Evidence based

CBD and Pain: Current Research & Understanding

Pain can be a drain on your quality of life. Here’s how CBD may be used to alleviate pain and help manage the common causes of chronic pain.

Article By
Justin Cooke , posted 1 month ago

Chronic pain is a debilitating problem for millions of people around the world. Even with significant advancements in pain medications, it can be difficult to alleviate pain effectively without the use of addictive medications.

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

Here’s an in-depth guide on how CBD is used to treat chronic and acute pain. We’ll go over how it works, how much to use, and why so many people go to this once controversial plant to improve their quality of life.

  • Table of Contents

Summary: Using CBD for Pain

The human body is wired to respond to danger through many clever mechanisms. Pain is the body’s vital response — warning the brain of damage to the body — signaling the avoidance of the cause to avoid further damage.

Unfortunately, when damage occurs, pain can persist for weeks or even months At this point, the pain signal is no longer helpful and can instead cause a serious decline in the quality of life.

CBD may support pain in the following ways:

  • Blocks pain transmission in the spinal cord and brain — through the vanilloid and opioid pain receptors
  • Reduces inflammation — one of the primary causes of pain in the human body
  • Alleviates common side-effects of pain — including insomnia, depression, and anxiety
  • Reduces the underlying causes of arthritis pain — one of the most common causes of pain
  • Fights cancer growth — thus reducing the pain caused by tumors as they increase in size

In most cases of chronic pain, high doses are required for relief — for this reason, a high-potency CBD oil will offer the greatest therapeutic benefits.  We’ve included a simple dosage chart in this article to help you get started.

For minor pain management from low-grade arthritis or minor traumatic injuries, a smaller dose may do the trick.

Tips to getting the most from your CBD for managing your pain:

  1. If the cause of the pain is unknown, always seek proper medical advice before managing the pain at home on your own
  2. If you are taking other pain medications, consult with your doctor before using CBD to avoid negative drug interactions
  3. Titrate your dose — start with a smaller dose and build up day by day until you receive the effects you’re looking for
  4. Combine CBD supplementation with other pain-killing activities such as physiotherapy, gentle exercise, or other herbs and supplements

Defining Pain

What is pain? Where does it come from?

The human body is filled with sensors designed specifically to sense damage or dysfunction — they’re 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 comfortable.

How Pain Works

The process of pain is complex and involves the interaction of many different cells, neurotransmitters, and specialized sensors. Here’s a basic overview of how this works.

Step 1: Painful Stimulus

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 We Classify Different Types of Pain

1. Acute Pain

Acute pain comes on suddenly. This is the type of pain we experience when we cut our finger or stub our toe. Acute pain is short-lived, but it can evolve into chronic pain if it persists for longer than 6 months.

2. Chronic Pain

Chronic pain is a 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.

3. Other Classifications of Pain

There are other ways of classifying pain, depending on the location:

  • Bone Pain — pain in the bones
  • Soft Tissue Pain — pain in soft tissues such as muscles and ligaments
  • Nerve Pain — pain originating from nerve damage or dysfunction
  • Referred Pain — pain felt in areas away from the site of injury
  • Phantom Pain — pain in a limb or organ that has been removed
  • Psychosomatic Pain — pain originating from psychological dysfunction
  • Breakthrough pain — chronic or acute pain that appears between scheduled medication use

Common Causes of Pain

  • Shingles virus (Varicella zoster)
  • Trigeminal Neuralgia
  • Diabetic peripheral neuropathy
  • Complex regional pain syndrome
  • Central pain syndrome
  • Fibromyalgia
  • Cancer
  • Arthritis
  • Traumatic injury
  • Spinal Cord Injury
  • Multiple sclerosis

Using CBD for Pain

CBD is an excellent pain-killer, but only if it’s taken in the right dose.

Most of the research on CBD for pain management involves high doses of the compound or a combination of CBD with other known painkillers.

1. CBD for Chronic Pain

There are many different causes of chronic pain — the main one being inflammation.

Inflammation is a complex chemical reaction in the human body designed to improve the recovery times of organ or tissue damage. This process is designed to eliminate infectious or harmful invaders within the body. Inflammation can sometimes reach a state of self-perpetuation. When this happens, inflammatory processes damage the tissue, which triggers more inflammation — perpetuating the cycle.

This can result in chronic pain lasting years.

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].

2. CBD for Arthritis Pain

There are two main types of arthritis; osteoarthritis and rheumatoid arthritis. Although both stem from different underlying causes, both result in chronic pain. It can cause anywhere from mild, sporadic pain to severe, debilitating levels of pain.

CBD reduces the pain involved with both forms of arthritis by blocking the inflammatory processes causing the problem and through analgesic effects acting in the spinal cord and brain.

For best results, it’s recommended to use CBD both internally and topically on the affected joints.

What Form of CBD Works Best For Pain?

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

1. CBD Oils & Tinctures

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.

To take CBD oils and tinctures, simply measure out the intended dose using the supplied dropper, and place under the tongue for fast onset of effects, or swallow for a slower onset of effects. 

A high potency CBD oil or tincture is recommended for most cases of pain management.

2. CBD Capsules

CBD capsules are another popular method of consuming CBD — they’re convenient, have a long duration of effects, and come in virtually any potency you may need.

3. Topical CBD Products

Topical CBD products are best for pain involving the muscles, ligaments, and skin. It delivers the cannabinoids directly to the source of the pain. The main issue with topical CBD products is that they often aren’t strong enough to produce analgesic effects.

Always look for high-potency topical CBD products for treating traumatic injuries, skin conditions, or muscle/ligament/bone injuries.

How Much CBD Should I Take?

Most of the research investigating the effects of CBD on pain management recommends high doses. Lower doses may offer some benefit but it isn’t always reliable.

Therefore, it’s best to use medium or high strength doses when treating pain conditions. For especially difficult to treat pain, significantly higher doses may be necessary. It’s also beneficial in these cases to use CBD alongside other pain-management techniques.

General Dosage Guidelines for Pain Conditions

Low Strength CBDMedium Strength CBDHigh Strength CBD
• Mild muscle pain
• Psychosomatic pain
• Early-stage arthritis
• Moderate muscle pain
• Bone fractures
• Abdominal pain
• Arthritis
• Multiple sclerosis
• ALS
• Ligament injuries
• Cancer pain
• Bone pain
• Severe muscle pain
• Arthritis

Calculating CBD Dosage Strengths by Weight

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

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

It’s important to note that these are simply recommendations, and your individual dose may vary — a lot.

Therefore these guidelines are designed to simply provide a rough estimate on the dose you need to help put things into context.

After determining the strength you’re likely to need, use your weight to calculate how much CBD you may need per day (in mg).

Remember, these doses are in pure CBD — you can use these numbers to figure out how much CBD oil, capsules, or edibles you should take to get the right amount of CBD.

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 mg

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 is 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 in one person doesn’t always work the same way for another.

Side-effects of CBD May Include:

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

Conclusion: 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 inflammatory processes but is also useful for general pain.

It 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 combine CBD use with other pain-reducing activities or supplements.


References

  1. Rubin, J. J. (2005). Psychosomatic pain: new insights and management strategies. Southern medical journal, 98(11), 1099-1111.
  2. Russo, E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245.
  3. Johnson, J. R., Burnell-Nugent, M., Lossignol, D., Ganae-Motan, E. D., Potts, R., & Fallon, M. T. (2010). Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. Journal of Pain and symptom management, 39(2), 167-179.
  4. Russo, E. B., Guy, G. W., & Robson, P. J. (2007). Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex®, a cannabis‐based medicine. Chemistry & biodiversity, 4(8), 1729-1743.
  5. Ware, M. A., Wang, T., Shapiro, S., Robinson, A., Ducruet, T., Huynh, T., … & Collet, J. P. (2010). Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. Canadian Medical Association Journal, 182(14), E694-E701.

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