CBD Oil for Pain

Current pain medications have limitations, especially in cases where the pain is unresponsive to treatment. Safe and tolerable alternative pain relief options are sorely needed. Expanding research into CBD oil for pain as an adjunct therapy could help fill that gap, solidifying assistance with pain relief as one of the benefits of CBD oil.

 

The majority of medical cannabis prescriptions relate to chronic pain, with a large portion of those prescriptions being CBD-only medicines. Having easeful and affordable access to legal low-dose CBD may reduce the burden on healthcare providers and help Aussies who need relief from chronic pain. 

 

Does CBD oil work for chronic pain?

The cannabis plant has been used to help manage pain since ancient times; now modern research confirms CBD and other parts of the cannabis plant can have pain-relieving actions.

 

CBD was first isolated in the 1940s, and since then, research assessing its analgesic qualities has spanned from the petri dish to humans.

 

We now know that CBD not only eases pain but has complementary anti-inflammatory and antioxidant activity. Both of these therapeutic actions add to the analgesic qualities of CBD by directly or indirectly reducing pain severity.

How does CBD oil work for chronic pain?

CBD interacts with numerous receptors in the human body, many of which have the potential to reduce pain, inflammation and potentially mitigate the deterioration of nerve damage that perpetuates chronic pain. 

Chronic pain and the endocannabinoid system

Part of CBD’s pain-reducing prowess is through its influence on the endocannabinoid system. This eccentric system has an impact on pretty much every aspect of your life – from your mood and sleep to appetite and pain sensation.

 

The endocannabinoid system activates or inhibits sensations and perception of pain through chemical signals in the spinal cord and nervous system. The ability of CBD to influence endocannabinoids, neurotransmitters and other signals in the body makes CBD a promising therapeutic to address or mediate chronic pain.

 

How CBD oil effects neuropathic pain

A range of medical conditions can damage nerve fibres and areas of the central nervous system leading to neuropathic pain. Burning, tingling, and sharp or shooting sensations are common neuropathic pain symptoms.

 

How CBD reduces neuropathic pain is still under investigation, yet from animal research we understand that CBD upregulates a key endocannabinoid known as anandamide (AEA). When anandamide levels are low, maladaptive processes in the nervous system can lead to hyperexcitability that increases pain and inflammation.

 

By increasing AEA levels with CBD oil treatment, it is possible to reduce the activation of pain receptors in the nervous system and modulate the signalling cascade that results in neuropathic pain. 

Does CBD help with inflammation and pain?

One prominent feature of inflammatory conditions are chemical molecules called cytokines. Proinflammatory cytokines are critical drivers of pain for things like osteoarthritis, rheumatoid arthritis, migraines or endometriosis.

 

Proinflammatory cytokines act as messengers upregulating inflammation, leading to a cascade of other inflammatory signals that create pain sensations. With its anti-inflammatory actions, CBD may be able to dampen the inflammatory response in some conditions.

Emerging research supports CBD oil for chronic pain

Chronic pain can be a part of the picture for countless diseases and medical conditions. Up until recently, THC has been the main cannabinoid associated with treating chronic pain, and now research is revealing the powerful potential of CBD oil for chronic pain as well. 

 

Neuropathic pain

Part of the challenge with studying medical cannabis or CBD oil is that much of the evidence is contradictory, with some research acknowledging CBD may help with neuropathic pain, whilst other reviews state that the evidence available is of low quality and more comprehensive studies are needed. 

 

The Australian Therapeutic Goods Administration (TGA) also states that evidence for CBD oil benefiting chronic non-cancer pain is limited and should not be used as a first-line treatment. Nonetheless, in Australia CBD can be approved for neuropathic pain with animal studies and early human trials supporting its use. 

 

For example, a 2020 study of 29 people showed topical CBD oil significantly reduced chronic neuropathic pain in the feet and legs when compared to a placebo. Substantial reductions were reported in the intensity of pain, particularly sharp pain, itchy and cold sensations.

 

Inflammation and Arthritis

In animal studies, oral CBD oil decreased pain measures, swelling and inflammatory cytokines. This research also found a better response when CBD was given with terpenes and other cannabis plant compounds rather than as CBD isolate. 

 

In terms of arthritis pain, animal studies show when given in the early phase of osteoarthritis CBD reduces pain and inhibits nerve damage as the disease progresses. Conversely, a recent human study showed little difference between CBD and a placebo. However, this could be due to the dose (only 30mg/d) compared to the severity of pain.

 

Cancer pain

Much of the research on cannabinoids and cancer pain includes CBD and THC medications. However, some early evidence is beginning to support CBD-only or CBD-dominant therapies in the management of cancer pain. 

 

Certainly, anecdotes abound regarding CBD for reducing cancer pain and other symptoms such as anxiety and sleep disturbances. To assess this in the clinical setting, a 2020 study evaluated different ratios of medical cannabis in relation to cancer pain and palliative care. 

 

The study found that cancer patients in the THC-dominant and CBD-dominant groups showed significant improvements in pain intensity, as well as physical and psychological distress measures. 

 

Cancer pain may be a circumstance where cannabinoid therapies could provide benefit when other treatments have failed, but more research is needed to cement CBD oil as an effective treatment in managing cancer-related pain.

 

Fortunately, a number of Australian research projects are underway to assess the effect of CBD oil on cancer pain – stay tuned!

Reducing polypharmacy and addictive pain medication

Limited evidence exists surrounding CBD reducing the need for other medications, however, some small studies show promising outcomes. 

 

In a study of 97 chronic pain patients who were taking opioid medications to manage their pain, CBD oil was given in capsules. After 8 weeks of CBD treatment significantly reduced pain.

 

The authors of this study concluded “that using CBD for chronic pain in patients using opioids has a significant effect on reducing opioid intake, reducing pain and improving quality of life. Over half of the participants who added CBD hemp extract reduced or eliminated opioids over the course of 8 weeks”.

 

Other painful conditions 

You’ve probably heard it before, but it’s important to understand that in the medical cannabis arena scientific research lags behind the anecdotes of individuals and even the practical experience of medical professionals. 

 

So when it comes to other chronic painful conditions such as endometriosis, chronic back pain or migraines, CBD oil may be helpful – but we are yet to have the research to back up such claims. 

 

Australian surveys of women with endometriosis report that many self-manage their chronic pain with cannabis. Research reveals that the mechanisms of action behind CBD are likely to benefit people with endometriosis – as yet, quality human trials have not confirmed this.

 

Similarly, the use of CBD oil for chronic back pain, headaches or migraines, as well as painful conditions like temporomandibular disorders, has been widely discussed amongst patients and clinicians. Again, we will have to wait for well-designed clinical trials to confirm if CBD will be beneficial in these painful conditions.

 

How does CBD compare to other pain medications?

Early research suggests CBD could offer an alternative to commonly used pain medications where its anti-inflammatory and analgesic actions showed comparable benefits in physical pain and inflammatory cytokines measures.

 

NSAIDs such as ibuprofen or opioid medications are commonly used to manage chronic pain. When taken according to the instructions and medical guidance they can be safe and effective ways to reduce pain. 

 

Unfortunately, these medications still have known and very real risks. Addiction and over-use of opioids continues to have devastating effects in our communities.

 

And, that ibuprofen in the bathroom cabinet may seem timid, but there are serious concerns surrounding increased risk for cardiovascular diseases, stomach ulcers and gastrointestinal bleeding.

 

Given that more than 12% of Australians exceed the maximum daily dose for over-the-counter pain medications or are unaware of the side effects, cautions or contraindications, it is clear that safe and effective alternatives are needed.

 

While CBD research is limited in some areas, study after study concludes it has a good safety profile and is generally well-tolerated. This makes low-dose CBD oil a plausible plant-based alternative to current pharmaceutical medicines for mild chronic pain.

 

Does CBD eliminate pain?

CBD may help reduce chronic pain for many individuals, but research is still emerging about exactly how it works, and in what conditions CBD will relieve pain. Just like any medication, CBD is not suitable for everyone.

 

CBD may provide the human body with more than a handful of health benefits, but each human body is unique; therefore CBD may not reduce or eliminate pain for all individuals. So it is important to discuss with your regular GP or our team at CA Connect to see if CBD might be appropriate for you.

Medical cannabis for chronic pain

CBD oil is not suitable for everyone. For more severe pain or complicated conditions requiring additional management by a physician, other forms of medical cannabis may be a viable option. Medical cannabis prescription can include CBD, THC or a combination of both and can be in higher doses than the maximum low-dose CBD amount of 150mg/day.

 

Medicinal cannabis or higher doses of CBD may be beneficial for other conditions such as multiple sclerosis, cancer pain, fibromyalgia, endometriosis, migraines or neuropathic pain. For more details on how medical cannabis can assist with relieving painful conditions as an adjunct therapy, speak with the team at CA Clinics.

 

How to access low-dose CBD oil for pain

Our simple online and phone consultation process offers a streamlined approach to access low-dose CBD oil, if you are eligible, under the guidance of a pharmacist and healthcare practitioner. 

 

If you are experiencing chronic pain, see if you are eligible to access low-dose CBD oil here or find out more about CA Connect treatment plans.

 

Jessica Kindynis BHSc Nat

Author

Jessica Kindynis BHSc Nat

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