2001, October). Clinical investigation of delta-9-tetrahydrocannabinol (THC) as an alternative therapy for overactive bladders in spinal cord injury patients. In Cologne, Germany: Congress on Cannabis and Cannabinoids.
8. Hagenbach, U., Luz, S., Ghafoor, N., Berger, J. M., Grotenhermen, F., Brenneisen, R., & Mäder, M. (2007). The treatment of spasticity with Δ 9-tetrahydrocannabinol in persons with spinal cord injury. Spinal cord, 45(8), 551.
9. Maurer, M., Henn, V., Dittrich, A., & Hofmann, A. (1990). Delta-9-tetrahydrocannabinol shows antispastic and analgesic effects in a single case double-blind trial. European archives of psychiatry and clinical neuroscience, 240(1), 1-4.
10. Malec, J., Harvey, R. F., & Cayner, J. J. (1982). Cannabis effect on spasticity in spinal cord injury. Archives of Physical Medicine and Rehabilitation, 63(3), 116-118.
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