Evidence based

CBD and Neuropathic Pain: Current Research & Understanding

Neuropathic pain is notoriously difficult to treat, with only 40% to 60% of patients able to find partial relief from their symptoms with conventional treatments. CBD has been shown to offer broad benefits for neuropathic pain in a number of different ways.

Article By
Justin Cooke , posted 1 month ago

The human body is full of sensors leading to the brain. They sense temperature, touch, and tissue damage, and relay that information back to the brain for processing.

Neuropathic pain can be the result of damage to the nerves or pain sensors.

There aren’t many effective treatments for neuropathic pain outside of heavy pharmaceutical painkillers — which can have nasty side-effects and can be highly addictive. This type of pain is notoriously difficult to treat — with only 40% to 60% of those affected achieving partial relief from their symptoms [1].

CBD has recently become a popular treatment for neuropathic pain because it works similarly to pharmaceutical pain-killers but isn’t considered addictive and has little to no side-effects in standard doses.

We’ll go over what makes CBD so useful for treating neuropathic pain, how to use it effectively, and what other measures you can do to get the best chances of finding relief from your pain.

So, without further ado, let’s get into it.

  • Table of Contents

Summary: Using CBD for Neuropathic Pain

CBD and other cannabinoids offer relief from various causes of neuropathic pain in humans [2, 3].

Although research is still needed to fully understand how CBD is useful for neuropathic pain, there are well-known links between this compound and the health of the nerve cells.

For starters, CBD interacts primarily with the endocannabinoid system — the series of receptors and eicosanoids (called endocannabinoids) that regulate homeostasis throughout the body. There are endocannabinoid receptors found on virtually every organ in the human body, with the highest concentration in the central nervous system.

The endocannabinoid system functions like “read receipts” used in text messages.

When the nerves send a message, the receiving nerve cell uses the endocannabinoid system to tell the sending nerve that the message was received. This system keeps the entire nervous system in constant feedback with itself and prevents sending the same message more than once — which is exactly what’s going on with neuropathic pain.

CBD strengthens the endocannabinoid system by preventing the main endocannabinoid compounds from breaking down too quickly. This makes the endocannabinoid system more effective, lowering the chances of sending false pain signals to the brain.

Other benefits include direct blockage of pain through the vanilloid pain receptors [4], as well as support for related symptoms such as depression, inflammation, and anxiety.

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.

There are a few types of neuropathic pain depending on which nerves are affected.

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:

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:

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

Causes of Neuropathic 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)

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 and 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.

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.

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.

Nevertheless, here are some general dosing guidelines for people who aren’t sure where to start.

Calculating CBD Dosage Strengths by Weight

Unit of MeasureLow StrengthMedium StrengthHigh Strength
Imperial (Pounds)1 mg for every 10 lbs3 mg for every 10 lbs6 mg for every 10 lbs
Metric (Kilograms)1 mg for every 4.5 kg3 mg for every 4.5 kg6 mg for every 4.5 kg

Using these general guidelines, you can determine roughly what dose you can expect to need to get the level of support you’re looking for.

It’s important to note that these are simply recommendations, and your dose may vary — a lot. It’s not uncommon for people using CBD for neuropathic pain to be taking doses as high as 600 mg per day.

Daily Doses of CBD by Weight and Strength (in mg)

Weight (lbs)Low StrengthMedium StrengthHigh Strength

100 lbs

10 mg

30 mg

60 mg

125 lbs

13 mg

38 mg

75 mg

150 lbs

15 mg

45 mg

90 mg

175 lbs

17 mg

52 mg

105

200 lbs

20 mg

60 mg

120 mg

225 lbs

22 mg

67 mg

135 mg

250 lbs

25 mg

75 mg

150 mg

Potential 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

Final Verdict: Using CBD 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 remains 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.


References

  1. Dworkin, R. H., O’connor, A. B., Backonja, M., Farrar, J. T., Finnerup, N. B., Jensen, T. S., … & Portenoy, R. K. (2007). Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain, 132(3), 237-251.
  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.

Conditions that May Respond to Cannabidiol