Evidence based

CBD Oil For Pain Relief: Benefits, Dosage, & Side-Effects

CBD oil is a popular natural health supplement for managing pain.

But does it really work?

Learn what the evidence suggests, what products to use, and why so many people are swapping their pain meds with CBD oil.

Article By
Justin Cooke , last updated on November 20, 2020

Chronic pain is a problem for millions of people around the world.

Over the last couple of years, CBD oil and other cannabis extracts have shown impressive results in managing pain — without the nasty side-effects of prescription painkillers.

People are using CBD products to manage pain from arthritis, multiple sclerosis, fibromyalgia, migraine headaches, amyotrophic lateral sclerosis, nerve damage, PMS, and much more. 

Learn how it works and what the research says about it. 

  • MEDICALLY REVIEWED BY

    Carlos G. Aguirre, M.D., Pediatric Neurologist

    Updated on November 20, 2020

  • Table of Contents

Top Picks: Best CBD Oils For Pain (2020)

How To Choose High Quality CBD Products For Pain

Different forms of CBD are going to offer a different set of benefits toward pain management.

The main factor to consider when choosing what CBD products to use is the source of the pain. If the problem is on the surface of the skin or in the muscles, a CBD pain cream is usually the best option.

Pain originating from inside the body, such as PMS pain, cancer pain, or deep joint pain may be better managed through a CBD oil or capsule instead.

CBD Oils & Tinctures For Pain Management

CBD oils and tinctures are an excellent option for pain management. They have a relatively fast onset of effects, keep for long periods of time, and doses are easily tweaked to fit the individual needs of the user.

This is the most common method of using CBD, by far. They’re easy to use, allow for completely customizable dosing, and are rapidly absorbed into the body.

For faster effects, hold the oil under your tongue for a few minutes before you swallow. The CBD will be absorbed much more quickly through the tiny blood vessels under your tongue.

The best CBD oils for pain come with a full-spectrum extract, and offer a high potency of active full-spectrum hemp extract.

Recommended CBD Oils for Pain

Number Product Total CBD Potency Cost per mg CBD Link

1

Royal CBD Oil

250 – 2500 mg

8.3 – 83.3 mg/mL

$0.09 – $0.20

2

Good Morning. By Headery

900 mg

30 mg/mL

$0.08

3

Nordic Oil Full-Spectrum CBD Oil With Curcumin & Piperine

1500 mg

150 mg/mL

€0.10

What’s the Dose of CBD Oil For Pain?

The optimal dosage for CBD products can vary from person to person. Use our CBD oil dosage calculator to find the optimal dose for you based on weight and desired strength.

Most of the research investigating the effects of CBD on pain management recommends high doses — usually around 1 – 1.5 mg/kg of bodyweight. For a 150 pound person (68 kg) this works out to somewhere between 60 and 100 mg of CBD per dose.

Therefore, it’s best to use medium or high strength doses when treating pain conditions. For especially difficult to treat pain, even higher doses may be necessary.

It’s also beneficial in these cases to use CBD alongside other pain-management techniques such as physiotherapy, stretching, diet changes, and exercise.

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Does CBD Oil Have Any Side-Effects?

Although CBD has been proven safe and effective, it’s important to know about the potential side-effects of CBD. The most common side effect is drowsiness or fatigue, but some people experience effects like nausea, dizziness, or diarrhea.

To avoid side-effects, it’s wise to start with a low dose of CBD (around 5 mg) first to see how it affects you before moving on to a full dose.

The most common side effects of CBD include:

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

What Are The Benefits of CBD Oil For Pain?

  1. Blocks pain transmission in the spinal cord and brain — through the vanilloid and opioid pain receptors
  2. Reduces inflammation one of the primary causes of pain in the human body
  3. Alleviates common side-effects of pain — including insomnia, depression, and anxiety
  4. Reduces the underlying causes of arthritis pain — one of the most common causes of pain
  5. Regulates nerve cell health & regeneration — which may offer support for pain associated with ALS, multiple sclerosis, PMS, endometriosis, fibromyalgia, and more
  6. Reduces swelling and inflammation in the muscles after a workout

1. CBD Oil For Arthritis Pain

Arthritis is the leading cause of chronic pain in the developed world. It’s thought to affect as many as 54 million people per year.

There are two different types of arthritis — CBD has been shown to offer support for both:

  1. Rheumatoid Arthritis — arthritis caused by autoimmune disease (the body’s immune cells attack the joint tissue, causing pain)
  2. Osteoarthritis —arthritis caused by low-grade inflammation in the joints, leading to a loss of protective cartilage and further inflammation

CBD has been shown to inhibit an enzyme known as lipoxygenase (LOX) [4] — which is a key mediator in the type of inflammation taking place alongside osteoarthritis [5]. By slowing the activity of the LOX enzymes, CBD can slow the progression of inflammation in the joints and lead to a gradual reduction of pain symptoms over time.

Another study found that CBD extract inhibited several key inflammatory mediators involved with rheumatoid arthritis, leading to the production of rheumatoid arthritis synovial fibroblasts (RASF) [6]. RASF formation plays a key role in the underlying process causing rheumatoid arthritis.

By blocking these fibroblasts, CBD may interrupt the underlying cause of the condition.

Related: Check out the best CBD oils and creams for arthritis pain.

2. CBD Oil For Inflammatory Pain

Inflammation is a function of the immune system. It’s your body’s initial response to irritation or damage. Imagine getting a cut or scrape on your skin. Before anything else happens, the area around the scratch or cut becomes red and swollen — this is inflammation taking the initial steps to begin the healing process.

The inflammatory process may occur in response to infection or physical injury (bumps, bruises, fractures) as well as to metabolic, degenerative, and autoimmune conditions.

When you suffer an injury, such as an ankle sprain, the inflammation is particularly noticeable.

But when inflammation occurs internally at lower levels with conditions like irritable bowel syndrome, heart disease, or diabetes the signs can go unnoticed — potentially leading to long-term damage.

The benefits of CBD for inflammation

  • Reduces inflammation
  • Reduces swelling and redness
  • Prevents autoimmune inflammation
  • Widens the blood vessels to reduce inflammation faster

3. CBD Oil For Pain From Neurodegenerative Disorders

“Neurodegenerative disorder” is an umbrella term to describe several conditions involving the gradual destruction of nervous tissue.

The most common cause for neurodegeneration is an autoimmune disease, but other factors include prion diseases, protein or fat metabolism dysfunction, or exposure to toxic substances.

As the neurons becomes damaged, chronic pain is a common side effect.

CBD primarily helps through its anti-inflammatory and neuroprotective benefits. By alleviating underlying inflammation, CBD oil can help reduce pain and may be able to slow the progression of the disease.

CBD oil has been shown to support the following neurodegenerative disorders:

  • Multiple sclerosis [8]
  • Spinal cord injuries [9]
  • Parkinson’s Disease [10]
  • Huntington’s Disease [11]

4. CBD Oil For Muscle Pain (DOMS)

Many people are using CBD oil for muscle recovery between workouts. The active ingredients in CBD oil help relax muscle tension, ease chronic pain, promote faster cell recovery, and prevent inflammation. All of these effects make CBD oil great for use as a post-workout supplement.

One of the most common causes of muscle pain (aside from injuries) is a condition called DOMS (delayed onset muscle soreness). DOMS is caused by micro-tears to the muscles during a workout (a normal part of the process). DOMS pain usually begins about 24 hours after the exercise and can last up to 72 hours.

DOMS can make it difficult to continue exercising, which is why people are using CBD oils to reduce the severity and potentially even prevent DOMS from occurring in the first place.

For best results, combine your CBD oil with a topical CBD pain cream as well.

The benefits of CBD oil for muscle pain include:

  • Blocks pain signals from reaching the brain
  • Reduces inflammation in the muscles
  • Relaxes tight or spastic muscles
  • Speeds healing and recovery between workouts

5. CBD For Neuropathic Pain (Nerve Pain)

This type of pain arises when there’s damage to peripheral nerves, i.e. nerves outside of the spinal cord and brain.

Peripheral nerve damage can result in persistent impairment of nerve function even after the nerve recovers from the original injury [3].

Causes for nerve damage may include:

  • Trauma or injury
  • Exposure to neurotoxic substances
  • Metabolic disorder (such as diabetes or cardiovascular disease)
  • Autoimmune disease (such as rheumatoid arthritis)

Similar to chronic inflammatory pain, neuropathic pain can cause hypersensitization to pain signals [3].

The benefits of CBD oil for neuropathic pain:

  • Reduces pain transmission through the nerves
  • Activates the vanilloid pain receptors
  • Protects the nerve cells from further damage
  • Defends against oxidative damage
  • Supports microglia health in the spinal cord and brain

6. CBD For Chronic Pain

Chronic pain is a fancy word for long-term pain. It can suggest an underlying dysfunction of the tissue involved and can last anywhere from 6 months to years. Chronic pain is common and can be debilitating.

The longer the pain persists, the more it may become resistant to pain management techniques.

A 2008 review article investigated the effects of CBD and THC on chronic pain that was unresponsive to other medications. Researchers in this study concluded that CBD was an excellent pain-management tool for chronic pain, without any adverse side-effects [2].

7. CBD For Fibromyalgia Pain

A challenging condition to treat, fibromyalgia involves chronic muscle and joint pain throughout the body, along with fatigue, sleep disturbances, and cognitive impairment.

The benefits of CBD oil for fibromyalgia include:

  • Alleviates chronic pain & inflammation
  • May support sleep quality
  • Fights anxiety & depression

8. CBD for Chemotherapy-Induced Pain

An animal study found CBD may prevent painful hypersensitization of nerve receptors to temperature and pressure, a side-effect from chemotherapy medications [10]. The study found that CBD alleviated pain by binding directly to serotonin receptors in the brain.

9. CBD for NSAID-Induced Chronic Pain

NSAIDs are a common class of anti-inflammatories like aspirin and ibuprofen.

Many kidney transplant patients experience chronic pain due to toxic effects to the kidneys of  NSAID — which they need to take following surgery.

In a small clinical trial, kidney transplant patients were given doses of 50 mg to 150 mg of CBD twice per day. Results showed partial to complete pain relief in the majority of participants within the first 15 days of the 3-week study [11].

How To Use CBD Oil For Pain Management

CBD is a great natural painkiller, but only if used correctly. It’s critical you use the right CBD oil, find an effective dose for your body, and remain persistent with your dosage schedule.

Here are 5 steps to consider to get the most out of your CBD supplements.

1. Speak With Your Doctor

It’s important to follow a few key steps when using CBD to address pain symptoms.

Anybody experiencing pain should first schedule a visit their doctor. Pain is a warning sign that something is wrong, so it’s important to get checked out to learn what’s causing the pain.

2. Use the Right CBD Products

Next, the right form of CBD should be used — this could involve CBD topicals, CBD oils, or CBD capsules.

Generally speaking, topicals are best for muscle, joint, and skin-related pain, and internal CBD (oils, capsules, gummies, vapes), are better for all other forms of pain.

When to Use CBD Topically vs. Internally

  CBD Oils CBD E-Liquid CBD Topicals
Strengths • Better for reaching deep muscle tissues
• Provides direct pain inhibition on the opioid pain receptors
• Offers additional relaxing benefits
•  Provides the fastest relief from symptoms
•  The most convenient form of using CBD
• Delivers CBD directly to the muscle
• Best for surface level muscle pain and inflammation
• Provides fast relief locally
Weaknesses • Doesn’t provide a strong dose of CBD to the affected area directly
• Can be too sedating in high doses for some people
• May not provide enough relief to the muscle itself
• Requires you to vape, which may be harmful to health in other ways
• Can be messy
• Hard to reach a high dose of CBD to muscles found deeper below the skin

3. Be Patient & Persistent With Your Dose

Once you find a product that matches the type of pain you’re trying to treat and identify an effective dose, the next step is to form a routine around using CBD.

It can take several days or weeks to start feeling the benefits of CBD (depending on the type of pain). Most people will take two or three doses of CBD oils or capsules throughout the day (every 6 hours or so).

For topicals, you may want to apply to the affected area even more frequently (every 3-4 hours).

Topical CBD Expected Wait Times

Cause of Muscle Soreness Expected Onset Time For CBD Pain CreamsExpected Onset Time For CBD Oil
Stress & Tension 15 – 60 minutes 1 – 3 hours
Post-Exercise Recovery 15 – 60 minutes 3 – 8 hours
Ligament Injury 15 – 60 minutes 1 – 3 hours
Joint Injury 15 – 60 minutes 1 – 3 hours
Torn Muscle 15 – 60 minutes 1 – 3 hours
Muscle Sprain 15 – 60 minutes 1 – 3 hours
Autoimmune Disorder 1 – 8 hours 1 – 2 weeks
Compartment Syndrome 15 – 60 minutes 1 – 3 hours

4. Combine CBD With Other Pain-Relief Measures

For best results, CBD shouldn’t be the only step you’re taking to alleviate pain. You should seek advice for other forms of pain management and use CBD products merely to supplement these other changes.

This could involve stretching or exercising, visiting a physiotherapist, eliminating potential pain triggers, and eating a well-balanced diet.

5. Check the Potency of the Products You’re Using

When it comes to using CBD for pain and inflammation — not all products are created equal.

There are plenty of CBD products out there, but not all of them are going to provide a strong enough dose of CBD for the desired effects.

If you try and use a low-potency CBD oil for a high dose — you’re going to need to take half the bottle for a single dose. it’s much more cost-effective to order a high-potency oil instead that allows you to get the desired dose with just a few drops, or a few millilitres of oil.

What Potency Should I Buy?
Product Types Recommended Minimum Potency
CBD Oils 33 mg/mL
CBD Topicals 8 mg/mL
CBD Capsules 15 mg/mL
CBD Vape Oils 10 mg/mL

6. Read The Ingredient list

As with many of the other uses of CBD, it’s best to find products formulated with other ingredients to make the effects even stronger.

CBD is great, there’s no question about it, but we can make it even better by combining the compound with other beneficial ingredients that can help reduce pain, ease muscle tension, and speed healing.

The best formula will vary a lot depending on the cause of the pain.

Other painkilling ingredients to look for in CBD products:

  • Turmeric (Curcuma longa)
  • Boswellia (Boswellia serrata)
  • Magnesium
  • L-Glucosamine
  • Kava kava (Piper methysticum)

What is Pain? What Causes It?

The human body is filled with sensors designed to sense damage — called the nociceptors.

Whenever nociceptors detect damage, they transmit signals to the brain that we perceive as pain.

The system warns us when we’re in danger and reminds us to be careful around injured areas of the body to allow for recovery.

In most cases, pain is a good thing. Without it, we could easily cause irreversible damage to the body without even knowing it.

The problem with pain is that sometimes the signals sent by the nociceptors are unnecessary (no real damage is occurring), excessive (signals are much higher than they need to be), or go on for too long.

It’s under these circumstances that want to block out pain so that we may go about our daily life more comfortably.

While pain can be described according to its qualities, such as sharp or dull, hot or cold, tingling, numb, etc. for treatment purposes pain is often divided into two categories, according to its cause.

Examples of different types of pain:

  1. Inflammatory pain — pain caused as a side effect of inflammation
  2. Muscle Pain — pain in the muscles, usually experienced after exercise
  3. Chronic Pain — pain that persists longer than 4 weeks
  4. Acute Pain — pain that has been present for 4 weeks or less
  5. Bone Pain — pain in the bones
  6. Soft Tissue Pain — pain in soft tissues such as muscles and ligaments
  7. Nerve Pain — pain originating from nerve damage or dysfunction
  8. Referred Pain — pain felt in areas away from the site of injury
  9. Phantom Pain — pain in a limb or organ that has been removed
  10. Psychosomatic Pain — pain originating from psychological dysfunction
  11. Breakthrough pain — chronic or acute pain that appears between scheduled medication use
  12. Cancer pain — pain caused by cancerous tumor formation
  13. PMS pain — pain from cramping caused during menstruation

Pain Transmission: How It Works

Step 1: Painful Stimulus — The Cause of Pain

This is the cause of the pain. Special receptors in the skin and internal organs are activated whenever there’s damage in the area. They initiate the transmission of the pain signal towards the brain using the peripheral nerves.

Step 2: Pain Signal Travels to Dorsal Horn in the Spinal Cord

The peripheral nervous system meets the spinal cord — the start of the central nervous system. The pain signal must pass through a region called the dorsal horn. This is the region where compounds such as endorphins and opiate medications are used to limit the intensity of the signal.

Step 3: Pain Signals are Sent to the Brain

Any pain signals that make it past the dorsal horn make their way to the thalamus in the brain where it’s processed and sent to higher brain regions. It’s these higher brain regions that perceive the pain.

How Neurological Disorders Can Increase Pain

When pain persists and becomes chronic the interpretive mechanisms in your brain can go awry — leading to hypersensitization, amplification of pain messages, and worsening of chronic pain symptoms [6].

Referred to as maladaptive pathological changes [7] this process can cause physical changes in your brain, evidence of which has been demonstrated on neuroimaging studies showing reduced connectivity between areas of the brain and spinal cord where pain messages are processed [6].

This essentially means the more pain you feel, the easier it is to feel pain again, i.e., the threshold is lowered, so small triggers can lead to inappropriate pain responses.

Impaired nervous system communication reduces your body’s ability to interpret and respond to pain appropriately, resulting in increased activity of the inflammatory cascade. This shows up on laboratory tests as elevated levels of pro-inflammatory signaling molecules and decreased levels of pain-inhibiting molecules like IL-10 [6].

These changes are most evident in neuropathic pain syndromes but have also been found to occur in chronic inflammatory conditions. In these types of conditions, pain can persist even after inflammation has been brought under control [7].

How Anxiety & Depression Make Pain Worse

Pain, anxiety, and depression are intricately intertwined — they often occur together.

While it’s easy to see how chronic inflammatory or neuropathic pain can lead to anxiety and depression, the reverse can also occur. These negative emotional states can cause physiological changes in the brain and body that promote pain.

This makes managing pain much more complicated because now there’s also an emotional aspect to consider.

Anxiety & Pain: Fanning the Flame

Chronic pain sufferers often become anxious about their condition. Once anxiety sets in it activates the stress response resulting in elevated levels of stress chemicals — notably cortisol and pro-inflammatory cytokines.

Studies show these stress chemicals may cause pain-processing areas of the brain and spinal cord to become hypersensitive to pain messages — a condition known as anxiety-induced hyperalgesia [24].

This essentially means when we’re stressed we experience more inflammation and feel more pain.

Depression & Pain: A Self-Perpetuating Cycle

The relationship between depression and chronic pain may be mutually reinforcing.

Chronic pain can cause depression by inhibiting secretion of dopamine [25], a neurotransmitter responsible for feelings of reward and accomplishment — such as when you perform well in school or at work, or successfully complete a marathon (or a 5K).

Conversely, depression, i.e. low dopamine, has been found to suppress activity in certain areas of the brain that inhibit pain messages, resulting in heightened pain perception [26].

To boil it down, pain causes depression by lowering dopamine levels — and low dopamine causes pain by suppressing areas of the brain responsible for controlling pain.

How CBD May Help With Anxiety & Depression

There’s promising evidence that CBD offers benefits for treating complex pain syndromes involving anxiety and depression.

A large clinical study of psychiatric patients with anxiety and sleep disorders found that anxiety decreased and sleep quality improved significantly within the first month of CBD supplementation [27].

CBD has also been shown to decrease symptoms of depression in laboratory animal studies [28].

However, there’s still much to learn about the complex cause-effect relationship between pain, anxiety, and depression and CBD may prove helpful for some people, in this regard, but less so for others.

Key Takeaways: Is CBD Effective for Pain?

CBD is an excellent option for people suffering from the pain of various causes.

It’s especially useful for addressing pain brought on by inflammation, autoimunity, or arthritis.

CBD works at virtually all stages of pain transmission — directly at the site of injury, in the dorsal horn where the opioid receptors are found, and in the brain at the opioid and vanilloid receptors in the brain.

Most of the research involving CBD for pain management suggests a dose-dependent effect — meaning that the higher the dose you take, the more it inhibits pain sensations.

For best results, it’s recommended that you find a high-quality CBD oil made with full-spectrum hemp extract and a relatively high potency of active CBD (at least 1000 mg per bottle). Combine CBD use with other pain-reducing activities or supplements for even greater benefit.


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