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Does CBD oil work for chronic pain management?

Many people use cannabidiol (CBD) to relieve pain. Understanding CBD can help overcome the stigma associated with it.

Benefits and pain relief

According to the National Centers for Complementary and Integrative Health (NCCIH), some evidence suggests that cannabis or CBD could have modest benefits for chronic pain.

While CBD is a promising option for pain relief, research has not yet proven it safe and effective, and the Food and Drug Administration (FDA) have not approved CBD for treating pain.

A 2020 review reports that CBD could have benefits for relieving chronic pain, improving sleep, and reducing inflammation, but that these effects are condition-specific.

More evidence is needed to determine the therapeutic potential of CBD and to determine safe and effective dosages for pain.

Based on the current research, here are some possible benefits of CBD oil:

Neuropathic pain

Neuropathic pain is pain caused by damage to the nerves. This type of pain is common in diseases such as multiple sclerosis, injuries such as herniated discs, and infections such as shingles.

A 2017 review found that CBD helped with chronic neuropathy pain in humans. The researchers looked at 11 randomized controlled trials with 1,219 patients.

However, a 2018 Cochrane review concluded that the potential benefits of cannabis-based medicine might be outweighed by its potential harms.

This research looked into the effects of cannabis-derived medicines, including CBD, for chronic neuropathic pain. It looked at 16 studies and 1,750 participants.

More research is needed to understand the role of CBD in chronic neuropathic pain management, including the risks, benefits, and ideal dosages.

Arthritis pain

A 2016 study in the European Journal of Pain used an animal model to see if CBD could help people with arthritis manage their pain. Researchers applied a topical gel containing CBD to rats with arthritis for 4 days.

Their researchers noted a significant drop in inflammation and signs of pain, without additional side effects.

People using CBD oil for arthritis may find relief from their pain, but more human studies need to be done to confirm these findings.


Multiple sclerosis

Multiple sclerosis (MS) is an autoimmune condition that affects the entire body through the nerves and brain.

Muscle spasms are one of the most common symptoms of MS. These spasms can be so strong they cause constant pain in some people.

One report found that short-term use of CBD oil could reduce the levels of muscle spasms a person feels. The results are modest, but many people reported a reduction in symptoms. More studies on humans are needed to verify these results.

Chronic pain

The same report studied CBD use for general chronic pain. Researchers compiled the results of multiple systematic reviews covering dozens of trials and studies. Their research concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults.

A separate study in the Journal of Experimental Medicine supports these results. This research suggests that using CBD can reduce pain and inflammation.

The researchers also found that subjects were not likely to build up a tolerance to the effects of CBD, so they would not need to increase their dose over time.

They noted that cannabinoids, such as CBD, could offer helpful new treatments for people with chronic pain.

Other uses CBD currently has a range of applications and promising possibilities. These include:

  • helping people quit smoking

  • managing drug withdrawal

  • treating seizures and epilepsy

  • treating anxiety

  • reducing some effects of Alzheimer’s disease

  • reducing antipsychotic effects for people with schizophrenia

  • potentially combating type 1 diabetes and cancer in the future

Although more research is required to confirm the benefits of CBD oil, it is shaping up as a potentially promising and versatile treatment. The Food and Drug Administration (FDA) have approved one form of CBD, called Epidiolex, to treat two rare forms of epilepsy and to treat seizures caused by a rare condition called tuberous sclerosis complex. More generally, marijuana-derived CBD products are not yet legal at the federal level but are legal under the laws of some states. People should check their state’s laws and those of any place they intend to travel. They must keep in mind that the FDA do not approve or regulate nonprescription CBD products. As a result, labeling may be inaccurate.

Dosage The FDA does not regulate CBD for most conditions. As a result, dosages are currently open to interpretation, and people should treat them with caution. Anyone who wishes to use CBD should first speak to a doctor about whether it will be beneficial or safe, and how much to take. The FDA has approved a purified form of CBD for some types of epilepsy, with the brand name Epidiolex. People using this medication should follow the doctor’s advice about doses.

Side effects Most people tolerate CBD oil well, but there are some possible side effects. According to a 2017 review in Cannabis and Cannabinoid Research, the most common side effects include:

  • fatigue

  • diarrhea

  • changes in appetite

  • weight gain or weight loss

In addition, using CBD oil with other medications may make those medications more or less effective. The review also notes that scientists have yet to study some aspects of CBD, such as its long-term effects on hormones. Further long-term studies will be helpful in determining any side effects CBD has on the body over time. Consult a doctor before using CBD, as it may interact with certain over-the-counter dietary supplements and medicines, as well as some prescription medications — especially those that warn against consuming grapefruit. CBD might also interfere with an enzyme called cytochrome P450 complex. This disruption could affect the liver’s ability to break down toxins, increasing the risk of liver toxicity. The patient information leaflet for Epidiolex cautions that there is a risk of liver damage, lethargy, and possibly depression and thoughts of suicide, but these potential side effects are true of other treatments for epilepsy, too. One study in Frontiers in Pharmacology, suggested cannabinoids’ anti-inflammatory effect may reduce inflammation too much. A large reduction in inflammation could diminish the lungs’ defense system, increasing the risk of infection.

Other considerations Almost all research on CBD oil and pain comes from adult trials. Experts do not recommend CBD oil for use in children, as there is little research on the effects of CBD oil on a child’s developing brain. However, people may use Epidiolex for children ages 2 and above who have rare forms of epilepsy. People should not use CBD oil when pregnant or breastfeeding. People should use caution when taking CBD products by mouth alongside high-fat meals. High-fat meals can dramatically increase the blood concentrations of CBD, which can increase the risk of side effects. The FDA does not regulate CBD products in the same way they regulate drugs or dietary supplements, so companies sometimes mislabel or misrepresent their products. That means it’s especially important to do some research and find a quality product.

Summary While many studies have suggested CBD oil is helpful for pain, more research is necessary, especially long-term studies with human subjects. However, CBD oil does show promise as a treatment for pain. Some scientific and anecdotal evidence suggests that it can help people manage chronic pain in various contexts. CBD oil is especially promising due to its lack of intoxicating effects and a possible lower potential for side effects than many other pain medications. People should discuss CBD oil with their doctor if they are considering using it for the first time.

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