Best CBD Oil For Nerve Pain: Benefits & Dosage For Neuropathic Pain
Neuropathic pain is notoriously difficult to treat.
Only 40% to 60% of patients able to find partial relief from their symptoms with conventional treatments.
Recent evidence suggests CBD oil may be a powerful natural treatment option for nerve-related pain.
Learn how it works & how to use it.
The human body is full of sensors leading to the brain. They sense temperature, touch, and tissue damage, and relay that information back to the brain for processing.
Neuropathic pain can be the result of damage to the nerves or pain sensors.
Learn what makes CBD so useful for treating neuropathic pain, how to use it effectively, and what other measures you can do to get the best chances of finding relief from your pain.
So, without further ado, let’s get into it.
MEDICALLY REVIEWED BY
Updated on November 06, 2020
Table of Contents
- Can CBD Oil Help With Neuropathic (Nerve) Pain?
- The benefits of CBD oil for neuropathic pain include:
- What’s The Effective Dose of CBD For Neuropathic Pain?
- CBD Dosage Calculator
- What Are The Side-Effects of CBD?
- Here are some of the most common side-effects of CBD:
- Which Type of CBD Should I Use?
- 1. CBD Oils & Tinctures
- 2. CBD Capsules
- 3. Topical CBD Products
- 4. CBD Edibles
- What is Neuropathic Pain?
- What Are The Causes of Neuropathic (Nerve) Pain?
- Treatments for Neuropathic Pain
- CBD For Spinal Cord Injury
- What is a Spinal Cord Injury?
- Spinal Cord Injury Symptoms
- Types of Spinal Cord Injury
- The Location of the Spinal Cord Injury Matters
- Causes of Spinal Cord Injuries
- What the Research Says
- Results of This Survey Listed:
- Potential Benefits of THC for Spinal Cord Injuries
- What is a Spinal Cord Injury?
- Key Takeaways: Does CBD Oil Work For Neuropathic Pain?
- References Cited in This Article
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Can CBD Oil Help With Neuropathic (Nerve) Pain?
CBD and other cannabinoids offer relief from various causes of neuropathic pain in humans [2, 3].
It offers most of these benefits through its ability to interact with the endocannabinoid system (ECS).
The ECS consists of a series of receptors and eicosanoids (called endocannabinoids) that regulate homeostasis (balance) throughout the body. There are endocannabinoid receptors found on virtually every organ in the human body, with the highest concentration in the central nervous system.
The endocannabinoid system functions like “read receipts” used in text messages.
When the nerves send a message, the receiving nerve cell uses the endocannabinoid system to tell the sending nerve that the message was received.
This system keeps the entire nervous system in constant feedback with itself and prevents sending the same message more than once — which is essentially what happens when we experience neuropathic pain.
CBD also supports nerve pain by reducing inflammation, activating the vanilloid pain receptors, and alleviates many of the common side-effects of nerve pain.
The benefits of CBD oil for neuropathic pain include:
- Protects the nerve cells & brain
- Supports nerve cell regeneration
- Blocks pain transmission
- Regulates electrical activity in the brain
- Alleviates anxiety & depression
- Supports sleep
What’s The Effective Dose of CBD For Neuropathic Pain?
When it comes to treating neuropathic pain — a notoriously difficult type of pain to alleviate — a higher strength of CBD is generally recommended. Most of the research showing benefits from CBD noted an abnormally large dose of the compound to achieve this success.
For this reason, it’s a good idea to work out the dose yourself to find out what’s best for you and your symptoms.
You can use our CBD oil dosage calculator to find the best dose based on your weight and desired level of effects.
Start small and increase the dose every day until you either experience relief from symptoms — meaning you’ve found your dose — or experience side-effects. If you experience side-effects, you may need to dial the dose back to the last side-effect-free dose.
If you’re still not getting any reduction in pain symptoms with this dose, you may need to combine CBD with other forms of pain management — after consulting with a doctor, of course.
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What Are The Side-Effects of CBD?
Although CBD has been proven to be highly safe many times over, it’s important to know about the potential side-effects it may produce.
Everybody is different, and what works for one person doesn’t always work the same way for another.
Here are some of the most common side-effects of CBD:
- Appetite suppression
- Dry mouth
- Lower heart rate
Which Type of CBD Should I Use?
CBD comes in all different forms — not all are going to work for every condition.
1. CBD Oils & Tinctures
CBD oils and tinctures provide the easiest methods of taking CBD. All you need to do is measure out the desired dose (more on this later) and pop it into your mouth. You can choose to hold the oil/tincture under your tongue for faster absorption or swallow it right away — both will work well.
2. CBD Capsules
CBD capsules are another excellent dosing option you can employ. Capsules are small and easy to carry, deliver standardized CBD doses, and have great bioavailability. They’re also an excellent option for people who don’t want to taste the CBD oil — which can have an earthy, undesirable taste in some cases.
3. Topical CBD Products
Topical CBD is another good option, but only if the source of your neuropathic pain is close to the surface of the skin. It’s recommended that you use it alongside internal forms of CBD, such as capsules, edibles, or oils. This is because the cannabinoids in topical CBD products won’t reach the spinal cord and brain where most of the pain relief comes from when treating neuropathic pain.
4. CBD Edibles
CBD Edibles, including gummies or baked goods, are certainly a fun way of taking CBD — but they’re often inconsistent with dosing (with the exception of gummies). The dosages listed are estimates, and the actual CBD content inside can vary significantly.
For this reason, we don’t recommend relying on CBD edibles as your everyday maintenance dose of CBD for neuropathic pain.
What is Neuropathic Pain?
Neuropathic pain is a type of pain involving damage to or dysfunction of the nerves and somatic sensors found throughout the body.
Any damage to or dysfunction of the nerves and sensory tissues can send pain signals to the brain. These signals warn the body of real damage or dysfunction, but they can also be caused by false messages sent to the brain.
These messages warn the brain of damage that may or may not exist. This makes neuropathic pain difficult to treat, especially when the underlying cause can’t be identified.
1. Central Neuropathic Pain
The central nervous system is any part of the nervous system inside the brain and spinal cord. This is separated from the peripheral nervous system by a semipermeable barrier called the blood-brain barrier.
Central neuropathic pain, therefore, involves pain originating from nerves located inside the central nervous system.
It’s caused by conditions such as:
- Multiple sclerosis
- Spinal cord injuries
2. Peripheral Neuropathic Pain
The peripheral nervous system involves any part of the nervous system outside of the brain and spinal cord. This includes all the nerves in the limbs, abdominal cavity, legs, and face.
Often, when a nerve becomes damaged, the repair process may not go as planned. Instead of returning the nerve to the way it was before the damage, the nerve becomes unusually sensitive and will send pain signals to the brain when it shouldn’t.
The original damage can happen from many different causes, primarily traumatic injuries or specific viruses that target the nerve cells directly — such as herpes virus or shingles.
This type of pain is caused by conditions such as:
- Metabolic syndrome
- Herpes zoster infection
- HIV infection
- Nutritional deficiencies
- Environmental toxin exposure
- Autoimmune disorders
- Traumatic injuries
3. Mixed — Peripheral and Central Neuropathic Pain
Mixed neuropathic pain involves pain stemming from nerves found both inside the central nervous system and inside the peripheral nervous system.
Causes for mixed neuropathic pain include:
- Chemotherapy treatments
- HIV and other viral infections
- Heavy metal toxicity
What Are The Causes of Neuropathic (Nerve) Pain?
Neuropathic pain is caused by damage or dysfunction of the nerve cells. There are many causes for nerve damage in the body, such as:
- Multiple sclerosis
- Varicella-zoster infection
- Epstein Barr Virus infection (EBV)
- Traumatic injuries
- Trigeminal neuralgia
Treatments for Neuropathic Pain
- Antidepressants (SSRIs, SNRIs, and tricyclic antidepressants)
- Opiate pain medications (morphine, fentanyl, tramadol, and methadone)
- Surgical nerve blocks (severe cases only)
- Topical analgesics (lidocaine)
CBD For Spinal Cord Injury
Spinal cord injuries can have debilitating and life-altering consequences. Injuries can cause varying levels of paralysis, spasticity, loss of sensation, muscle weakness, and nerve pain that can persist for the rest of that person’s life.
There are some treatments available for this condition, most of which are supportive — helping those affected manage pain, depression, and other side-effects of the condition.
CBD cannot cure a spinal cord injury — however, it does likely offer a great deal of support for those affected by managing symptoms and promoting the repair of nerve cells in the damaged areas of the spinal cord.
There’s also some indication that CBD can support the recovery process — lowering the severity of side-effects and improving motor function in the affected nerves .
The Benefits of CBD Oil For Spinal Cord Injury Includes:
- Managing chronic pain
- Relieving symptoms of mild to moderate depression
- Adjunctive treatment to prevent antibiotic resistance during lung infection
- Alleviating insomnia
- Promoting nerve regeneration
- Possibly reducing the extent of nerve damage from the incident
What is a Spinal Cord Injury?
The spinal cord is an extension of the brain. It contains high concentrations of nerve cell tracts that send and receive messages between the body and the brain. Any damage to the spinal cord can result in serious consequences, including paralysis, spasms, neuropathic pain, or loss of organ function.
The spinal cord contains millions of nerve “intersections” that distribute signals to every part of the body. The area of the spinal cord that is damaged will determine what side-effects develop and where.
For example, if the region of the spine containing the nerves that control leg muscles is damaged, it means that there will be a weakness or complete loss of function in those muscles and sensory deficits in one or both legs.
Spinal Cord Injury Symptoms
- Motor deficits
- Sensory deficits (of pain, touch, temperature, location, and vibration senses)
- Bedsoresfrom prolonged immobility
- Changes in mood
- Chronic pain
- Difficulty breathing
- Frequent infections
- Muscle pain
- Nerve pain
- Poor libido
Types of Spinal Cord Injury
Depending on how severe the injury is, there are three main classifications that doctors use to describe the condition:
- Incomplete spinal cord injury — involves damage that hasn’t completely inhibited nerve transmission past the site of injury.
- Complete spinal cord injury — damage to the spinal cord is severe enough that no nerve signals can pass across the site of injury.
- Brown Séquard Syndrome— damage to exactly one half section of the cord, either left or right hemisection.
There are also several other types of spinal cord injury such as: dorsal column lesion, irregular lesions, small or large central lesion, tumor of the dorsal root, or tumor of the meninges or bone.
The Location of the Spinal Cord Injury Matters
Nerves leave the brain and head down the spinal cord in bundles and pairs. They branch off at various points along the way to go to their target organs, and some tracts will cross sides.
The location of the damage to the spinal cord will determine which areas of the body are affected.
Complete damage of the spinal cord will prevent all nerves below the damaged point to stop receiving or sending messages. Therefore, to classify the level of injury, doctors will assess the lowest levels of different sensations and functions of the nerves in the spinal cord.
There are four main divisions of the spinal cord — organized according to the vertebral column. The vertebral column starts at one at the base of the skull and goes all the way to the coccyx. The spinal cord, in fact, actually ends between vertebrae L1-L2, and is followed by a bundle of nerves called the cauda equina the rest of the way down.
Causes of Spinal Cord Injuries
- Car accidents
- Gunshot wounds
- Stab wounds
- Tumor growths
- Sports injuries
- Toxic exposure
- Ischemic damage
What the Research Says
In 2012, researchers conducted a study on the use of CBD for spinal cord injuries in rats . Rats were either placed in the treatment group and given CBD, or into the control group where no treatment was given. At the end of the six-day study, rats in the CBD treatment group had significant improvements in motor function and reduced injury side-effects than rats in the no-treatment group. Therefore, the researchers conducting this study concluded that CBD might be a useful treatment option for spinal cord lesions (injuries).
Another study used a survey that was handed out to 10 spinal cord injury patients at the Spinal Cord Injury ward of the Miami V.A. Hospital who were using marijuana to treat their symptoms. The survey was kept confidential and involved questions about the most common symptoms of the condition and how marijuana use affected them.
Results of This Survey Listed:
|Symptoms||Made Worse||Made Better||No Effect||Distraction||Not Applicable|
THC has also offered benefits for spinal cord injuries. For this reason, a full-spectrum cannabis extract containing both CBD and THC is considered the best option.
Potential Benefits of THC for Spinal Cord Injuries
- Reduces muscle spasms involved with spinal cord injuries 
- Improves bladder control in spinal cord injuries 
- Reduces pain associated with spinal cord injuries 
THC remains illegal throughout most of the world, so it may be difficult to find products containing more than 0.3% THC concentration. Further robust studies will be needed to better characterize standard effects and determine efficacy.
Key Takeaways: Does CBD Oil Work For Neuropathic Pain?
The causes of neuropathic pain can range from neurological issues such as multiple sclerosis or a stroke to nutritional deficiencies and diabetes.
No matter what’s causing neuropathic pain, the benefits of CBD remains much the same.
CBD can support neuropathic pain in the following ways:
- Increases anandamide levels
- Activates the vanilloid receptors
- Inhibits inflammation that may be causing neuropathic pain
- Mildly activates the opioid receptors in the spinal cord and brain
When it comes to treating neuropathic pain, a higher dose is usually recommended — however, this can vary from person to person. Whenever using CBD for the first time, it’s wise to start low and increase slowly over time until you receive the benefits you’re looking for.
Research has shown CBD alleviates neuropathic pain that didn't respond to conventional treatment. View the best CBD oils for nerve pain.
2014 Spinal Cord Injury Wellness Summit
The Use of Medical Marijuana to Manage Symptom Burden in Spinal Cord Injury
By Gregory T. Carter, MD, MS
Medical Director, St. Luke’s Rehabilitation Institute, Spokane, Washington, and faculty, University of Washington Medical School
The national conversation about cannabis (marijuana) is changing rapidly, and many people with SCI would like to know more about its use as a medical treatment for pain and other symptoms. In this forum presentation, Dr. Carter discusses the history of medical cannabis in the U.S., the physiological effects of cannabis, and the current scientific evidence regarding the safety and effectiveness of cannabis as a treatment for neuropathic pain when used under a physician’s supervision. Watch the video or read the report, below.
Presentation time: 54 minutes. After watching, please complete our two-minute survey!
You can also watch this video on YouTube with or without closed-captioning. For a complete list of our SCI Forum videos, go to http://sci.washington.edu/info/forums/forum_videos.asp.
- What is Marijuana (Cannabis)?
- History and Background
- How Does It Work?
- Medical vs. Recreational Cannabis
- Benefits of Medical Cannabis
- Using Medical Marijuana
- A Word of Caution
- Take-Home Message
Marijuana (cannabis) is much in the news today. Medical marijuana, although still illegal under federal law, has been legal in several states for some time, and state laws about recreational marijuana are changing. As marijuana becomes more available, people interested in medical marijuana want information about what it is, what it’s good for, and how to use it.
What is Marijuana (Cannabis)?
Marijuana refers to the dried leaves, flowers, stems and seeds from the hemp plant Cannabis sativa, which contains numerous active chemical compounds called cannabinoids. Delta-9-tetrahydrocannabinol (THC) is the primary psychoactive ingredient in cannabis that acts on the brain and changes mood or consciousness. Other chemical compounds in cannabis that have biologic activity include cannabinol (CBN), cannabidiol (CBD), and cannabichromene. CBD, in particular, is thought to have significant analgesic (pain-relieving) and anti-inflammatory activity without the psychoactive effect (high) of THC.
History and Background
Cannabis has been used for medicinal purposes for thousands of years. It was first brought into western medicine in the 1840s by an English surgeon who learned about it in his travels through the Middle East.
For several decades cannabis was regularly prescribed by physicians in the U.S. and dispensed at pharmacies as a tincture or tonic for “nerve pain.” Beginning in 1937 the federal government started taxing and restricting its use, in spite of objections by the American Medical Association. In 1951 cannabis was classified as a narcotic, and finally in 1970 it was classified as a schedule 1 drug (like heroin and LSD), meaning it is considered dangerous and without accepted medicinal use. It has remained in this classification despite favorable findings from various government-appointed commissions on cannabis over the years: Nixon-appointed Shafer Commission in 1972; U.S. Institute of Medicine in 1982; and the U.S. National Institutes of Health Workshop on Medical Marijuana in 1997. Furthermore, the National Academy of Sciences and the American College of Physicians have all issued cautiously positive statements about cannabis.
“I’m here to say on the record that the classification as a schedule 1 drug doesn’t make any sense scientifically,” Carter said.
How Does it Work?
“We now understand a great deal about how cannabis works in the body,” Carter said. The cannabinoids activate specific receptors found throughout the body to produce pharmacologic effects, particularly in the central nervous system and the immune system. Pain is reduced when cannabis receptors are activated in the nervous system pathways that regulate pain perception.
When it is smoked, cannabis compounds pass rapidly from the lungs to the bloodstream, which carries the chemical to the brain and other organs. Vaporized cannabis produces the same effects without the smoke. It is absorbed more slowly when ingested in food or drink. The highest density of cannabinoid receptors is found in parts of the brain that influence pleasure, memory, thinking, concentration, sensory and time perception, and coordinated movement.
“I first stumbled onto medical cannabis 20 years ago when an ALS patient told me she was using it for pain and spasticity,” Carter recalled. “When medical marijuana became legal in Washington State, I began prescribing it.”
Medical vs Recreational Cannabis
Recreational strains are much different than the medical strains,” Carter said. Recreational marijuana has high levels of the THC compound because of its mind-altering effects, and that’s what recreational users are looking for. Medical cannabis is low in THC and higher in other compounds that help with pain and spasticity, such as cannabidiol (CBD) and cannabinol (CBN).
“Many people taking medical cannabis do not want to get high, and some find the intoxication unpleasant,” Carter said. “My ALS patients take cannabis to ease their suffering so they can spend quality time with their families. They don’t want to be intoxicated; they want to be present.”
Because cannabis is a schedule 1 drug, it has been difficult to get funding to conduct research on its medical use. In spite of this hurdle, “we now know on the basis of science and clinical trials that cannabis and cannabinoids work very well for neuropathic pain and spasticity,” Carter said.
Several studies involving people with a variety of diagnoses have had promising results.1-3 A 2011 systematic review of 18 randomized clinical trials of cannabinoids for non-cancer pain found significant analgesic effects with no serious adverse effects.4
“The overall weight of evidence so far is markedly in favor of cannabinoids being safe and effective to treat pain,” Carter concluded.
Benefits of Medical Cannabis
- Relieves pain.
- Relieves muscle spasms (cannabinoids also can enhance the effects of other anti-spasticity medications like baclofen).
- Safe and well-tolerated.
- Doesn’t cause constipation. “In fact, cannabinoids have a weakly stimulatory effect on the gut,” Carter noted.
- Doesn’t suppress your breathing (like opioids).
- You can’t overdose (like you can with opioids).
- There is no physical addiction in cannabis. “There is a psychological addiction if it’s being used solely for the intoxicating effect,” Carter explained, “but there is no harsh physical withdrawal like there is with opioids or even nicotine because cannabis leaves the body so slowly.”
Using Medical Marijuana
- Talk to your physician. Even if you live in a state where recreational marijuana is legal, medical cannabis is formulated to have more of the treatment effects and much less of the intoxicating effects.
- Your physician will sign an authorization explaining why you would benefit from medical cannabis. In states where medical marijuana is legal, this authorization can be taken to a medical marijuana dispensary.
- Dosing is important. Start low and go slow, meaning start with a small amount and slowly increase the amount until you get the desired benefit.
- Use a vaporizer. The plant material is heated up and you inhale the hot mist. The effect is rapid, and you will know right away after inhaling what the effect is, just like smoking it but without the negative health effects of smoke.
- Start with two to three inhalations. Stop. Wait 10 minutes and see how you feel. You do not need to be high to get pain relief.
- Tinctures are available, but ingesting is not recommended because it takes longer to get an effect, and it is easy to ingest too much and become unpleasantly intoxicated.
- It can be used topically as a liniment.
- Everyone is different. Some people will benefit from cannabis, others may not.
A Word of Caution
Carter points out that “cannabis is not for everybody. It has side effects.” Cannabis can cause disinhibition, relaxation, drowsiness, feeling of well-being, exhilaration and euphoria. It can also cause disorganized thoughts, confusion, agitation and paranoia. Since it can impair your balance and stability, individuals who are able to walk need to be careful to avoid falling. Finally, it impairs memory, judgment and motor skills, so don’t drive!
2014 Spinal Cord Injury Wellness Summit The Use of Medical Marijuana to Manage Symptom Burden in Spinal Cord Injury By Gregory T. Carter, MD, MS Medical Director, St. Luke’s