Chronic Pain & CBD Oil
Can I manage my arthritis pain with CBD Oil? Learn about CBD for Pain Management with some insight from some of the industry’s leading experts.
Chronic pain, is a real pain – that’s a fact, waking up with it, living with it and going to bed with it – there’s the painsomnia too (of course!). It’s constantly there, and only with mental strength can we try to place it out of our minds to get on with our daily life. There’s plenty of pain medications and drugs on the market, and I have tried plenty of them too – from NSAIDs, steroids, co-codamol and arcoxia. With @ArthritisFoodie, I am documenting my tests and trials with natural remedies to ease arthritis pain.
There are more than 100 types of arthritis, with Rheumatoid Arthritis and Osteoarthritis being the most diagnosed and well known. With this, there are lots of drugs too. Not much is helping the chronic pain I feel in my ankles each day though. So, one of the remedies I have been most interested to learn about is the power of CBD, formally known as ‘Cannabidiol’. It’s legal in small quantities in the UK (but the THC part of the plant isn’t) and it is one of the fastest growing industries – it’s seen as a ‘miracle plant’ and its popularity is growing like it’s the new ‘avocado on toast’.
So, I was really excited to attend (with a kind someone who has membership there) the talk about CBD at the private member’s club Annabel’s in Mayfair, London. I made some notes during the talk and hopefully this blog will give you some insight into what I learned from the panel.
I tried CBD Oil from Holland & Barrett, for a month in February 2019, but I wasn’t sure if it was the right strength/product/didn’t understand how it worked.
The discussion: To CBD or not to CBD? That is the Question!
“CBD, or Cannabidiol, is one of the key chemical components of cannabis, and is showing a huge promise in the treatment and alleviation of a long list of medical conditions, chronic pain, and skin concerns, but there are still question marks as to whether or not it has any proven health effects.”
Who was on the panel?
Dr Danni Gordon: is a trained and registered medical doctor at Harley Street in London, but she has been practicing in Canada where she treated thousands of patients with CBD, from mental health, to cancer, pain and fatigue. Her goal is to train UK physicians in medical cannabis, and emphasise that cannabis is the most useful herbal tool. She is a Cannabinoid Medicine and Integrative Medicine Specialist too.
Dr Matthew Brown: is a Consultant at the Royal Marsden Hospital specialising in pain medicine and anesthetics, with a focus on pain relief for cancer patients. He is interested in the research on pain mechanisms, and how medical cannabis sit within this, as he is on the board of George Botanicals – a leading UK brand in the CBD space.
What is CBD?
CBD is one of the 104 chemical compounds known as cannabinoids found in the cannabis or marijuana plant, Cannabis sativa, and it is the non-psychoactive part of the cannabis plant that doesn’t make you high, so it’s currently legal in most countries. “CBD lacks the cannabis-like intoxicating properties of THC and, for this reason, has been traditionally considered non-psychoactive”. THC, or Tetrahydrocannabinol, is the main psychoactive cannabinoid found in cannabis, and creates the sensation of getting “high”, which is the part that is considered illegal. In the UK, you can only buy CBD oil that contains a maximum THC content of 0.2%.
Where does CBD come from?
CBD oil is made by extracting CBD from the flowers and leaves of a cannabis plant, then diluting it with a transporter oil, such as coconut or hemp seed oil. Hemp Seed Oil is from the seeds of the cannabis plant, and hemp seeds and hemp seed oil have been used for cooking and other purposes for years. It is legal because it does not contain significant amounts of cannabinoids, like CBD and THC.
“Hemp seed oil or cannabis seed oil is high in antioxidants, amino acids, and omega-3 and -6 fatty acids. It’s great in a smoothie and like many natural oils, is wonderful for skin but contains zero CBD (cannabidiol) and none of the benefits of CBD.”
Cindy Capobianco, co-founder of Lord Jones.
Does CBD have a history of medicinal use?
It’s great to learn about CBD, but what about medicinal cannabis? Is it the same thing? Well, no, it’s not, as medicinal cannabis does have some THC in, as the THC scientifically enables the CBD to be more effective within the body, it can be prescribed, but it is hard, and the process is long. This is frustrating, as Cannabis has been used for medical purposes across the world for centuries, going as far back as 2900BC, which is exactly 4,918 years ago.
What I was most surprised to learn, is that Queen Victoria used medical cannabis when she was in labour, and it was a very established part of medical practise up until the 1930s in the UK. It fell off in the 1930s, during the prohibition period in America (which the UK mirrored) into being seen and abused as a recreational drug, rather than a drug for health.
What is the current legal status of cannabis in the UK?
Legislation in the UK has recently changed, and now medical cannabis has both TCH and CBD. However, in the NHS in order to prescribe it, it has to be a multi-disciplinary decision. A GP cannot prescribe it, it first has to go to a specialist and then it has to be signed off by the director of the hospital. There is a huge amount of paperwork and the patient has to try all of the other alternatives too. Opioids that cause more harm than cannabis are easier to get hold of than medicinal cannabis. Getting a prescription on private healthcare is a swifter process, but of course, not everybody has the access to this.
Is there proof that it works?
Dr Danni Gordon has many anecdotal “case studies” from her own use of it with patients in Canada that prove it does work – for pain relief, anxiety and so much more. There is exponential growth in research happening, but studying the hemp plant has been illegal.
It’s also hard to test, as there is also a huge array of chemicals within the plant – and there are different strains of it too. For example, you have a study looking at pain – the dose varies, type of pain varies, and type of CBD varies too. However, there are cannabinoid receptors within our bodies that react to it either way, it is something our body natural is accustomed to, more on this in the science section below.
Apparently, it also has anti-acne effects, Danny has had psoriasis patients who have used CBD and TCH creams and it has helped them. I was interested to know this in the case of psoriatic arthritis.
How do you take CBD, what is its best form?
For wellness use – there is the option of oral oil form 5-10mg drops, 2 to 10 times a day. However, you can also find dry herbal ones or vapourisers / vaping oils, with flowers that look like cannabis, but don’t have TCH. You can even buy CBD tea now too!
The best way to get CBD, and to see if it can help, is through a doctor by getting a prescription – as this is CBD and TCH in its proper natural form – without the CBD being extracted. There are a lot of new companies coming out in UK claiming to produce it, but it is always best to go on their website and check who is on their scientific board to be able trust the product. Overall, it is important to do your own research before buying and trying the products. There are plenty of good health shops, such as Holland and Barratt that stock the products.
The panel mentioned that it’s worth noting that if you have low blood pressure you have to be careful. Drug interaction is also a potential if you have epilepsy drugs. Research has also not been done yet either in terms of how it could affect chemotherapy and different types of cancers.
Finally, give it time and try different strengths of it:
“What I find with a lot of chronic pain conditions is because CBD actually interacts with our own cannabis system in our own bodies, called the endocannabinoid system, it doesn’t actually turn pain off directly like a painkiller… it down regulates our perception of pain and the kind of tones of our nervous system… it can help with chronic pain over a period of time, but often it might take weeks or months to see any effect and it doesn’t cure chronic pain, so you have to keep taking it… use a different dose, or a different product or add a tiny bit of THC (legal in Canada).” – Dr Dani.
You could try some CBD Tea, if the oil drops aren’t for you!
What is the science of the body telling us about CBD?
We have receptors in our bodies for cannabinoids, a specialised system called the endocannabinoid system (ECS), which is involved in regulating a variety of functions including sleep, appetite, pain and immune system response. CBD with TCH activates the natural cannabinoids in the body called endocannabinoids, which are neurotransmitters that bind to cannabinoid receptors in your nervous system, reducing inflammation and pain by interacting with neurotransmitters.
Research has been grey, but what we are seeing is a move away from randomised studies to the idea that we can collect data from the real world – functional, mobility, and general wellbeing. We will eventually see a shift of change towards accepting this kind of data, but it needs to be funded for it to be found.
A lot of the industry is being led by entrepreneurs as pharmaceuticals who want to take a strand of the chemical, but you should be taking the whole plant to get the full benefits, as if you don’t have THC the CBD takes longer to work and is less effective.
Future of CBD & the Holistic Approach
When will it be relaxed enough to not have the hurdles, and to be able to be prescribed medicinal cannabis a lot easier? In ten years’, is the prediction from the panel.
Finally, CBD is not a silver bullet solution, and it can only work if everything is in line – good health, exercise, diet, sleep and so on – binding into a whole holistic approach to health and wellbeing.
Extra Tips from the Panel
Anxiety and sleeplessness are common in people with chronic pain. Sleep hygiene is essential – it should be quiet and dark an hour before bedtime, don’t go on your iPad or phone before sleep, not having coffee before bed, try to have the last one before 1pm! I recently listened to a podcast about sleep – link is here.
I also had a chance at the end to approach some of the panel and chat to them about the ways in which I could manage my arthritis pain (and pass these ideas on to through Arthritis Foodie). These were some of the extra suggestions that I am going to go away and try:
- Magnesium – to take this as a supplement.
- Menthol – in creams to soothe the pain.
- Acupuncture – I have had this in my neck before, but not frequently enough to feel any significant difference – and I have never tried it in my ankles before.
- Pain team at my hospital (St George’s) – to find out who this is and to try and get a referral to help with the management of pain.
CBD oil must be given a try in a holistic approach, and you have to do your own analysis as to how it is helping you, as there is no research out there.
It is safe to use and buy from approved places, but if you need the real strength of it, getting hold of medicinal cannabis through your specialist is the best option.
Always look for natural CBD, as some companies water it down with other things! Trial and test more than one. Further reading about CBD oil for chronic pain: on Dr Dani’s site.
I will be trying CBD again, just in the process of researching the best one, so stay tuned!
Using CBD for Arthritis: Tips for How to Get Started
Enthusiasts of cannabidiol (better known as CBD) rave about the substance’s health benefits. Some small studies have shown that CBD could be a remedy for anxiety and help children with post-traumatic stress disorder get to sleep. The substance was even FDA-approved last year as a prescription drug to manage rare, severe forms of epilepsy.
So naturally, you might be wondering: Can CBD help people with arthritis and related diseases cope with pain? Anecdotal reports from patients and some preliminary research suggests yes, but the science is still emerging and more research is needed.
Here’s what you need to know right now about how to use CBD to ease arthritis symptoms, how to find a high-quality CBD product, and how to work with your doctor to incorporate CBD into your arthritis treatment plan.
What Is CBD, and Can It Help with Arthritis?
CBD is a chemical found derived from hemp. Hemp and marijuana are both types of cannabis plants, but they are very different from each other. They each have different quantities of various phytocannabinoids, which are substances naturally found in the cannabis plant. (It’s sort of like how different kinds of berries contain different combinations of antioxidants.)
- Marijuana contains an abundance of THC (tetrahydrocannabinol), which is the cannabinoid that gets you high.
- Hemp contains less than 0.3 percent THC. It contains CBD, which is a cannabinoid that doesn’t have any psychoactive effects. CBD cannot make you feel high. Instead, CBD works in other ways with your endocannabinoid system, which is a group of receptors in the body that are affected by the dozens of other documented cannabinoids.
“Cannabinoids can inhibit or excite the release of neurotransmitters [brain chemicals] and play a role in modulating the body’s natural inflammatory response, which are the two things we’re concerned about when talking about CBD for arthritis,” says Hervé Damas,MD, a Miami-based physician and founder of Grassroots Herbals, a CBD product company.
CBD is thought to work on pain in two parts of the body: the site of soreness (such as your finger joints) and the central nervous system, which sends pain signals to the brain when it detects certain stimulation or damage to nerves and cells.
The ability for CBD to calm that response is one reason the compound might be a viable pain remedy for people with arthritis. Another is CBD’s anti-inflammatory properties. Inflammation occurs when your body is fighting a perceived infection. In autoimmune diseases such as rheumatoid arthritis, the immune system is attacking healthy parts of your body like your joints.
It’s important to note that while early research on animals has shown promise for CBD, more research is needed before we can draw anything conclusive for humans. However, anecdotal reports from people who have started incorporating CBD into their arthritis treatment are positive. One CreakyJoints member shared on Facebook that topical CBD “helps better than any other ointment I’ve ever used.” CBD could be worth exploring as a potential solution to pain as part of an overall arthritis treatment plan.
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How to Find the Right CBD Product for You
From supermarkets and pharmacies to health food stores and online retailers, CBD can be found just about everywhere. But how do you choose the right CBD product for your health needs?
1. Pick the CBD Formulation You Want to Use
CBD comes in a few different forms. Commonly used ones include:
- Edibles: You eat CBD infused into gummies, chocolates, sodas, baked goods, and other edible items
- Vaporizer: You inhale CBD through a vape pen that heats up the oil
- Sublingual drops: You take a few drops under your tongue of a high-concentrate solution of CBD
- Topicals: You apply creams, lotions, balms and other products with CBD directly to your skin
The different types of CBD take effect in your body at different rates. Here’s how long you can expect different types of CBD products to kick in, according to Dr. Damas:
- Edibles: 30 minutes to two hours
- Vaporizer: Two minutes
- Sublingual drops: 15-30 minutes
- Topicals: 10 minutes
2. Look for Signs of High-Quality CBD
Don’t just buy the least expensive one on the shelf. There are lots of poor-quality CBD products on the market (some of which don’t contain the amount of CBD they claim, per these FDA warning letters).
Dr. Damas recommends looking for CBD products that are made in the United States, use a carbon dioxide-based extraction method (“It’s the cleanest,” he says), come from organically grown hemp, and don’t contain a lot of extra ingredients. Consumer Reports also has a thorough guide to shopping for CBD that can help you find a high-quality product.
3. Pick the Right Dose
As for dosing of CBD oil, the jury’s still out on just how much you should take. Start with a low dose (such as 5 to 10 mg), and gradually work your way up over a few weeks until you notice the effects.
“Usually people find pain relief when they take 20 to 35 milligrams of CBD daily,” says Dr. Damas.
You can take the full dose at once or break it up throughout the day. Experiment with what makes you feel best. You should start seeing improvements shortly after you start supplementing with CBD, with more noticeable effects kicking in after two weeks.
How to Discuss CBD with Your Doctor
You should talk to the doctor who treats your arthritis before you start taking CBD or any other supplement. They can let you know if CBD might interact with any medications you currently take or potentially worsen a chronic condition. For example, “CBD may make it easier to bleed,” says Dr. Damas. “So if you’re going to have surgery, you might want to stop taking it before the procedure.”
Check out this list of potential drug interactions with CBD from the U.S. National Library of Medicine, but you should always check with your doctor about your individual case.
Keep in mind that your doctor’s knowledge of CBD might be limited. There isn’t a lot of research about the benefits of CBD or about ideal dosages or formulations, so your doctor might not be able to be overly specific in terms of their recommendations. However, they still need to know that you’re taking CBD. Chances are, they’ll be interested in hearing about your experience using CBD products and your self-reports on how CBD may be helping to manage your pain or other symptoms.
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CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We present patients through our popular social media channels, our website CreakyJoints.org, and the 50-State Network, which includes nearly 1,500 trained volunteer patient, caregiver and healthcare activists.
CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We represent patients through our popular social media channels, our website CreakyJoints.org, and the 50-State Network, which includes nearly 1,500 trained volunteer patient, caregiver and healthcare activists.
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