Can CBD Help with Pain Management?

By: Caroline Donsbach, OTD, OTR/L

What is CBD?

CBD, or cannabidiol, is a non-intoxicating cannabinoid product derived from hemp or cannabis plants. Unlike its more controversial counterpart THC, which causes the euphoric “high” experienced with recreational cannabis use, CBD is becoming associated with a variety of health benefits.

While research is still ongoing, studies suggest that the medical benefits of CBD are wide and can be used for many conditions, including sleep disorders, chronic stress, inflammation, pain relief, and much more.

CBD has become increasingly available commercially over the last few years following its legalization on the federal level with the passage of the 2018 Farm Bill. It should be noted that the quality of these products can vary as most are not regulated by the FDA and are currently most often used outside of the supervision of a physician.

CBD for Pain Management

Many factors make CBD an attractive and potentially promising alternative to traditional pain medications. These include its natural source, numerous potential uses, decreased risk of dependency and addiction, and its relative safety to name a few. Evidence suggests that CBD may have multiple avenues for alleviating pain, including modulating receptor signals, disrupting descending pain signal transmission, and anti-inflammatory properties, among others. CBD has added appeal over traditional narcotic-level pain relievers due to its decreased impact on respiratory function as compared to opioids. In addition, studies indicate that CBD may be beneficial for a variety of types of pain in a variety of patient populations.

While evidence is promising, well-controlled research into the use of medical CBD for pain management is still lacking. Further clinical trials are needed to determine effectiveness and safety across patient populations. For this reason, the FDA has yet to approve any CBD products for pain management specifically.

What Are the Risks of Using CBD?

Current studies indicate that medical CBD has, so far, exhibited few non-serious adverse effects including, but potentially not limited to: sedation, headaches, dry mouth, dry throat, fatigue, dizziness, diarrhea, and nausea; however, more research is needed to explore any potential long-term health effects as well as the impact of medical CBD on other drug interactions.

Currently, regulation of CBD products is lacking in most countries, including the United States. Care should be taken when purchasing CBD products as discrepancies have been noted in the labeling of purity and dosage.

How Can I Take CBD?

Method

Absorption Time

Risk Factors

By mouth – capsules, food, liquid

Absorbed via digestive tract;

Slow absorption (1-3 hours)

Tricky to dose, impacted by meals, unknown effects on stomach acid and GI tract

Sublinguals (under the tongue), tinctures, sprays

Absorbed via bloodstream by dissolving under the tongue or in the mouth;

Quick absorption (15-45 minutes)

Unknown

Topical – creams and lotions

Further research is needed

Unknown if CBD is actually delivered through the skin

Inhalation – vaporizing pens

Quick absorption (15-45 minutes)

Unknown risk on lung health, potential for other chemical by-products in oils

How Much CBD Should I Take?

Unfortunately, there are currently no quality studies that have evaluated the dosage range of CBD for pain management.

Key Takeaways:

  • Medical CBD may have wide-ranging health benefits.
  • CBD will not make you feel “high” in the way THC does because it’s a non-intoxicant.
  • Well-controlled studies investigating the effects of CBD on pain are lacking. While promising in many areas, current evidence is mixed at best. Further clinical trials are needed in order to create safe usage and prescription guidelines for the use of CBD for pain management.
  • Due to the lack of FDA regulation, care should be taken to ensure the quality of commercially available CBD products.
  • Consult your physician before trying medical CBD-based products for pain management.

If you are seeking other methods of pain management, physical therapy can be helpful. To schedule an evaluation with one of our physical therapists, contact us online or call (804) 764-1000.

Resources:

Biomedicines | Free Full-Text | Tetrahydrocannabinol and Cannabidiol for Pain Treatment—An Update on the Evidence (mdpi.com)

Cannabidiol as a Treatment for Chronic Pain: A Survey of Patients’ Perspectives and Attitudes – PMC (nih.gov)

Cannabinoids and Pain: New Insights From Old Molecules – PMC (nih.gov)

CBD for Arthritis Pain | Arthritis Foundation

CBD: Safe and effective? – Mayo Clinic

CBD vs THC: What’s the Difference? – CFAH

Effectiveness of Cannabidiol to Manage Chronic Pain: A Systematic Review (sciencedirectassets.com)

Efficacy, Safety, and Regulation of Cannabidiol on Chronic Pain: A Systematic Review – PMC (nih.gov)

JPR_A_278718 1241..1250 (nih.gov)

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