Cbd oil or balm for back pain

CBD Oil vs. CBD Topicals for Back Pain – Which Is Best?

People worldwide have reached for cannabis to treat pain for hundreds of years. These days, the growing legality of marijuana means that users are spoiled for choice regarding products. However, not everyone wants the intoxicating high associated with THC, and the substance remains illegal in numerous locations. Fortunately, CBD oil from hemp is widely available and broadly tolerated in most states.

When it comes to chronic back pain, which affects 8% of all Americans, knowing which CBD product is a good fit is potentially tricky. When faced with such a plethora of choices, the search can certainly be overwhelming!

CBD oil and topicals are viable options for those with chronic back pain. So, which is best? This article looks at CBD oils vs. CBD topicals as the best option for chronic pain. It also outlines how to use both products. Keep scrolling to see the top-rated CBD brands at the end of the article.

Back Pain 101

Unlike many other conditions, back pain has no prejudice and can affect anyone at any age! It can also occur for various reasons, from injury to bad posture or other underlying conditions. There are so many occurrences that could lead to back pain, some of which are listed below:

  • Sprained ligaments
  • Strained muscles
  • Ruptured discs
  • Irritated joints
  • Obesity
  • Arthritis
  • Blood clots
  • Kidney infections
  • Kidney stones

While many cases of back pain are short-lived, there are plenty of cases where back pain gets progressively worse, and this can be incredibly debilitating.

According to the American Chiropractic Association, lower back pain is the single leading cause of disability worldwide, a massive indicator of its severity.

Cannabis for Back Pain

Millions of people worldwide reach for a joint to ease pain symptoms as the drug is associated with fast-acting relief. However, with such a large number of people living with back pain, there has been a shift towards non-intoxicating variants of the plant, which is where CBD oil and CBD topicals come in.

For those living with chronic back pain, cannabis may not be a viable option – especially if they are working or have other responsibilities that require the avoidance of intoxicants.

So, what are the medicinal alternatives to high-THC cannabis? Luckily, there is a significant number to choose from, with CBD oil and CBD topicals among the most popular.

What Is CBD Oil?

Cannabidiol (CBD) is a non-intoxicating compound found in the marijuana plant that has grown in popularity. Arguably more sought after now than THC, studies have shown CBD to have some potential in helping to manage various medical ailments.

Researchers have found that CBD interacts with the body’s endocannabinoid system (ECS), which is vital for regulating many of our bodily functions. This ranges from core temperature to how we feel pain, emotion, hunger, and more.

When consumed, CBD interacts with cannabinoid receptors found throughout this system to help combat different issues. In the case of back pain, taking CBD might help our bodies fight off pain symptoms (including inflammation) much more effectively.

Does CBD Help with Back Pain? What Does the Research Say?

There are few clinical trials outlining the efficacy of CBD for back pain. However, a study published in the Journal of Opioid Management in 2020 investigated CBD’s ability to treat chronic back pain. The researchers looked into two patient case reports. The individuals in question used a specific CBD cream that contained 400mg of the cannabinoid per two-ounce container.

The patients experienced significant symptom and pain relief after using the cream. The researchers concluded that additional studies are warranted to determine if CBD products should have a more central role in treating chronic and acute pain.

Although the available research into CBD for back pain is promising, there is very little of it. Significantly more studies are needed before drawing any conclusions. Nonetheless, many people are adamant that cannabidiol helps reduce back pain symptoms. While there is a wide array of CBD products to choose from, they all fall into one of three distinct forms, which will be covered below.

Types of CBD for Back Pain

Generally speaking, one can categorize CBD products as follows:

  • Full-Spectrum: Contains dozens of cannabinoids, terpenes, and flavonoids. Crucially, such products may contain up to 0.3% THC when derived from hemp.
  • Broad-Spectrum: These items contain everything one will find in a full-spectrum product except THC. Broad-spectrum CBD should contain 0% THC.
  • CBD Isolate: Any products containing no other cannabinoids or hemp compounds barring CBD are known as isolates. On occasion, a manufacturer may add terpenes after the initial extraction phase.

Proponents of full-spectrum CBD point towards the so-called entourage effect. This is a suggestion that the cannabis plant’s compounds work better together than in isolation. However, individuals who don’t want any THC in their system tend to gravitate towards broad-spectrum or CBD isolate products.

How to Use CBD Oil for Back Pain

One can use CBD oil in many ways, so this is down to personal preference. Many patients do not like the taste of CBD oil, so they may opt to put a few drops into their food to mask the flavor.

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For those seeking a quick hit of relief, applying a couple of drops beneath the tongue is among the fastest ways of benefiting from the cannabinoid. There are beds of tiny blood vessels called capillaries under the tongue. They allow for rapid absorption directly into the bloodstream without having to go through any of the metabolic breakdown processes of the digestive system.

How Much CBD Oil to Use for Back Pain?

Regardless of the CBD product one uses, its effects vary depending on:

  • The user’s bodyweight
  • Body chemistry
  • The user’s general health
  • The condition someone uses CBD for
  • CBD concentration

As always, the best idea is to start low and go slow – meaning start with a very low dose and increase slowly until the desired effect is reached.

What Are CBD Topicals?

CBD topicals have become more popular over recent years as we have moved further away from the traditional ways of using cannabis to help with our ailments. However, what exactly are cannabis topicals, and how are they used for back pain?

A CBD topical is a cannabis-infused ointment, cream, balm, or lotion used externally on the skin for localized relief.

Many users try topicals to help with skin conditions like eczema and psoriasis. However, this is not their only application.

So, can a topical cause one to get high? The short answer is no. Topicals absorb through the skin, potentially offering the anti-inflammatory benefits of cannabis. However, they do not reach the bloodstream but merely penetrate the CB2 receptors in the affected area. Consequently, they do not cause a high. CBD topicals extracted from hemp contain little or no THC, meaning they wouldn’t lead to intoxication even if they did reach the bloodstream.

However, it is important to note that while topicals TYPICALLY won’t penetrate the bloodstream, this isn’t the case with transdermal patches. Patches pass cannabinoids through to the bloodstream and can cause a high if they contain THC.

For those living with back pain, topicals can also offer a pleasant sensation due to the essential oils they often contain.

How to Use CBD Topicals for Back Pain

CBD topicals are useful for anyone who dislikes the taste or texture of CBD oil. Whether the product is a cream, ointment, or balm, one should apply it directly to the affected area. There are many topicals with other ingredients to target particular issues, so shop around to find the best product.

How Much CBD Topical to Use for Back Pain?

It is significantly more challenging to track one’s dosage when using a CBD topical than oil. In general, brands provide vague advice on how to use it. They usually suggest that the user apply the topical directly to the affected area without recommending a precise dosage. In reality, it is up to the user to decide whether they want to apply the topical liberally or not.

However, pay attention to the CBD concentration of the topical. For example, a 60-gram container with 1,500mg of CBD has 25mg of the cannabinoid per gram. Individuals in severe pain should shop for topicals with the highest CBD concentration.

What About CBD Cream for Back Pain?

It is easy to get confused by the different CBD topicals available. There are CBD creams, balms, ointments, lotions, and more. However, it is important to note that the main difference lies in the topical’s consistency. Here’s a quick overview:

  • CBD Cream: Creams are relatively thick because they contain a high proportion of oil. In general, a cream is about half oil and half water and may also have additional ingredients such as shea butter.
  • CBD Lotion: This topical has a high-water content and is thinner than a cream. Typically, lotions are formulated with lightweight products such as hyaluronic acid.
  • CBD Balm: A balm is thicker than a cream but not as thick as an ointment. It doesn’t contain water and usually has a waxy texture. A balm may also have added ingredients such as beeswax.
  • CBD Ointment: An ointment is thicker and greasier than any other topical on this list.

Overall, lotions are the easiest topical to apply and good options for individuals with acne-prone skin. Creams are suitable for users with sensitive or dry skin, while balms and ointments stay on the skin longer.

CBD Oil vs. CBD Topicals for Back Pain – Which Is Best?

While CBD oil and CBD topicals can help manage back pain and discomfort, is there one that rules over the other regarding efficacy?

When we consider how topicals and CBD oil are absorbed into the body, CBD oil seems to offer better overall benefits. Rather than targeting one specific problem area, CBD oil can provide its purported benefits across the entire body.

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However, as we have mentioned – plenty of people prefer to target the affected area as and when necessary. As a result, CBD topicals seem like the obvious option for back pain specifically.

Final Thoughts on CBD Oil vs. CBD Cream for Back Pain

Regarding variety, it is clear that CBD topicals offer the broadest range of choice for long-suffering back pain patients. One can opt for CBD-rich products that contain everything needed to help ease the pain, plus added extras.

CBD oil is the most popular hemp product for a reason. It is potentially effective and takes effect very quickly, given it goes directly into the bloodstream after administration. Want to learn more about CBD oil? Check out the top brands below.

Do Topical CBD Products Actually Do Anything for Pain?

You don’t need me to tell you that CBD (cannabidiol) is everywhere. You can eat it, you can drink it, you can vape it, you can even bathe in it. And although there’s still plenty to learn about this fascinating little compound, fans of it claim that it has some pretty impressive benefits—particularly when it comes to managing pain.

Personally, I always keep a few jars of it at my desk to help with the shoulder and neck muscle tension inherent in a job consisting mainly of typing and holding a phone next to my face. But it turns out that the research behind these claims is pretty sparse, to say the least. Here’s what you need to know before you give topical CBD a try.

What is CBD?

Cannabidiol, commonly referred to as CBD, is a cannabinoid, a type of compound found in cannabis (marijuana). Unlike the more well-known cannabinoid THC (tetrahydrocannabinol), CBD does not produce a high.

Both THC and CBD act on a system of receptors in your body called cannabinoid receptors. You have cannabinoid receptors throughout your body and, so far, researchers have identified two major types: CB1 (found primarily in the central nervous system, including parts of the brain and spinal cord) and CB2 (found mainly in immune system tissues). Interestingly, both have been found in skin. Researchers have also found that while THC can bind to and activate both types of receptors, CBD seems to modulate and somewhat block the effects of CB1 and CB2 receptors. So, any effect that CBD has on CB receptors may actually be more related to regulating and even counteracting some of the actions of THC and other cannabinoids in the brain.

Why does the body have receptors for compounds in cannabis? Well, it doesn’t exactly. Cannabinoids like THC and CBD are similar enough to compounds that your body naturally makes, called endocannabinoids, that they can interact with this system. Normally, the endocannabinoid system is thought to play a role in a variety of functions in the body, helping to regulate things like parts of the immune system, the release of hormones, metabolism, and memory.

If you’re ingesting something that only has CBD in it and no THC, you won’t have significant effects in the brain. This is why CBD is often referred to as being “non-psychoactive,” although that’s clearly a bit of an oversimplification because it does do something to the central nervous system.

More recent research suggests that many of CBD’s effects may occur outside of CB receptors, Jordan Tishler, M.D., medical cannabis expert at InhaleMD in Boston, tells SELF. In fact, according to a recent review published in Molecules, CBD may have effects on some serotonin receptors (known to play a role in depression and anxiety), adenosine receptors (one of the neurological targets for caffeine), and even TRPV-1 receptors (more commonly associated with taste and the sensation of spiciness).

“It actually is a very promiscuous compound,” Kevin Boehnke, Ph.D., research fellow in the department of anesthesiology and the Chronic Pain and Fatigue Research Center at the University of Michigan, tells SELF. “It will bind to receptors in multiple different pathways,” which makes it difficult to know how it might cause noticeable effects.

“Cannabidiol is a super messy drug,” Ziva Cooper, Ph.D., research director of the UCLA Cannabis Research Initiative in the Jane and Terry Semel Institute for Neuroscience and Human Behavior and the department of psychiatry and biobehavioral sciences, tells SELF. “It has lots and lots of targets and it’s not clear how much of its effects on each target contribute to the potential pain relieving effects.”

All of this points to how hard it is to study the specific effects of CBD on its own—which might be why it’s tempting to claim that it’s the cure for everything without a whole lot of research to actually back up all of those claims.

Here’s what the research says about using CBD for pain.

The most common medical reason for which people report using CBD is to manage chronic pain, followed closely by managing arthritis or joint pain. But does it actually work?

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When the National Academies of Sciences, Medicine, and Engineering evaluated decades of cannabis research, they concluded that “in adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.”

But that’s not quite as exciting for CBD as it sounds: “We don’t know cannabidiol’s effects on its own,” says Cooper, who was part of the National Academies committee that put together this report. “[The conclusions about cannabis and cannabinoids] were based on what we know about THC or THC plus cannabidiol.”

In fact, the most compelling research they found for using cannabinoids for pain came from a large review and meta-analysis published in JAMA in 2015. For the study, researchers looked at results from 79 previous studies of cannabinoids and various medical conditions, including chronic pain. However, of those studies, only four involved CBD (without THC)—none of which were looking at pain. So although we might assume that CBD is doing something to help address pain—according to the studies involving the whole cannabis plant—we don’t have great evidence to prove it.

“It might be that cannabidiol by itself is helpful for pain, but at this point we don’t know that,” Cooper says.

The studies we do have about CBD for pain are all animal studies. For example, in a 2017 study published in Pain, researchers gave rats an injection into one of their knee joints to model osteoarthritis. Rats then either received doses of CBD or saline directly into an artery in the knee joint. Results showed that, after receiving CBD, rats showed less inflammation in the joint area and fewer pain-related behaviors (like shaking or withdrawing the affected paw or not being able to bear weight in that paw) compared to those that received saline.

Another study published in 2016 in the European Journal of Pain also looked at arthritis in rats but did so with a topical formulation of CBD. After the rats received an injection into one knee joint to model arthritis, they received a gel that contained either 10 percent CBD (in four different total amounts) or 1 percent CBD (the control) on four consecutive days. The gel was massaged into the rats’ shaved backs for 30 seconds each time.

Then the researchers measured the inflammation in each rat’s knee joint, the level of CBD that made it into their bloodstream, and their pain-related behaviors. They found that the rats that were given the two highest doses of CBD showed significantly lower levels of inflammation and lower pain behavior scores compared to those that got the control. The two lower doses didn’t show much of an effect.

But if you’re reading this, you are probably not a rat, which means these results aren’t directly applicable to your life. Although we know that rats do share much of our physiology—including CB1 and CB2 receptors—these studies don’t really tell us if humans would have the same results with CBD.

“There’s really no substitute for doing proper human studies, which are difficult, expensive, and ethically complicated,” Dr. Tishler says. And we simply don’t have them for CBD and pain.

The only thing that comes close is a Phase 2 clinical trial using a proprietary CBD transdermal gel (meaning it’s meant to go through the skin into the bloodstream) in 320 patients with knee osteoarthritis over 12 weeks, which has not been peer-reviewed to date. Unfortunately, in almost all of the study’s measures of pain, those who received CBD didn’t have statistically different scores from those who got placebo. But “they found some reductions in pain and improvements in physical function,” Boehnke says.

So…is CBD cream just an expensive placebo?

It’s totally possible (and actually pretty likely) that any effect you get from a commercially available topical CBD product is a placebo effect or related to some other aspect of the product. But there are a few things going on here that are more complex than they seem.

First off, we don’t know much about the correct dose of CBD needed for a pain-relieving effect. The doses in the rat studies that were effective were pretty large (for a rat, obviously). And the human participants in the Phase 2 clinical trial we mentioned received 250 mg of synthetic CBD topically per day—as much as many consumer topical CBD products contain in a single jar.

And even though the lotion was applied topically in the rat study, it wasn’t applied locally to the knee. Instead, the researchers were really using the topical application to get it into the rats’ bloodstream, or what’s called systemic administration. But you’d likely need a different dose for it to be effective locally (if you applied it just to your aching shoulder, for instance) in a human. We have no idea what that dose should look like.