How Does CBD Work for Pain Relief and Which Is The Best Topical CBD For Pain?

The best topical CBD for pain products don’t just mask pain or inflammation as some over-the-counter topical pain relief creams do. This happens because CBDs are known to block chronic pain receptors on the skin. Cannabinoid receptors are part of the body’s endocannabinoid system, a body-wide system discovered in the 1990s that affects many important functions.

We have cannabinoid receptors throughout our body and, so far, researchers have identified two major types: CB1 (found primarily in the central nervous system, including parts of the brain and spinal cord) and CB2 (found mainly in immune system tissues). Interestingly, both have been found in the skin.

CBD seems to modulate and somewhat block the effects of CB1 and CB2 receptors.

Why does the body have receptors for compounds in cannabis? Well, it doesn’t exactly. CBD compounds are similar enough to compounds that our body naturally makes, called endocannabinoids, that they can interact with this system. Normally, the endocannabinoid system is thought to play a role in a variety of functions in the body, helping to regulate things like parts of the immune system, the release of hormones, metabolism, and memory.

Here’s what the research says about using CBD for pain.

The most common medical reason for which people report using CBD is to manage chronic pain, followed closely by managing arthritis or joint pain. But does it actually work?

When the National Academies of Sciences, Medicine, and Engineering evaluated decades of cannabis research, they concluded that “in adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.”

The most compelling research they found for using cannabinoids for pain came from a large review and meta-analysis published in JAMA in 2015. For the study, researchers looked at results from 79 previous studies of cannabinoids and various medical conditions, including chronic pain. However, of those studies, only four involved CBD (without THC)—none of which were looking at pain. So although we might assume that CBD is doing something to help address pain—according to the studies involving the whole cannabis plant—we don’t have great evidence to prove it.

“It might be that cannabidiol by itself is helpful for pain, but at this point, we don’t know that,” Cooper says.

The studies we do have about CBD for pain are all animal studies. For example, in a 2017 study published in Pain, researchers gave rats an injection into one of their knee joints to model osteoarthritis. Rats then either received doses of CBD or saline directly into an artery in the knee joint. Results showed that, after receiving CBD, rats showed less inflammation in the joint area and fewer pain-related behaviors (like shaking or withdrawing the affected paw or not being able to bear weight in that paw) compared to those that received saline.

Another study published in 2016 in the European Journal of Pain also looked at arthritis in rats but did so with a topical formulation of CBD. After the rats received an injection into one knee joint to model arthritis, they received a gel that contained either 10 percent CBD (in four different total amounts) or 1 percent CBD (the control) on four consecutive days. The gel was massaged into the rats’ shaved backs for 30 seconds each time.

Then the researchers measured the inflammation in each rat’s knee joint, the level of CBD that made it into their bloodstream, and their pain-related behaviors. They found that the rats that were given the two highest doses of CBD showed significantly lower levels of inflammation and lower pain behavior scores compared to those that got the control. The two lower doses didn’t show much of an effect.

But if you’re reading this, you are probably not a rat, which means these results aren’t directly applicable to your life. Although we know that rats do share much of our physiology—including CB1 and CB2 receptors—these studies don’t really tell us if humans would have the same results with CBD.

“There’s really no substitute for doing proper human studies, which are difficult, expensive, and ethically complicated,” Dr. Tishler says. And we simply don’t have them for CBD and pain.

Consider this before you buy a topical CBD for pain product:

The first thing to be aware of is the amount of CBD that a product claims to contain. Because the studies we have about CBD and pain all looked at systemic administration rather than truly local, we don’t really know what the correct dose would be when applied locally. It’s tempting to go for the highest amount you can find, but it’s really up to you since we don’t even know where to start.

It’s also important to remember that, although generally benign, side effects have been reported with some forms of CBD. For instance, oral CBD taken in large amounts that have shown some limited promise in helping with anxiety issues may come with side effects, such as diarrhea, reduced appetite, fatigue, and interactions with other drugs you might be taking, specifically blood thinners, Cooper says.

But some studies have found essentially zero side effects of high-dose CBD (900mg) and those that researchers do see—like drug interactions—aren’t considered to be issues when CBD is used topically.

If you’re worried about a purely topical CBD product getting into your bloodstream, Dr. Tishler explains that’s unlikely. CBD is hydrophobic (meaning it isn’t water-soluble) and lipophilic (attracted to lipids, like oils) and tends to stay on the outer layer of skin or possibly accumulate in the sebaceous glands unless it’s paired with “enhancers” (ingredients designed to help them make it through the skin, at which point they would instead be transdermal). Making a truly “water-soluble CBD” has been a challenge for the industry, although there are a variety of patents out there.

That said, we don’t always know exactly what’s in the CBD products out there due to a lack of regulation. Until recently, CBD was regulated as a Schedule 1 substance, meaning that the federal government believed it had a high potential for abuse and no accepted medical value. But the FDA approval of Epidiolex last year and the passage of the Farm Bill in December 2018 changed things by lifting the federal ban on commercial hemp production (hemp also contains CBD in lower amounts than cannabis). But it also made things more confusing because we’re still waiting on actual CBD regulations from the FDA. In the meantime, companies are treating hemp-derived CBD as if it’s perfectly legal, Dr. Tishler says.

The lack of regulation has also left the door open for products to be subject to both “contamination and adulteration,” Dr. Tishler says. One study, published in JAMA in 2017, found that almost 70 percent of CBD products—including vape cartridges, tinctures, and oils—sold online did not contain the things they claimed to in the right amounts. That’s why Boehnke recommends only buying CBD products that you can verify (via a certificate of analysis) do contain what they’re supposed to. And Boenhke offers the same advice he does for all cannabinoid products: Start at a low dose and if you decide to increase it, go slowly. (Start low, go slow.)

Ultimately, though, I still love my CBD creams and don’t plan on abandoning them any time soon (I also love my bottle of ibuprofen, for the record). But if you’re interested in turning to CBD to manage serious pain, it’s probably worth talking to your doctor about all of your options first.

Look on the label and determine the TYPE of CBD being offered – isolate or full-spectrum? This is important to know because isolates typically need to be administered in much higher doses to be effective whereas full-spectrum CBD is commonly more beneficial and more immediately effective at much lower doses.

Get The Best Topical CBD For Pain:

Top Quality CBD Creams for Pain Relief – Proudly Made In The USA

Further Resources:

Top Quality CBD Products You Can Trust – Proudly Made In The USA

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For More CBD News & Tips:

Benefits of CBD Oil – 12 Amazing Health Benefits of CBD Oil!

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THC vs CBD: What’s The Difference?

Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and may be inaccurately labeled.

The information contained on this website is presented for the purpose of educating people about cannabis. Nothing contained on this website should be construed nor is intended to be used for medical diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified health care provider.

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