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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.

CBD oil is derived from the cannabis plant. People report using this oil for relief from pain, anxiety, depression, and sleep disorders.

There is limited evidence from human studies to support the benefits of CBD oil, due to restrictions on the use of and research on cannabis. As cannabis is becoming legalized in various regions, research is gaining momentum and shows some promising results.

In this article, we look at how CBD oil works and how people use it to relieve chronic pain.

A small bottle of CBD oil against a green background with a dropper held above it

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CBD is one of more than 100 compounds found in cannabis, called cannabinoids. Many plants contain cannabinoids, but people most commonly link these compounds to cannabis.

Unlike other cannabinoids — such as tetrahydrocannabinol (THC) — CBD does not produce a euphoric “high.” This is because CBD does not affect the same receptors as THC.

The human body has an endocannabinoid system (ECS) that receives and translates signals from cannabinoids. It produces some cannabinoids of its own, which are called endocannabinoids. The ECS helps regulate functions such as sleep, immune-system responses, and pain.

When THC enters the body, it produces a “high” feeling by affecting the brain’s endocannabinoid receptors. This activates the brain’s reward system, producing pleasure chemicals such as dopamine.

Does CBD make you high?

CBD is an entirely different compound from THC, and its effects are very complex. It does not produce a “high” and does not impair a person’s functioning, but it influences the body to use its own endocannabinoids more effectively.

According to a 2015 study published in Neurotherapeutics, CBD influences many other receptor systems in our body and will influence the ECS in combination with other cannabinoids.

For example, CBD can increase the body’s levels of anandamide, a compound associated with regulating pain, which can reduce pain perception and improve mood.

Cannabidiol may also limit inflammation in the brain and nervous system, which may benefit people experiencing pain, insomnia, and certain immune system responses.

For more information and resources on CBD and CBD products, please visit our dedicated hub.

Different varieties of cannabis plants — such as hemp and marijuana — contain different levels of chemical compounds.

How people breed the plant affects the CBD levels. Most CBD oil comes from industrial hemp, which usually has a higher CBD content than marijuana.

Makers of CBD oil use different methods to extract the compound. The extract is then added to a carrier oil and called CBD oil.

CBD oil comes in many different strengths, and people use it in various ways. It is best to discuss CBD oil with a doctor before using it.

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.

CBD currently has a range of applications and promising possibilities.

  • 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.

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.

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.

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.

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.

What precautions would you advise if someone wants to try CBD oil to treat pain?

Users should follow legal channels to obtain CBD.

The science is emerging to support its use, especially in a time where most people want to avoid addicting opioids while treating chronic pain.

Because of the changes in social acceptance for the use of the marijuana plant and the urgency to address the opioid crisis, there is funding for clinical trials.

A 2017 study found CBD was effective for chronic neuropathy pain. It may have a role in reducing inflammation as well.

An individual should talk to a doctor first, start with the lowest doses possible, read the information available, and be an informed consumer.

Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Is CBD legal? Hemp-derived CBD products with less than 0.3% THC are legal federally but still illegal under some state laws. Cannabis-derived CBD products, on the other hand, are illegal federally but legal under some state laws. Check local legislation, especially when traveling. Also, keep in mind that the Food and Drug Administration (FDA) have not approved nonprescription CBD products, which may be inaccurately labeled.

Last medically reviewed on November 3, 2020

Cannabidiol or CBD oil has become popular for pain treatment. This article looks at how it works, how to use it, and the benefits and risks of CBD oil.

CBD Oil As a Muscle Relaxant [Try this All-Natural Treatment]

There’s a lot of misconception about the difference between muscle relaxers and painkillers. There’s also confusion regarding the role CBD oil plays as an alternative treatment option for both.

First, painkillers function via the central nervous system (CNS). They work to “deceive” the mind into thinking there is no pain, when in reality there is.

Consider a serious bone fracture. A skateboarder shatters his tibia into 19 different pieces and rushes to the nearest emergency room. Once doctors shoot him up with dilaudid (or morphine, or whatever), pain receptor function ceases and he becomes none the wiser regarding the searing pain that’s coursing through his body. In fact, he’s probably happy as a clam.

Do muscle relaxers work the same?

Muscle relaxers (known in the clinical world as ‘neuromuscular blocking agents’) work differently. Instead of functioning through the CNS by blocking pain transmission at the brain, they function at the actual site of the muscle(s). This cuts off nerve transmission at the acute musculoskeletal level. Think of painkillers as affecting the brain, and muscle relaxers as affecting actual muscles.

Understandably, this brings about some confusion as to what cannabis’ exact role is in terms of pain management. We all know that CBD is an excellent pain modulator within the central nervous system, but does it function at the actual site of muscles as well? In other words, is CBD oil as a muscle relaxer an actual thing, or are people just getting the terms ‘muscle relaxers’ and ‘painkillers’ mixed up?

As it turns out, cannabis does function well as both a neurological “painkiller” and an acute neuromuscular blocking agent.

In this article, we’ll go over exactly how CBD as a muscle relaxant functions at the physiological level. Many people are switching over from their prescription relaxant medications to CBD oils. This is for a number of different reasons, which we’ll talk about below.

As is always the case with health, however, it pays to know what’s going on at the physiological level before you jump headlong into a new treatment option.

Muscle Relaxers: What are they, and why are they dangerous?

Liked we explained briefly, muscle relaxers work by severing neurological communications between the CNS (the brain) and the actual muscles themselves. In that regard, relaxants and painkillers are indeed similar. The only real difference is the specific location where the nerve transmission interruption takes place

Now bear in mind that is a broad, relative explanation. If a neurologist were to read that, they’d probably feel inclined to elaborate on several dozen different things to provide a more exacting definition. But for our purposes, it will suffice.

In terms of the different kinds of muscle relaxers out there, several different types are commonly prescribed to treat localized spasticity. More often than not they’re used as acute (temporary) treatments, but sometimes they can be used along with opioid painkillers for effective treatment of chronic pain as well.

Common Muscle Relaxers

Xanax and Valium are probably the two most well-known muscle relaxers. These drugs are called benzodiazepines. Though they’re often used as anti-anxiety or sleep medications, they have good muscle-relaxing properties as well. Valium especially is a frequently prescribed relaxant for mild-to-moderate acute musculoskeletal pain wherein full-strength opioid painkillers are unnecessary.

Drugs like Zanaflex (tizanidine) are also common and work to reduce spasticity in cases of spinal cord injury or multiple sclerosis (of which CBD is another great treatment option, by the way).

Prescription medications like Soma (carisoprodol), Flexeril (cyclobenzaprine), and Robaxin represent the strongest class of muscle relaxants. These are Schedule IV Controlled Substances (as are Xanax and Valium). They produce meprobamate as a byproduct of their chemical breakdown. Meprobamate is a powerful tranquilizer that produces a sensation of whole-body euphoria. It is dangerous because it can galvanize dependence, abuse, and full-on addiction.

While not statistically as dangerous as opioid painkillers , prescription muscle relaxants still present a dangerous array of potential side effects (such as depression, low blood pressure, and liver problems), and can even be fatal when combined with alcohol or over the counter sleep medications. (Sadly, many combine muscle relaxants with heavy alcohol use as a potential means for suicide).

What are Muscle Relaxants Used for?

Muscle relaxers are used for uncontrollable muscle spasms that originate via neurological impulses sent from the central nervous system. These spasms (which can be extremely painful) originate from several different things:

  • Spinal cord injury or damage (the brain and spinal cord compose the CNS)
  • Diseases like multiple sclerosis , cerebral palsy, and fibromyalgia
  • Acute muscle strains and tears

Some use prescription pharmaceutical relaxants to treat these involuntary muscle contractions. The relaxants work by interrupting neurological communication at the site of the muscle. Spastic signals from the CNS come to a stop, and the muscles relax and shut down. (Surgical procedures also sometimes incorporate relaxants to provide temporary paralysis).

You can see then, the difference between the function of painkillers and muscle relaxants; in our aforementioned hypothetical situation of the skateboarder with the shattered tibia, a muscle relaxant would be an entirely insufficient treatment – he’s dealing with severe acute trauma, not spastic neurological signals between the CNS and various muscle groups.

CBD Oil as Muscle Relaxant: So how does it work?

With the fundamental understanding of muscle relaxants and what they do behind us, we can now look into the physiological roles of CBD (cannabidiol) oil, and how it functions as a neuromuscular blocker.

When muscle groups contract (whether voluntarily or involuntarily), it is in response to a nerve impulse that originates from within the central nervous system. Long neurons extend from the spinal cord and stretch outwards to various organs and muscle groups throughout the body. When these neurons reach the synapse of a particular group of muscle fibers, cell-to-cell communication takes place and the fibers contract. (That’s an elementary way to put it, but it will have to suffice in order to skip talking about action potentials, sarcomeres, and ion differentiation across cell membranes).

In any regard, in order for CBD to work as a muscle relaxant, cannabinoid receptors must be present at the site of muscular synapses. This is where the endocannabinoid system comes in.

If you haven’t heard of the endocannabinoid system (ECS) , you need to inform yourself now. In short, it is an innate network of cannabinoids and cannabinoid receptors that occur 100% naturally in the human body. Everyone has the receptors, whether they’ve smoked marijuana every day for 50 years or have never touched the drug in their life.

The ECS: A complex yet remarkable receptor network

Studies have shown the ECS to be present in virtually every single physiological system in the human body. In a nutshell, this explains the incredibly far-reaching medical potential of cannabis.

The National Organization for the Reform of Marijuana Laws (NORML) has called the endocannabinoid system “… the most important physiologic system involved in establishing and maintaining human health.”

In terms of the ECS acting as a muscle contraction regulatory device, studies have found cannabinoid receptors in the signaling machinery of skeletal muscle. In other words, it appears cannabinoids (such as CBD) may play a significant role in the communication between muscle groups and the neurons that control them.

Remember research is still a long way off in regards to pinpointing how this works. Also, it is unclear how exactly the ECS functions regarding the chemical pathways of cell-to-cell communication. One thing is for certain, though — cannabinoids absolutely play a part in the alleviation of muscle spasticity .

In fact, cannabis has for years shown excellent results in multiple sclerosis patients that deal with chronic spasticity. It’s only been somewhat recently, though, that individuals started using the oil to treat spasms stemming from other conditions.

Why CBD Oil?

If you’re wondering why we keep talking about CBD, or if you’re wondering what the heck it even is, it’s essentially a non-psychoactive cannabinoid that comes from the marijuana plant.

The two primary cannabinoids in marijuana are THC and CBD. THC is the psychoactive component that’s responsible for getting us high. When you smoke a joint, for example, you inhale both CBD and THC. CBD oil is an all-natural extraction of the non-psychoactive cannabinoid. That is, a way to receive all the medical and therapeutic benefits of cannabis without having to get high.

CBD as a Muscle Relaxant: The Bottom Line

Alleviating muscle spasms at the molecular level is just one of the many potential uses of CBD . Thousands of people have switched over to it from prescription medications (like carisoprodol or benzodiazepines) due to the high costs and dangerous side effects of the latter.

Keep in mind though that CBD oil for muscle spasms will not work for everyone. If you’re considering using it for your own condition, do your research and select a reputable tincture.

The oils we’ve selected below have been some of the most reputable and proven brands in recent years. They have shown good results for a variety of muscle and pain-related conditions, including spasticity.

Ever thought about using CBD oil as a muscle relaxant? Keep on reading to explore the truth, because there's A LOT of difference between your options.