How to Use CBD Oil for Pain Management

Have you heard that CBD oil made from hemp offers natural pain relief but are skeptical that it may be just another internet fad?

You have come to the right place! This article will take an in depth look at the empirical research behind CBD oil for pain relief along with other handy information for those new to cannabidiol. 

Pain: Understanding the Basics 

Scientists have divided pain into two basic classes: Neuropathic and Nociceptive. While most pain can be classified as one or the other, some conditions also include a mixture of both kinds of pain, such as sciatica.   

Let’s take a closer look at each type of pain, the associated conditions, and current treatment models.  

Neuropathic Pain: 

Sometimes referred to as “nerve pain,” neuropathic pain is the result of damaged nerves (either from injury or chronic conditions) that are actually sending bogus information to the central nervous system, creating the sensation of pain when there is no mechanical cause.  

The sensation of neuropathic pain can vary from person to person, but is often described as a burning, shooting, tingling or electric type of pain. It can come and go or be constant. It is often chronic since it is not caused by something that can be fixed such as a broken bone or a burn that will eventually heal.  

Instead, the root of neuropathic pain is a malfunctioning in the nerves, or the central nervous system, that causes a miscommunication where the person feels pain despite there being no visible cause of pain.  

This type of pain is associated with a variety of conditions, including: 

• Phantom limb syndrome (pain in a limb after amputation) 
• Facial nerve conditions 

• Diabetes 
• HIV or AIDS 
• Alcoholism 
• Multiple Sclerosis 
• Fibromyalgia 

• Shingles 
• Spinal surgery 
• Syphilis 
• Some migraines 
• Some back pain 

Treatments for Neuropathic Pain:

Anticonvulsants 

Originally developed as treatments for epilepsy, anticonvulsants were later found to be effective in treating neuropathic pain from neuropathy (nerve damage) and certain types of back pain. How they work to relieve pain is still a bit of a mystery, although it is assumed they interfere with the transmission of nerve signals.  

Examples of this type of medication include topiramate, Topamax®, Neurontin®, Fenatrex® and Lyrica®. Side effects can vary from mild to severe, although severe toxicity is rare. They include: 

• Tiredness 
• Cognitive impairment 
• Tremors 

• Gastrointestinal problems 
• Weight loss/gain 
• Skin, bone, blood, liver toxicity in rare cases 
• Fetal toxicity 

Antidepressants  

There are several types of antidepressants, however, the two that seem to have an effect on neuropathic pain include Tricyclic antidepressants (TCAs) and selective serotonin-NE reuptake inhibitors (SNRIs).  

Examples of TCAs include Amitriptyline, Desipramine, Doxepin, and Imipramine. Common SNRIs include Venlafaxine (Effexor®), Duloxetine (Cymbalta®), and Milnacipran (Savella®).  

Although not entirely understood (which gives some patients pause), the mechanism that appears to be working to alleviate this type of chronic pain is these antidepressants’ ability to regulate the uptake of two important neurotransmitters, serotonin and norepinephrine.  

Finding the right treatment for neuropathic pain with the use of these kinds of psychotropic drugs can be a trial and error process as pain management doctors work with their patients to find a balance of pharmaceuticals that have manageable side effects for each individual patient.  

Nociceptive Pain: 

This kind of pain is caused when special pain nerve fibers throughout the body are activated from injury, chemical processes in the body, or inflammation.  

Nociceptive nerves can be activated by trauma and injury, tissue damage (by way of chemical mediators that signal the nerves), and inflammation.  

In addition, these nerves can also trigger inflammation by sending their own signals that actually promote inflammation to affected areas, which in turn can stimulate more nociceptive nerves. Thus, left untreated, this can cause a snowball effect of increasing pain and inflammation that is fairly typical of injuries such as sprains, fractures and contusions.  

Nociceptive pain is responsible for pain associated with: 

• Injury 
• Inflammation 
• Burns 
• Bruises 

• Bone fractures or breaks 
• Joint damage such as with arthritis 
• Muscle pain 

Treatments for Nociceptive Pain: 

NSAIDS 

Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) are often the first line of treatment for nociceptive pain. They are the most widely available over the counter pain medication and include drugs such as aspirin, ibuprofen, naproxen as well as a host of prescription drugs in this class.  

Most NSAIDS work by blocking a set of enzymes in the body known as COX (1&2) which produce a chemical in the body known as prostaglandins, which in turn promote inflammation (which plays a role in healing). This inflammation can result in swelling, pain and fever.  

Thus, NSAIDS are often effective at reducing this important source of pain, but at the cost of blocking COX 1 and COX 2, which have other important roles, including protecting the stomach from its own acid production and important blood clotting processes.  

Although widely tolerated well by most of the population in the short term, there are some significant long-term side effects of this class of drugs including ulcers, liver and kidney failure, edema, and they may increase a risk for heart attack and stroke in at risk populations.  

Opioids 

When nociceptive pain is severe or chronic, opioids are often prescribed. There are many examples of this narcotic, including codeine, morphine, hydrocodone, fentanyl, oxycodone, tapentadol and oxymorphone. They are from both natural sources (from the poppy plant) called opiates, and synthetic sources, called opioids.  

Your body was designed to work with dopamine receptors. When you do something that gives your body a boost, such as eat, exercise, or enjoy a bonding moment with a friend, your body produces natural dopamine’s.  

Think of it as a reward system where your body/brain work together to make sure you are rewarded for the kinds of behaviors that lead to a greater chance of survival.  

Dopamine’s basically block some of the pain receptors in the brain and produces a calming or euphoric effect. By introducing opioids to the body via medication, dopamine’s flood the system radically reducing nociceptive pain for most people.  

However, at the same time, the body is being massively “rewarded” on a physiological level for taking the pill. Thus, in very short order, the body will begin to crave the medication, a.k.a. addiction, literally at the cellular level.  

It probably goes without saying, but the statistics of the current opioid crisis in the U.S. cannot be overstated. Recent statistics show:  

• 1 in 5 young adult deaths in the U.S. can now be attributed to opiate abuse 
• Deaths from opioids in people 25-34 have risen from 4% in 2001 to 20% in 2016 
• Heroin related deaths jumped 533% from 2002 to 2016 

What’s worse, we now know that profit motives of huge pharmaceutical companies were (are?) a huge driver of the current crisis. Lawsuits currently in progress show that Big Pharma has been lying about the addictive nature of opioids, bribing doctors to overprescribe opioids, as well as overlooking signs of dangerous levels of over-prescription at specific pharmacies.  

Is it any wonder so many people are turning to CBD oil for pain management to reduce their dependence on dangerous addictive opioids and the potential serious side effects of long-term NSAID use? 

CBD for Pain Management 

Now that we have a brief overview of the types of pain and their common pharmaceutical treatments, it should be obvious that the search for non-addictive, low side-effect, low toxicity, non-mood altering treatment options is a priority for the medical community and the millions of people that suffer from both chronic and temporary pain.  

This is where CBD comes in. CBD, also known as cannabidiol, is one of over 100 cannabinoids found in cannabis. Cannabinoids are the chemical compounds in the plant that are most responsible for the many health benefits associated with medical marijuana as well as CBD oil.  

Medical Marijuana Versus CBD Oil: What’s the Difference? 

Medical Marijuana is cannabis that has been developed for pharmaceutical or recreational use that is distributed by prescription in states that have laws that allow it to be sold as medicine. The use of medical marijuana to treat pain is on the rise.  

In fact, states that have loosened their marijuana laws are showing a decrease in the rates of opioid addiction as many patients are working with doctors to reduce their opioid use using this natural plant. Moreover, cannabis can reduce pain without the dangerous side effects of the other drugs commonly prescribed for pain.  

It should be noted that some doctors are hesitant to prescribe medical marijuana, citing that the mechanisms through which it works to alleviate pain are still unknown. Ironically, the same doctors may be willing to prescribe pharmaceuticals despite well known risks, toxicity, and a lack of understanding of their precise mechanisms (as we see in the case of the use of antidepressants and anticonvulsants for neuropathy).  

However, there are some downsides of medical marijuana: 

• Annual fees to maintain a prescription card can be costly 
• Most insurance companies will not cover the cost 
• Finding a pain management doctor willing to prescribe it can be a hassle 
• Facing negative judgement from family, friends and coworkers 

• Medical marijuana usually contains high levels of THC, the psychoactive component most responsible for the high associated with this drug 
• Not everyone wants to be associated with the drug given its history as an illegal drug 
• Impaired motor and cognitive function from the high is impractical for use during work hours 

CBD oil, on the other hand, is developed from extracting the cannabinoids of industrial hemp, a strain of cannabis used for centuries in the textile industries. Industrial hemp strains are required by law to have less than .3% THC in them.  

The extraction process involves using one of several techniques to separate the cannabinoids that are naturally occurring in this plant, the dominant one being CBD. It is usually sold as a health supplement with the dosage of CBD clearly marked. 

CBD oil comes in many forms including oil tinctures, creams, capsules and edibles such as candies.  

CBD oil has several advantages over medical marijuana, including: 

• Contains only trace amounts (if any) of THC, so you won’t get high or experience mind-altering affects that can interfere with your focus and ability to be fully mobile, such as driving a car. 
• In general, CBD for pain relief is less expensive than medical marijuana.  
• CBD oil for pain control does not require a prescription.  
• CBD oil is legal in all 50 states.  

• CBD oil is not associated with the illegal drug culture than many associate with marijuana. 

Scientific Research on CBD

In the late 1980’s, for the first time, researchers discovered the presences of receptors in the brain of a rat that were specifically designed to detect and bind to cannabinoids. Within a few years, they had identified the genes associated with this receptor (proving that it was genetic) as well as identifying other cannabinoid specific receptors.  

Over the next few decades to today, it has become accepted knowledge that the human body has an endocannabinoid system that plays an important role in many other body functions including pain, disease, and overall health.  

Although research has continued, there has been some resistance due to complications with the way that FDA and DEA are intertwined in terms of policy because of the DEAs scheduling of controlled substances subject to criminal law enforcement and prosecution.  

In addition, much of the research sited on pain has actually been done on marijuana, where both THC and CBD are found in abundance. In fact, these two cannabinoids may have their strongest effect when used in combination.  

For example, Sativex® is a 1:1 (CBD:THC) pharmaceutical that is naturally derived from cannabis, although it remains unapproved by the FDA because it includes THC, despite acceptance for the treatment of neuropathic pain for people with Multiple Sclerosis in most other developed countries.  

Another barrier to CBD research may well be the profit motives of pharmaceutical companies who are best located to conduct the expensive work of extensive clinical trials. They may have more interest in researching synthetics developed to mimic natural cannabinoids since they can be patented in medications such as Marinol®.  

Does CBD Work to Relieve Pain? 

Research on CBD and Pain: 

In recent years, CBD has been shown to be effective in limited clinical trials for the control of neuropathic pain as well as reducing inflammation.  

Moreover, because it is thought to be very safe with a very low potential for addiction or dangerous side effects, many scientists are recommending the further study of CBD as a safer and effective alternative to current treatment regimes in chronic pain management.  

Although still in it’s infancy, research on the topical application of CBD for pain also have some support in the clinical data.  

Anecdotal Support for CBD and Pain Relief: 

Research is expensive and takes time, and unfortunately, the interests of the people most able to conduct it are not always aligned with revealing the natural healing properties of chemicals they cannot patent or own.  

However, since CBD is almost certainly extremely safe in humans, (with the possible exception of small children and pregnant or nursing women), many people have been exploring the pain-relieving power of CBD oil on their own.  

In fact, message boards for conditions such as fibromyalgia, multiple sclerosis, arthritis and other conditions associated with chronic pain have shown more and more sufferers finding relief from their pain using CBD, a naturally occurring compound found in cannabis.  

It is important to note that such anecdotal support is not the same as clinical trials, however, in the absence of funded research, such positive results from fellow suffers can be a glimmer of hope for those that are trying to reduce their dependence on opiates or other medications in the control of chronic pain. 

When it comes to quality of life, some patients are taking matters into their own hands.  

The FDA has NOT Approved CBD for Pain or Other Specific Conditions 

Just a reminder, the FDA has not approved the use of CBD for any medical conditions, including the treatment of pain. CBD oil is not regulated as a drug or pharmaceutical, but is instead treated as a food supplement. 

While you can decide for yourself if CBD oil is worth trying for your pain, you should be sure to work with your doctor to make sure it won’t interfere with the other medications you may be taking.  

How to Use CBD Oil for Pain: Dosage Guide

There are four main ways to take CBD oil, and each can be effective for pain in some people. See my full article on the best cbd oil for pain to find out more about the different brands. Here is a quick breakdown of the main ways to consume CBD oil: 

Tinctures

The most common form of CBD Oil is tinctures. These small bottles have an eye dropper cap and you will drop the recommended dose under your tongue, holding for 30-60 seconds to allow the CBD to absorb directly into the blood stream.  

Advantages: 

• Acts fast, typically within 5-15 minutes 
• Can be added to food as a supplement 
• Least processed form of CBD
  

Disadvantages: 

• Can look conspicuous to use the drops  
• Not everyone likes the taste 

Oral Use of CBD for Pain 

Usually sold in capsule or soft-gel form, this is one of the most convenient ways to take CBD.  

Advantages: 

• Precise dosing, every time 
• Fast and convenient to take with less mess than the oil 

• Add to your daily pill regimen and take like the rest of your medication/supplements 

Disadvantages: 

• Can take up to an hour to be effective 
• May not be as bioavailable as other methods because the digestive process may decrease the rate of absorption 

Topicals

CBD creams, salves or lotions are developed for application directly at the site of pain and work by being absorbed directly into the skin.  

Advantages: 

• Fast pain relief targeted to the area of pain 
• Great for arthritis, pain from injury, and other localized pain 
• Supportive ingredients such as arnica can boost natural pain-relieving properties
  

Disadvantages: 

• Can be expensive, particularly when calculated per mg of CBD 
• Transdermal application may miss some of the other health benefits offered by CBD 

Vaping

Vaping and/or dabbing CBD involves heating CBD oil to a certain temperature, then inhaling the vapor/smoke. It needs to be done with specialized products and gear and is generally not recommended for beginners.  

Advantages: 

• Extremely fast acting relief 
• Highly bioavailable form of taking CBD for pain 
• The ritual itself can be a calming stress reliever, particularly for former smokers
  

Disadvantages: 

• Gear and products can be pricey 
• There are possible unknown additional health risks to smoking, even vaping 
• Accurate dosing is difficult 

What is the right Dosage? 

A lot of people new to CBD rightly want to learn what the right dosage is. However, the problem is that this is complicated by a lot of factors, including: 

• Size of the person 

• Experience level with CBD 
• Condition being addressed 
• Method of consumption 
• Strength and quality of the product
  

Some people don’t feel anything for the first week or two of using CBD oil. This is actually more common than you would think. It has to do with the body taking some time to build more receptors to make use of the chemical compounds found naturally in hemp.  

Different people can also experience different negative effects, such as nausea, if they take too much CBD oil. Therefore, the ideal CBD oil dosage for pain is different for everyone.  

Here is what I would suggest: Start with the minimum dosage recommended by the manufacturer of your oil. Give that a few days of regular dosing before upping the dosage gradually until you find your balance point and get the relief you are looking for. If you still are not getting relief, contact the manufacturer for more specific advice on the use of their specific product.  

 Here’s Our Top Pick:

Although this article was designed to give you the most up to date information on the research of CBD oil and pain management, I also want to help readers find high quality CBD products from top-notch manufacturers.  

In fact, you can find reviews of the best (and worst!) CBD companies out there. I have done hundreds of hours of research finding the best.  

Whether you are looking for CBD oil for back pain, foot pain, knee pain, joint pain, nerve pain, migraines, arthritis, fibromyalgia or other chronic pain conditions, your best bet is to start with a high-quality CBD oil from a trusted source.