CBD for chronic pain: The science doesn’t match the marketing
If you ask health care providers about the most challenging condition to treat, chronic pain is mentioned frequently. By its nature, chronic pain is a complex and multidimensional experience. Pain perception is affected by our unique biology, our mood, our social environment, and past experiences. If you or a loved one is suffering from chronic pain, you already know the heavy burden.
People are looking for novel, nonaddictive ways to treat pain
Given the ongoing challenges of chronic pain management coupled with the consequences of the opioid epidemic, pain management practitioners and their patients are searching for effective and safer alternatives to opioids to alleviate pain. With the legalization of marijuana in many states and resulting cultural acceptance of this drug for recreational and medical use, there has been an increased interest in using cannabis for a myriad of medical problems, including pain.
Cannabis (most commonly obtained from the Cannabis indica and Cannabis sativa plants) has three major components: cannabinoids, terpenoids, and flavonoids. While there are over a hundred different cannabinoids, the two major components are tetrahydrocannabional (THC) and cannabidiol (CBD). Historically more attention has been paid to the psychoactive (euphoric “getting high”) component of the cannabis plant, THC; there have been fewer scientific studies on the medical use of CBD, a non-psychoactive component of the plant.
What’s the thinking behind using cannabis for chronic pain?
CBD is emerging as a promising pharmaceutical agent to treat pain, inflammation, seizures, and anxiety without the psychoactive effects of THC. Our understanding of the role of CBD in pain management continues to evolve, and evidence from animal studies has shown that CBD exerts its pain-relieving effects through its various interactions and modulation of the endocannabinoid, inflammatory, and nociceptive (pain sensing) systems. The endocannabinoid system consists of cannabinoid receptors that interact with our own naturally occurring cannabinoids. This system is involved in regulating many functions in the body, including metabolism and appetite, mood and anxiety, and pain perception.
What’s the research that CBD works in humans?
Given its promising results in animal models, along with its relative safety, non-psychoactive properties, and low potential for abuse, CBD is an attractive candidate to relieve pain. Unfortunately, there is a lack of human studies about the effectiveness of CBD. However, there is an abundance of commercial advertisements about the magical effects of CBD, and it is frequently presented as a cure-it-all potion that will treat everything including diabetes, depression, cancer, chronic pain, and even your dog’s anxiety!
So far, pharmaceutical CBD is only approved by the FDA as adjunct therapy for the treatment of a special and rare form of epilepsy. Currently, CBD alone is not approved for treatment of pain in the United States. But a combination medication (that contains both THC and CBD in a 1:1 ratio) was approved by Health Canada for prescription for certain types of pain, specifically central neuropathic pain in multiple sclerosis, and the treatment of cancer pain unresponsive to optimized opioid therapy. There is currently no high-quality research study that supports the use of CBD alone for the treatment of pain.
Why is CBD presented to the public this way, when it is not without risks?
Given the rapid change in the legality of cannabis coupled with the increased appetite for something new, and driven by unprecedented profit margins, the advertising for cannabinoids in general and CBD in particular has gone wild. The FDA is very clear that it is illegal to market CBD by adding it to a food or labeling it as a dietary supplement. And it warns the public about its potential side effects, as it’s often advertised in a way that may lead people to mistakenly believe using CBD “can’t hurt.” CBD can cause liver injury, and can affect the male reproductive system (as demonstrated in laboratory animal studies).
Most importantly, CBD can interact with other important medications like blood thinners, heart medications, and immunosuppressants (medications given after organ transplantation), potentially changing the levels of these important medications in the blood and leading to catastrophic results, including death. Also, more information needs to be gathered about its safety in special populations such as the elderly, children, those who are immunocompromised, and pregnant and breastfeeding women.
Many of the CBD products on the market are unregulated
In fact, the FDA has issued several warning letters to companies and individuals that market unapproved new drugs that allegedly contain CBD. The FDA has tested the chemical content of cannabinoid compounds in some of the products, and many were found to not contain the levels of CBD the manufacturers had claimed they contain.
Beware of powerful testimonials
Finally, there is anecdotal wisdom, when experiences by patients and health professionals have positive results. While the experience or medication could be beneficial, that doesn’t mean it is going to work for everyone. That’s because each and every person is unique, and what works perfectly for one patient could have no effect on another patient. This is especially true for pain, where many other factors (our mood and stress level, our environment and other medical conditions, and our previous experiences) can affect the perception of pain. Please be careful, and keep in mind that some of these incredible-sounding testimonials are merely marketing materials meant to lure consumers to buy more products, as the CBD market is expected to hit $20 billion by 2024.
The bottom line: Don’t make CBD your first or only choice for pain relief
If you or someone close to you is considering trying CBD, I would recommend Dr. Robert Shmerling’s advice about the dos and don’ts in choosing an appropriate product. Until there is high-quality scientific evidence in humans, it is difficult to make a recommendation for the regular use of CBD in chronic pain management.
About the Author
Shafik Boyaji, MD , Contributor
Dr. Boyaji earned his medical degree from University of Aleppo, Syria. He completed an Internal Medicine residency at Michigan State University and an Anesthesiology residency at the Brigham and Women’s Hospital. Currently he is in fellowship … See Full Bio
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Cbd oil for neck pain
Even in years not plagued by global pandemics, working from home, and endless video conferencing, our necks take the brunt of abuse from hunching over computers, makeshift workstations, and too many hours sitting in non-ergonomic chairs. The result? Tech Neck: stiffness, pain and discomfort radiating from the back of the head down the neck and into the shoulders. The sensation may be dull, achy, stabbing, throbbing, or may even manifest as a headache, blurry vision, or limitation of mobility. Of course, neck pain also may be an indication of injury, age-related osteoarthritis, or other potentially serious underlying medical issues. All of these should be evaluated promptly by your healthcare professional. But if you are experiencing neck pain that you suspect most likely may be due to poor posture, prolonged sitting, or way too much connectivity, you may be a victim of Tech Neck, and there’s a lot you can do to help ease the pain. Before you reach for Over-the-Counter (OTC) pain medications, non-steroidal anti-inflammatories (NSAIDs), or even physician-prescribed analgesics, anti-inflammatories or muscle relaxants, you may want to consider other options to help relieve the pain and stiffness of Tech Neck.
Add CBD Tinctures and Topicals to Your “To Do” List
Cannabidiol (CBD) continues to garner attention as an effective natural means of reducing pain and inflammation, and for good reason. While more studies are needed and many are currently underway, research and experiential evidence suggests that CBD may possess analgesic, anti-inflammatory, anxiolytic, and neuroprotective properties that may aid in resolving nagging neck pain and more. CBD derived from the hemp plant contains little or no THC, so is non psychoactive and a good choice for those who need to stay focused and functional or seek a restorative, restful sleep to survive or even impress at the next morning’s video conference.
But how does CBD work?
CBD (cannabidiol) is one of at least 100 chemical compounds unique to the cannabis sativa or hemp plant. These compounds are referred to as cannabinoids. THC (tetrahydrocannabinol) is the cannabinoid most commonly associated with marijuana. However, unlike THC, CBD is non psychoactive and has been shown to offer a myriad of wellness benefits without the “high” effect of THC. An ever-increasing number of health studies and growing experiential evidence show that CBD may be helpful in promoting calm, addressing muscle tension and soreness, and supporting the musculoskeletal, gastrointestinal, nervous, and immune systems, among other useful applications. Adding to these benefits, CBD is considered to be non habit-forming and well tolerated, making it a desirable supplement choice.
The Endocannabinoid System
Cannabinoids are naturally effective in our bodies because, throughout our evolutionary development, we have been hardwired to gain the benefits of the cannabis sativa plant through the endocannabinoid system (ECS), a complex signaling network within the mammalian body that functions as a lock and key mechanism when cannabinoids are present or introduced into the bloodstream. These receptors exist throughout the body — nervous, musculoskeletal, digestive, immune, endocrine, circulatory, respiratory, and other systems — and are the reason why cannabinoids can have such diverse and profound effects. All mammals, including humans and companion animals, have an ECS, and the body produces “endo” (internal) cannabinoids (naturally occurring substances such as anandamide) that operate to keep the body’s systems in balance. However, when an external force such as injury, illness, or stress (think 2020 here) is introduced, our body’s own endocannabinoids may be depleted, resulting in an interruption to homeostasis that can manifest as anxiety, pain, inflammation, sleep disturbance, compromised immune function, and more. CBD and related “phyto” (plant) cannabinoids are natural compounds that can supplement the body’s own cannabinoids and lock into our cannabinoid receptors to address the imbalance and restore homeostasis.
Trove CBD topicals and tinctures are THC free and formulated with organically-grown USA hemp. Trove tinctures under the tongue or added to your favorite beverage provide systemic pain relief and help to calm the stress, relieve tension, and improve mental focus. Powerful Trove topical balms target specific areas of neck and shoulder pain and stiffness, release tension and muscle knots, and offer welcome and nearly immediate relief.
Triple Tested, Trusted and Transparent.
All Trove CBD products are triple-tested for quality, purity, consistency and concentration. QR codes on each product package link directly to the Trove website and to the Certificate of Analysis (CoA) for that specific product batch. Want more information on how to read, understand, and interpret a CoA? Click here to read our previous blog post.
Other Tools and Tips to Tackle Tech Neck
Change your workstation. Create a more ergonomically friendly work environment by changing the position of your desk, chair, or keyboard. Even if you are relegated to WFH from the dining room table, you can prop up your laptop to create your own “standing desk”. When you resume your sitting position, use back supports and make sure you change frequently the viewing position of your screen. Utilize a warm or cool neck compress periodically as you sit or stand at your workstation.
Movers and Shakers. Every now and then, remember to stand if you’re sitting, get up and stretch, move your head and neck, shake out your arms, roll your wrists, and wiggle your fingers. When you’re sitting, remember to pull your shoulders up, around and down again in both directions. Reach both hands around and give your shoulders and neck a mini massage now and then. Remember that taking a break from your monitor does not mean you pick up your phone and start scrolling on social media! And don’t neglect the break for your eyes. Take your eyes off your monitor, your mobile phone, the mounds of paper layered with all that small print, and shift your focus. Use lubricating eye drops, keep fresh air circulating, and drink plenty of water!
Take a break from neck pain
Trove CBD Balm 750 provides fast, targeted, temporary relief from neck and shoulder strains, tight muscle knots, and minor upper and lower back discomfort including general muscle soreness.
- Infused with THC-free hemp and other natural hydrating and therapeutic ingredients
- 750 mg CBD per 1.7 oz jar
Trove CBD Oil 750 taken under the tongue or on food or beverage helps provide systemic relief from pain and inflammation, addressing soreness and tension and supporting improved calm and mental focus.
- Infused with THC-free hemp in organic MCT coconut oil in choice of natural or with essential oil of lemon or peppermint to enhance therapeutic benefits and deliver exceptional flavor
- 25 mg CBD per 1 mL dropper (750 mg CBD per 30 mL bottle)
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.