CBD for Pain Control

How does CBD for pain control work?

This natural compound extracted from the Cannabis sativa plant will not get you high, since it does not produce the same psychotropic effects as its cannabinoid sibling, tetrahydrocannabinol (THC), but many people are finding that it can complement their pain care plan.

In fact, research shows that of the 62% of people who use CBD for a medical condition, the majority are treating chronic pain, arthritis, and joint pain, as well as anxiety. [1]

What’s more, CBD has minimal side effects and a low-risk, zero-addiction profile.

CBD has been shown to be:

• anti-inflammatory, meaning it has the potential to reduce joint pain associated with arthritis

• anti-oxidative, so it may reduce systematic inflammation by fighting oxidative stress and decrease symptoms of autoimmune conditions like lupus

• anti-emetic, meaning it can decrease vomiting and nausea associated with cancer treatments

• anti-psychotic, so it can ease symptoms of anxiety and post-traumatic stress disorder (PTSD)

• neuroprotective, meaning it may help to slow the progression of neurological disorders such as Multiple Sclerosis (MS). [2]

THE SCIENCE BEHIND CBD: HOW IT WORKS FOR PAIN AND PAIN-RELATED SYMPTOMS

Your Natural Endocannabinoid System Supports CBD

Our body’s endocannabinoid system is composed of three main components:

1. Cannabinoid receptors, namely CB1 and CB2. CB1 receptors are predominantly found in the central nervous system (CNS, the nerves attached along the spinal cord and around the brain) and are largely responsible for the cognitive and emotional effects of marijuana, as well as our perception of pain. CB2 receptors are more common in our peripheral nervous system (PNS, the outer nerves beyond the spinal cord and brain such as those in your arms and legs, although these receptors may also be found in our CNS) and in your immune cells.

2. Endogenous cannabinoids (the cannabinoids that your body produces)

3. Enzymes that facilitate the breakdown and use of cannabinoids 

Our natural endocannabinoids function on-demand, meaning that when our body senses inflammation or needs to return to homeostasis (a state of stable balance) it will release endocannabinoids that bind to cannabinoid receptors.

CBD itself does not bind to receptors but is thought to work by inducing other components of the cannabinoid system.

In fact, CBD exerts a wide array of effects on the body’s central and peripheral nervous systems, as well as the immune system. It works in conjunction with our endocannabinoid system to function in an antioxidant capacity, decrease inflammation, and act as an analgesic or pain reliever. CBD may even slow the progression of osteoarthritis and prevent nerve damage, according to early model studies.[4]

CBD’s Potential Benefits

Importantly, CBD is hydrophobic and lipophilic, meaning it will dissolve in fats. The dissolution helps it to be carried across the blood-brain barrier and affect your CNS, where it can have a broad range of positive effects on pain including:

• Reducing Pain Signals – CBD modulates pain and the sensation of pain by stimulating the reuptake of the neurotransmitter, adenosine, thereby boosting adenosine levels in the brain and inhibiting pain sensations. CBD may also block pain signals from reaching processing centers in the brain by binding to TPRV1, which is responsible for pain and inflammation.[5-7]

• Increasing Immune Response – CBD can modulate the immune response by decreasing levels of pro-inflammatory cytokines and inhibits the proliferation of T cells that are indicated in autoimmune and systemic inflammatory disorders.[8]

• Reducing Inflammation – CBD decreases oxidative stress and systemic inflammation by acting as an antioxidant. CBD may also decrease inflammation by preventing a reduction in microelements like zinc and selenium, which are important actors for a balanced immune response, and may reduce neuropathic pain (such as fibromyalgia or neuropathic back pain) by countering hyperalgesia (an abnormally heightened pain response).

• Improving Mood and Sleep – Chronic pain can disrupt your daily life, relationships, work, and mental health. If you are facing anxiety, depression, insomnia, and fatigue – all common with chronic pain – CBD may help you relax or get the restful sleep you need. Note, however, that many studies that relate CBD to improved sleep focus on full spectrum CBD (described below) and it is thought that the entourage effect of THC (along with terpenes and other cannabinoids) is mainly responsible for aiding in sleep.[9]

Given these benefits, CBD is thought to be helpful in easing the symptoms of the following conditions:

• Osteoarthritis – this painful joint condition has been examined quite a bit in relation to CBD. Some early studies show that CBD acts as an antagonist and blocks or debilitates the GPR55 receptor, which may slow osteoarthritis by facilitating bone reabsorption.[4]

• Type 2 Diabetes – CBD may activate a receptor called, PPAR-gamma, which may increase insulin sensitivity, an important step in improving type 2 diabetes, and decreasing the risk for developing diabetes-related neuropathic pain.[10]

• Cancer and Alzheimer’s –  CBD may exert an anti-cancer effect via the debilitation of GPR55 receptors in the body and by the activation of the PPAR-gamma receptor, which also degrades amyloid-beta plaque, a key molecule linked to the development of Alzheimer’s disease.[10]

• Lupus and Rheumatoid Arthritis –  CBD continues to be studied for these inflammatory and autoimmune conditions, as well as for fibromyalgia. Here’s more on cannabinoids and lupus.

• Multiple Sclerosis – there are mixed data for the use of CBD (as well as THC) in helping to reduce MS-related pain and spasticity. [2]

  Anxiety – as noted, anxiety related to living with chronic pain, or that exists on its own, maybe eased with CBD use, whether temporarily or in the long term.

Keep in mind that while CBD can have many benefits, it is not a cure-all and should not be viewed as an alternative to your other pain care treatments. Rather, CBD should be considered a complementary treatment to add to your pain management toolbox.

HOW TO USE CBD FOR PAIN: WHICH PRODUCTS TO TRY

The legality surrounding CBD and medicinal marijuana (which are a whole other category, described in our medical marijuana for pain guide) can make choosing and using the right product confusing. Here is what you may find when you start searching the marketplace.

Get to Know the CBD Isolate, Broad, and Full Spectrum Products

Scientists are still discovering the different ways in which CBD may help to fight disease and reduce pain and its related symptoms. They are also still working to understand the functionality of CBD as an isolated compound versus a whole plant. For example, you may come across product descriptions such as CBD isolate, Full Spectrum CBD, and Broad Spectrum CBD.

Here’s a quick cheat sheet but note that the efficacy of each is still up for debate.

refers to a product that is composed of the CBD compound only and is extracted from the marijuana plant. CBD isolates can be extracted from both hemp and non-hemp species of marijuana. Remember, for it to be federally legal, it must come from the hemp species. In states where medicinal marijuana is legal, you can find CBD isolates in a marijuana dispensary. Additionally, certain CBD isolates are synthetic forms, such as those used in the pharmaceuticals Marinol and Syndros – both FDA approved to relieve chemotherapy-induced nausea and to improve appetite in people with AIDS. [3]

products maintain the full profile of the marijuana plant and in addition to CBD, contain a variety of other cannabinoids including THC, CBDa, CBG, and CBN, as well as terpenes and other compounds such as flavonoids, proteins, phenols, sterols, and esters. Technically, full spectrum products can contain 0.3% or less THC, if they are derived from the hemp species, however, full spectrum CBD products derived from non-hemp marijuana tend to have a wider cannabinoid and terpene profile.

products maintain the whole profile of the marijuana plant, but with the THC mostly removed.

Choose a CBD Product that Fits Your Needs

Selecting a CBD product depends on:

• The pain you are experiencing

• The effect you are seeking, such as how quickly it will take effect after you use/apply the CBD, and how long that effect lasts

• Personal preference for administration

A budtender – that’s what they call dispensary pharmacists – or your doctor can guide you.

WHAT CAN I DO RIGHT NOW?

1. Find out what your state has legalized. The CBD Awareness Project lists state-by-state laws and initiatives while the National Organization for the Reform of Marijuana Laws (NORML) lists regulations. You can also try Leafly’s search engine

2. Think about the type of CBD you may wish to try – a topical, an oil, edibles, etc. Start small and go slow.

3. Look into a local dispensary and schedule an appointment with your doctor to talk about which CBD product may work for your specific symptoms.

Overall, the risks of taking CBD are very low, and the rewards can be quite promising. Still, it’s important to remember that more research is needed to understand the full effects of CBD. Your treatment is a personal choice and for many, a personal journey.

Sources

1.     Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res. 2018;3(1):152-161.

2.     Rudroff T, Sosnoff J. Cannabidiol to improve mobility in people with multiple sclerosis. Front Neurol. 2018;9:183.

3.     FDA. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). Updated August 3, 2020. Available at: www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd.

4.     Philpott HT, et al. Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. Pain. 2017 Dec; 158(12): 2442–2451.

5.     Yamaoka G, et al. Different analgesic effects of adenosine between postoperative and neuropathic pain. J Orthop Sci. 2013;18(1):130-136.

6.     De Petrocellis L, et al. Effects of cannabinoids and cannabinoid-enriched Cannabis extracts on TRP channels and endocannabinoid metabolic enzymes. Br J Pharmacol. 2011;163(7):1479-1494.

7.     De Gregorio D, McLaughlin R, Posa L, et al.Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain. 2019;160(1):136-150.

8.     Atalay S, Jarocka-Karpowicz I, Skrzydlewska E. Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants. 2020;9(1):21.

9.     Nicholson AN, Turner C, et al.  Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults. J Clin Psychopharmacol. 2004;23(3):305-313.

10.  O’Sullivan SE. An update on PPAR activation by cannabinoids. Br J Pharmacol. 2016;173(12):1899–1910.

11.  Russo, E. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br J Pharmacol. 2011;163(7):1344-1364.

12.  Supplements: Nutrition in a pill. Mayo Clinic. 2017. Available at: www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/supplements/art-20044894. Accessed July 2020.

13.  Nuutinen T. Medicinal properties of terpenes found in Cannabis sativa and Humulus lupulus. Eur J Med Chem. 2018;157(5):198-228.

14.  Bruni N, Della Pepa C, Oliaro-Bosso S, et al. Cannabinoid delivery systems for pain and inflammation treatment. Molecules. 2018;23(10):2478.

15.  Zgair A, Lee J, Wong J, et al. Oral administration of cannabis with lipids leads to high levels of cannabinoids in the intestinal lymphatic system and prominent immunomodulation. Sci Rep. 2017;7:14542.

16.  Arthritis Foundation. CBD for arthritis pain. Available at: www.arthritis.org/health-wellness/healthy-living/managing-pain/pain-relief-solutions/cbd-for-arthritis-pain. Accessed July 2020.

[Credit: The above article is extracted from https://www.practicalpainmanagement.com/patient/treatments/marijuana-cannabis/empowered-pain-patient-guide-cbd]

Further Resources:

For More CBD News & Tips:

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

What Does CBD Do To You? IMPORTANT To Know!

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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