CBD and Pain – Does it helps?
When it comes to pain, whether mild or chronic, the first thing that we think of is a pain killer. These have become so common, that they’ve literally become a part of our daily life. Painkillers are handy for both the doctors and the patients, especially when they come as an instant relief to stabbing pain. What else does someone in pain need?
However, the problem with most conventional painkillers is that while they do provide short-term relief, they might cause damage, in the long run, sometimes really severe. This is especially true when the pain relievers are used consistently or very often. In order to understand what problems these painkillers pose to our health in the long run, let’s try to take a deep dive into how these painkillers actually work.
How do pain killers work?
In order to understand how pain relievers help in reducing or alleviating pain, you first need to know how we actually feel the pain.
Our body has innumerable nerve endings in the skin tissues. When any part of the body gets hurt due to any reason, be it inflammation caused by arthritis or the injury caused by a hit, the tissues release a chemical called prostaglandin.
Some of the nerve endings in our tissues are highly sensitive to prostaglandins. Once they have sensed the release of this chemical, they immediately convey the message of pain through the nervous system to the brain. Complete information about where the pain is and how much it hurts is sent to the brain which makes you feel the pain. Though it hurts to feel the pain, you won’t be able to retract the body part from painful stimulus if your brain didn’t feel the pain.
What most pain relievers do is that they restrict your hurting cells’ capability to produce prostaglandin. Hence, clear or immediate signals are not transmitted to the brain about the pain. Or some pain relievers act in the brain, keeping it from receiving the signals coming from hurting cells. Yet some other, powerful pain killers work by interfering with the pain signals traveling through the nerves towards the brain. Hence, the signals do not reach the brain and you do not feel the pain.
Side effects of conventional pain killers
Although, they take away your pain, give you much-needed relief, but the painkillers can be a source of pain in the longer run, especially when used too often. Some of the common side effects associated with different types of painkillers are as follows;
- NSAIDs are the most commonly used painkillers. These are used to treat mild pains. Some of the examples include aspirin, ibuprofen, naproxen, etc. Long term use of these painkillers can cause bleeding in the stomach. They can result in stomach ulcers, kidney, and liver damage. In severe cases, bleeding in the brain may occur. For example in those patients who take aspirin for a long time due to heart problems.
- One of the strongest painkillers used to relieve chronic and continuous pain are called opioids. These are mostly prescribed to the patients who undergo aa surgery or those having a health issue that causes continuous pain e.g. cancer. Some of the commonly used opioids include morphine, codeine, Vicodin, hydromorphone, meperidine, oxycodone, fentanyl, and Darvon. Besides causing constipation in almost every patient, these medications can result in dizziness, nausea, depression, weakening of the immune system, drowsiness, and itching. Above all, these painkillers are of addictive nature and you just can’t stop taking them even when you’ve recovered.
It is because of these side effects of the conventional pain relievers and their highly addictive nature that masses are desperately turning to alternative means of relieving pain. There is no doubt that these medications are very useful in managing pain, but these are not a durable solution to the pain in most cases because of the severe side effects like depression and extreme dependency.
We need a solution that doesn’t repair the damage at the cost of our overall well-being. One such alternate medicine for pain management that is being looked upon as a potential solution to the problem is CBD or cannabidiol. Let’s have a look at what it is, how CBD helps in pain management and does it provide a sustainable solution without side effects?
What is CBD?
CBD, the short form of cannabidiol, is a phytocannabinoid. Now, what is that?
The cannabis genre of plants is rich in a particular type of chemical compound called cannabinoids. These are known for their capability to benefit the human body in several ways. Some of their popular medicinal uses are anti-anxiety, anti-inflammatory, and pain management drugs.
Some of the known cannabinoids found in cannabis plants include CBD, THC, CBC, and others. Of these, CBD and THC are the most well-known and have undergone some research. Unlike THC, CBD doesn’t make you feel psychologically high. It is non-psychoactive.
Hemp-Derived CBD vs. Marijuana-Derived CBD. Does it make any difference?
The cannabis genre of plants can further be divided into three species;
- Cannabis Ruderalis
- Cannabis Sativa
- Cannabis Indica
The notorious marijuana plant belongs to either the Sativa or Indica species. It is high in THC which is known for its intoxicating properties and is used mostly for recreational purposes although it too has medicinal benefits.
On the other hand, the hemp plant belongs to cannabis Sativa only. What differentiates both these plants belonging to the same genre is the THC content. Hemp doesn’t contain THC as high as is found in marijuana. It doesn’t contain more than 0.3% THC. This concentration of THC is known to be non-psychoactive. I.e. At 0.3% concentration or lower, THC doesn’t make you feel high.
Although CBD on its own is non-psychoactive no matter where it is derived from, marijuana-derived CBD products mean that they also have THC higher than 0.3% and will hence create a feeling of high.
When derived from hemp, CBD will not contain THC higher than 0.3% and is hence not intoxicating. So, hemp-derived CBD and marijuana-derived CBD does make a difference.
How CBD Interacts with our ECS?
In order to understand how CBD works in pain management, we need to have an understanding of our body’s endocannabinoid system i.e. ECS. Our body has a complex endocannabinoid system which is composed of three components;
- A network of receptors called CB1 receptors and CB2 receptors. The former is found in the central nervous system. These are the receptors that help our nervous system receive pain signals and perceive them. The CB2 receptors are found throughout the peripheral nervous system and in the immune system.
- The second important component of the endocannabinoid system is endocannabinoid. Remember phytocannabinoids? Those were the cannabinoid compounds derived from plants. Just like that, our body has its own natural cannabinoids which are called endocannabinoids. These are released by the body when the homeostasis is disturbed and the body needs to return to its balance. This also includes a stimulus of pain or inflammation. In such cases, specific cannabinoids are produced which bind to some particular receptors and covey signals.
- The third component is the enzymes which help in the breakdown of endocannabinoids and their use in the body.
What CBD does exactly to our ECS is not yet completely understood and there is a need for more research on this mechanism. However, it is believed after some initial research that CBD doesn’t act directly on the receptors. Rather it stimulates the production of some endocannabinoids and also the way they act on the receptors.
Since CBD has an impact on both the central and peripheral nervous systems, it can regulate a wide range of bodily functions. It is known for its anti-inflammatory and antioxidant capabilities. It helps relieve the pain and reduces inflammation.
CBD for Pain. How does It help?
CBD’s capability to reduce or eliminate pain lies in the fact that it is lipophilic i.e. it is readily soluble in fats. This means it can move easily from the bloodstream into your brain. Here it can bind itself to the receptors in the central nervous system and be able to control the pain signals.
Some of the ways in which it is thought to help are as follows;
- Increasing the Reuptake of Adenosine
CBD is capable of increasing the reuptake of adenosine in the brain. Adenosine is a neurotransmitter playing an important role in the sensation of pain. When its reuptake in the brain increases, the increased levels of adenosine mean the reduced sensation of pain.
- Interrupting the Pain Signals
Besides, CBD also helps by binding itself to the TPRV1 receptor. This binding keeps the pain signals from reaching the brain and hence cannot be processed and the pain is not felt.
- Reducing the Cytokines Level
CBD has known anti-inflammatory properties and is believed to reduce the levels of cytokines. When too many cytokines are released by our immune system in response to an infection it is termed a cytokine storm. It can cause inflammation and severe fever along with aches. CBD helps by reducing the release of too many cytokines and hence prevents inflammation.
- Reducing Inflammation
CBD’s antioxidant capabilities help prevent inflammation. Moreover, it prevents the shortage of micronutrients like zinc and selenium. This too in turn reduces inflammation. These micronutrients also play an important role in preventing neuropathic pain like fibromyalgia and hyperalgesia which is an abnormal response to pain.
- Improving Sleep, and Mood, Reducing Anxiety
Besides using CBD products for pain management they are also being increasingly relied upon for other symptoms resulting from chronic pain. It is being used to treat anxiety, insomnia, depression, fatigue, and stress. However, when it comes to treating anxiety with CBD the research supports the use of full-spectrum CBD products. This means that it works best when it works together with THC and terpenes found in cannabis plants. The combined effect of CBD and THC is called the entourage effect and it helps improve sleep, reduce anxiety, and improve mood along with reducing pain.
However, despite all the above-mentioned benefits, CBD is most suited when used to support your pain management medication and not as the only remedy for pain. There isn’t yet enough evidence that CBD on its own, without a comprehensive pain and anxiety management medication can provide a complete solution. Its anti-inflammatory and anti-oxidant capabilities are being studied as a potential treatment for osteoarthritis, multiple sclerosis, cancer, and a number of other conditions. Though early research does show promising results, CBD should not yet be relied upon solely for these conditions.
Is there enough scientific evidence to support the use of CBD for Pain?
When it comes to the support provided by thorough research, one of the strongest areas where science has backed the efficacy of CBD is in anti-seizure medicines. FDA has approved the use of CBD against two painful forms of epilepsy in children i.e. Dravet Syndrome and Lennox-Gastaut syndrome. Conventional medicine failed to reduce the incidents of epilepsy in these two types of epilepsy. CBD was not able to reduce but even stop the seizure attacks resulting from these two forms of epilepsy. It was after these promising results that the FDA approved the first CBD-based medicine to treat seizures in children. This medicine goes by the name of Epidiolex in the market.
Besides, there has been some research into the pain-relieving capabilities of CBD as well;
- A study published in the European Journal of Pain mentions research carried out on animals. It shows that the use of CBD topicals, e.g. CBD cream for pain was effective in reducing the pain caused by arthritis. It was effective in reducing inflammation from arthritis. However, there needs to be more in-depth research in this area especially that based on humans until CBD can be officially approved to be used against arthritis-related pain.
- In another study carried out in 2018, 7 patients were treated for chronic pain after they had undergone a kidney transplant. 6 of them reported feeling a significant reduction in pain while the 7th patient reported that the pain increased at a higher dosage of CBD. However, at the lower concentration of CBD, he felt relieved from pain. This study too was very limited and involved just a few subjects.
How to use CBD for Pain?
When it comes to the available CBD products for pain management, they are available in a huge variety. Some of the examples include,
- CBD tinctures and CBD oils for pain
- Ingestibles, like CBD gummies for pain
- CBD pain-relieving capsules and pills
- CBD topical products like CBD creams, balms, and salves
- CBD vape juices used in electronic cigarettes
How effective are different CBD products for Pain?
Since there are different ways of administering CBD for pain relief, the efficacy of each method depends upon a number of factors. Vaping CBD generally provides the quickest pain relief. However, the effects showed this way also fade away comparatively quickly.
CBD oils and tinctures usually come with a dropper. A few drops are kept under the tongue before swallowing. This method too provides quick absorption of CBD into the bloodstream and also offers a longer time span for CBD to stay in the body.
When taken with different foods e.g. mixed with beverages or breakfast cereals, CBD might take longer to show effects but also stay in the body for a longer span.
Balms, salves, creams, and other topicals provide a perfect solution for targeted pain relief. These can be applied directly on the spot which hurts e.g. the inflamed muscle or joint.
The mode of administration best suitable for you depends on how quickly the pain needs to be relieved i.e. how stabbing it is, where it hurts, and a number of other related features. To know more about how to use CBD and how effective each method is, read a detailed resource here.
What is the preferred dosage of CBD for Pain?
The standard dosage of CBD products is among the least understood areas when it comes to using CBD for pain relief. There is huge room for more research in this field. Moreover, one formula doesn’t fit all in this regard. It is mostly based on a trial and error basis. Your metabolic rate, weight, your sleep routine, etc. makes a lot of difference in just how effective or quick the results are for various doses.
It is always a good idea to start with a lower dose especially when you are to be exposed to CBD for the first time. Start with, for example, 2mg, and slowly increase the dose after a week or so until you think you are getting the desired results.
Refer to this blog for more detailed information on how the dosage may differ with methods of administration, what would be an appropriate dose for you and what is considered to be a safe concentration according to research.
The Legal Status of CBD
For a long time, CBD had been illegal both federally and at the individual states’ level. This was because the cultivation and commercial use of marijuana and hemp was not allowed because of the chances of abuse especially when CBD is accompanied by psychoactive THC.
It was only after the US Farm Bill was passed last year that the legal status of CBD changed, although the stance of US regulatory authorities is still unclear on CBD.
The cultivation of marijuana and sale of marijuana-derived products is still illegal at the state level although some states might legalize it. On the other hand, the cultivation of hemp and the commercial use of hemp-derived products is now legal at the federal level but some states have restrictions upon them.
It is important to note here that according to federal law, hemp means a cannabis plant species that has 0.3% or lower concentrations of THC. Anything above 0.3% THC will be considered marijuana which is illegal federally.
However, this is not all you need to know. Where CBD derived from hemp is legal at the federal level you still might not be allowed to possess it as your state may not allow it. Moreover, even if it is allowed in one form, it might be illegal in another form. There are even some states which haven’t yet come up with any clear legislation in this area. To know more in-depth about the legal status of CBD in your state refer to this detailed table on the stance of each of the 50 states on the legality of CBD.
When it comes to legality, you must be extra cautious while traveling across state borders. Carrying CBD products from one state to the other can cause you some problems as the two states might have different laws for the legality of CBD products. Moreover, the wording on the label of the product can also expose you to some unwanted questions. For example, if it mentions cannabis, it can confuse the officials because it may mean both marijuana and hemp.
Another important thing to note here is that although the CBD market has recently developed a lot, it is still a totally unregulated market. FDA does not regulate CBD products yet. This means that the labels might be misleading. They may contain a different concentration of CBD than what is mentioned. They may even contain a different concentration of THC.
How to choose the Best CBD Product for pain?
When a market is so unregulated and uncertain, the question arises, how can you be sure that you are buying what you intend to buy? The answer is, unfortunately, you cannot be sure. However, there are a few ways by which you can ensure a considerably precise purchase.
- Instead of buying online, or from a store, it would be safer to buy CBD products for pain at a pharmacy. Pharmacies usually have better checks on quality than the other sources.
- Moreover, you can go to the brands which provide lab-tested products. They give a certificate with the product that shows the product has been tested.
- Besides, if you are trying to avoid THC completely, or are wary about the results of an upcoming drug test, go for the CBD isolate or broad-spectrum products instead of the full spectrum ones. The CBD isolate products mean that they contain nothing but CBD. CBD broad-spectrum means CBD and terpenes are there but THC is totally excluded. Whereas, CBD full-spectrum products also include up to 0.3% THC. However, some studies suggest that CBD is even better at pain management when combined with THC and produces an entourage effect.
Side effects of CBD pain relievers
One of the biggest reasons why CBD has suddenly gained so much popularity as a pain reliever is that it has minimal side effects. Especially when you compare it with conventional pain killers, it is generally regarded as a much safer option, although relying solely on it is still not recommended until more scientific evidence is provided for its efficacy.
Kevin Boehnke a research investigator at the Michigan Medicine Chronic Pain and Fatigue Research Center indicates that CBD has only a few negative side effects and is generally well tolerated by most people.
Above all, what makes CBD a popular choice is its non-addictive nature. Besides. It has no serious long-term side effects. However, since every individual responds to a new supplement differently, caution needs to be taken anyway. In some people, CBD can cause minimal to mild side effects, especially in the beginning. These include;
- Diarrhea
- Fatigue
- Nausea
- Weight loss
- Loss of appetite
Moreover, if you are already taking some medicines, especially blood thinners, it is advisable to consult your physician before. Starting CBD supplements. This is because it can interact with certain medications to produce unwanted results.
Conclusion
Although CBD has become the biggest craze of the day in treat stubborn, chronic pains without doing the long-term damage, it must be noted that you are going to plunge into a fairly unregulated, uncertain market. So if you’ve decided to jump on the bandwagon, be cautious in selecting the right product for your particular case. Moreover, CBD can have negative side effects, especially when used with medicines that have grapefruit warnings. So, consulting a physician before starting to take CBD will be the safest option. He will also be in a better position to guide you regarding an appropriate dose.
References
https://www.sciencedirect.com/science/article/abs/pii/S0041134517309624