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The Ultimate Guide to CBD for Pain & Pain Perception

In the UK, more than 40% of the population are living with pain that has lasted for three months or more (defined as chronic pain), and that percentage goes up to 62% for those over the age of 65. Long-term pain has many causes and can differ in type – such as mild, sharp, severe, and dull – but in many cases, the source of chronic pain can be complex and difficult to treat. Thankfully, there are many ways to address pain, even outside of standard pharmaceutical approaches.

But have you considered Cannabidiol (CBD)? CBD has great therapeutic potential and research suggests that it can help to relieve pain, which could improve the daily lives of people living with chronic pain conditions. Consequently, it’s becoming favoured as an analgesic (pain-relieving) solution. In this article, we look at how CBD works and how people use it to relieve chronic pain, including for specific types of pain and conditions. But first, we explain how pain works.

Pain is a complex biological process. To understand how it works, it’s best to begin with some physiological basics.

The central nervous system, or CNS, is composed of the brain and spinal cord and the peripheral nervous system, or PNS, is composed of all other nerves. Your nervous system controls all your bodily functions, including mood, memory, and appetite.

Your body responds to pain that triggers the nervous system. For example, imagine you touch a hot stove. The signals from your hand travel along nerve fibres through your spinal cord and into your brain.

It interprets the communication and sends signals back down through the spinal cord and to your hand when it receives a pain message. If no tissue or nerve damage disrupts the signal, you’ll react and pull your hand away from the heat.

Pain isn’t just an unpleasant feeling; it’s biologically necessary. It saves you from further physical damage and allows you to heal. The sensation of pain, while incredibly discomforting, has an essential purpose — to prevent you from using the affected area. By resting, your cells and tissues can rebuild themselves after injury so they can continue their essential biological functions.

In the case of burnt fingers, using your hand causes a sensation of pain. You’ll then avoid using your hand until the pain subsides, thereby allowing the damaged tissues to heal.

Sometimes pain signals become confused. When one signal reacts to pain, others may also join in, potentially leading to chronic, severe pain.

Let’s return to the hot stove analogy. This time, imagine burning a towel on the stove. The smoke from the burning towel sets off one fire alarm to warn you of danger, and you quickly put out the flame. Unfortunately, even though the fire is out, all the fire alarms are now ringing.

When your body overreacts to pain, it’s a similar case, in that the body receives more pain signals than it needs to heal and protect itself. In chronic pain, you can experience debilitating pain months or even years after.

Health professionals categorize pain in three ways:

  1. acute
  2. long-term
  3. recurrent

Acute pain is caused by a specific incident. Typically, it’s a sharp pain that only lasts for a limited time and goes away when your body has healed. Conversely, long-term pain, also called chronic pain, persists over months or years.

Although pain is essential, living with continual pain or even short-term pain interferes with your comfort and ability to function. Therefore, finding a natural way to ease pain without unpleasant side effects is a desirable therapeutic goal.

Cannabidiol, better known as CBD, is one of the compounds found in the cannabis plant. Unlike delta-9-tetrahydrocannabinol (THC), CBD is a non-psychoactive compound and does not induce the “high” often associated with cannabis. Instead, CBD interacts with our endocannabinoid system (ECS) and influences its CB1 and CB2 receptors, which can help to regulate several of our cognitive and physical functions. This includes pain, mood, appetite, stress, and a number of related processes.

CBD is available in several different forms, including oils, edibles, topicals (products applied to the skin), and vape pens.

Recent studies and developments in the field of CBD suggest that CBD can be used for the management of painful conditions. The research is finding mainstream support in organisations such as the WHO World Health Organisation, WADA and several disease associations. The World Health Association recommended that CBD not be internationally scheduled as a controlled substance, The World Anti-Doping Agency (WADA) and the UK Anti-Doping Agency (ADA) has removed CBD from its banned substances list, and the Arthritis Foundation has acknowledged that CBD may help in managing arthritis-related pain. So, how does it work?

Your body’s cell signalling system, called the endocannabinoid system, is responsible for receiving signals in your brain and immune system and helping your cells respond. CBD is thought to interact with your endocannabinoid receptors — in particular the CB2 receptors which are found in our organs, bones, the lymphatic system, glands, and blood vessels — and stimulate a response that creates pain-relieving, anti-inflammatory effects, allowing your body to more effectively manage pain.

For example, CBD can increase the body’s levels of anandamide, a compound associated with regulating pain, which can reduce pain perception and improve mood.

Endocannabinoid system, image via Harvard Health Publishing (2021).

This is to do with the fact that the ECS plays a role in maintaining homeostasis. Homeostasis is the body’s natural ability to regulate its environment, including internal temperature and blood pressure.

Indeed, a review of studies on the body of research around CBD from 1975 to 2018 that looked at neuropathic pain and fibromyalgia, amongst others, concluded that CBD is effective in overall pain management and doesn’t have negative side effects (a finding that is supported by the WHO). Let’s look at this in more detail.

Inflammation is at the root of a number of diseases and conditions. While inflammation does play an important role in activating your body’s immune response to protect against foreign bodies such as bacteria and viruses, extended or extreme inflammation can cause long-term health issues. These concerns include increased production of free radicals in the body, which causes oxidative stress and cause damage to proteins, cells and even your DNA.

CBD works as an anti-inflammatory, pain-controlling agent as it lowers the production pro-inflammatory cytokines by the immune system. It therefore works in a similar way to medication such as NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) and steroidal drugs. But, unlike mainstream medical alternatives, it doesn’t have the same long list of negative side effects.

In a 2012 study on human embryonic kidney cells, scientists observed that CBD influences CB1 and CB2 receptors of the ECS to reduce inflammation and analgesia when reacting to a pain stimulus. 

 Arthritis is a common condition affecting more than 50 million adults. However, it isn’t a single condition but an umbrella term for over 100 types of joint pain and diseases. Pain, swelling, stiffness, and lack of mobility are widespread signs of these arthritic conditions. Arthritis can make daily activities like personal care or enjoying leisure activities impossible.

There are several human and animal trials that cover the potential of CBD to treat rheumatoid arthritis.

The first controlled trial conducted in 2006 focused on patients with rheumatoid arthritis found that, compared to a placebo, Sativex significantly improved participants’ pain during movement, pain at rest and quality of sleep.

A 2016 study conducted on rats with arthritis determined that CBD reduced inflammation and overall joint pain with no noticeable side effects.

In another 2022 study on cannabidiol as a treatment for arthritis and joint pain, CBD use was associated with improvements in pain (83%), physical function (66%), and sleep quality (66%).

Researchers also believe that CBD shows promise as a treatment for osteoporosis, a condition that causes bones to weaken, thin, and become more brittle.

Migraines are often accompanied by inflammation of blood vessels in the brain. CBD has proven anti-inflammatory properties which could help to mitigate this inflammation, reducing pain and other symptoms associated with migraines.

  • 2018 review of studies concluded that cannabinoids — due to their anticonvulsant, analgesic, antiemetic, and anti-inflammatory effects — present a promising class of compounds for both acute and prophylactic treatment of migraine pain.

  • Another 2018 review of studies found ‘accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache.’

  • 2017 study found that CBD (with THC), leads to lower acute pain, and the pain intensity also decreased. Taking a combination of CBD and THC compounds, the frequency of migraine attacks fell by over 40%. For participants with cluster headaches, there was also a noticeable decrease in pain.

Beyond pain relief during migraine attacks, CBD also shows promise in preventing migraines through its neuroprotectivie properties, which could safeguard brain cells from inflammation and damage, and help to reduce the severity and frequency of migraine attacks.

Image via: Aychman, Mackenzie, et al. “Cannabidiol’s neuroprotective properties and potential treatment of traumatic brain injuries.” Frontiers in Neurology, vol. 14, 2023.

Fibromyalgia affects the muscles and bones, causing a range of symptoms including stiffness, pain, exhaustion and extreme sensitivity to touch. There are a number of theories about what causes the condition, but it is likely due to the way that the brain interprets pain signals. CBD could be an effective method for managing symptoms of the condition as it may reduce the body’s sensitivity to pain.

There are currently no published studies on fibromyalgia that look at the effects of CBD on its own. However, cannabis has been linked to reduced pain and stiffness and significant drops in acute pain and fatigue. Indeed, 2019 research found that Bediol, which is high in CBD and THC, led to a 30% reduction of spontaneous pain in 18 of the 20 participants.

In another 2019 study of 367 fibromyalgia patients, 52.5% of participants, or 193 people, described their pain level as high. At the 6-month follow-up after taking a regular dose of cannabis, only 7.9 percent of those who responded, or 19 people, reported high levels of pain.

Studies suggest that CBD can help to relieve nerve pain, reduce inflammation and improve sleep, which could help with back and sciatica pain. In a 2019 study, orally consumed cannabinoids provided long-lasting relief of allodynia in a chronic, neuropathic sciatic nerve injury mouse model. 

An open-label, prospective, observational study in 2022 found that treatment with hemp-derived CBD gel caps was associated with significant improvements in pain scores and several quality-of-life measures for patients with lumbar spinal stenosis — a narrowing of the spinal canal, which can lead to sciatica. 

Finally, an anecdotal report found that CBD oil ‘cured’ one woman’s sciatica. She claimed that the oil ‘worked almost instantly and has left her virtually pain-free’ since. 

Neuropathy is a painful and debilitating condition. Feeling prickling, tingling, and numbness in your limbs can make it challenging to live comfortably. Basic tasks can feel like endless chores, and just making it through the day can feel impossible when your entire body hurts. 

Various events can cause neuropathic pain, including falls, accidents, and sports-related injuries. It may also develop in individuals who have diabetes, an autoimmune disease, or through smoking. According to an analysis of studies on pain, 8.2 to 8.9% of the UK population may suffer from chronic neuropathic pain. 

CBD could help the symptoms of extreme sensitivity and sharp, excruciating pain associated with neuropathy. For example, a small 2020 study found significant improvement in pain and troublesome sensations, which suggests that topical applications of CBD oil may help reduce neuropathy in the lower extremities. 

Another 2022 study with 54 people found that CBD could help relieve early symptoms of chemotherapy-induced peripheral neuropathy.

People experiencing pain may also develop anxiety, depression, and other mental health issues. However, there is some evidence that CBD may reduce the anxious behaviours that occur in multiple disorders. 

CBD’s anxiolytic or anxiety lessening properties may be helpful as a treatment for panic disorder, post-traumatic stress disorder, social anxiety disorder, generalized anxiety disorder, and obsess-compulsive disorder.

While the evidence for CBD as an anxiety treatment method for multiple anxiety disorders is promising, more studies must be conducted to determine its potential in other clinical populations. 

Pain also negatively affect sleep, and when you’re in pain, it’s impossible to get restorative rest. Your body needs rest for multiple reasons, including protecting brain health, repairing muscle tissue, and strengthening your immune system. 

Although it’s recommended to get seven to nine hours of sleep each night, this can seem insurmountable when in pain. However, studies show that CBD has the potential to encourage healthy sleep patterns. 

If you feel like pain and anxiety are ruining the chances of a good night’s sleep, CBD may be the answer as it eases discomfort and stress and soothes you into a restful slumber. 

Ibuprofen is one of the most common anti-inflammatories on the market, used for treating pain and fever. It’s effective at providing treatment, but may have a negative impact on your gut health and can damage the lining of your stomach. This is different to CBD, which also acts as an anti-inflammatory, but supports gut health and won’t impact your stomach.

Opioids such as OxyContin and Vicodin are becoming a bigger problem as the use and abuse of these medications is linked to increasing rates of addiction and overdose. Opioids are usually prescribed to manage pain, but they essentially mask the symptoms rather than dealing with the root cause and often lead to addiction in the long-term. The short-term effects are also problematic, causing dizziness, anxiety, irritability, nausea and vomiting.

CBD is being presented as an alternative for managing chronic and acute pain, because unlike opioids (and even THC for that matter), CBD is non-intoxicating and non-addictive. This ties in with recent studies that have shown a decreased reliance on opioids in areas where there is legal access to cannabis.

Indeed, in a 2022 review of studies, it was also concluded that CBD is an excellent alternative to an opioid in chronic pain because CBD is non-intoxicating in its pure form.

These products have been tested by third-party, independent quality control analysts via a vigorous process, and the certifications are available to view on the specific product pages. In addition to this, the Banned Substance Control Group (BSCG) have awarded us gold certification meaning our oil is 100% THC-free and recommended for safe use in sports.

If you’re considering using CBD to help manage your pain, here’s some key things to consider.

  • Medications: CBD has the potential to interact with certain medications, so it’s important to consult with a healthcare professional before taking CBD.
  • Type of CBD: Broad-spectrum CBD is a great option for those who want to experience the effects of CBD without consuming THC, the psychoactive compound in the cannabis plant. Clinical reports suggest that broad or full-spectrum CBD may have a better effect due to the number of cannabinoids and other plant compounds they contain that work together, otherwise known as the entourage effect
  • Type of Product: CBD products come in various forms, such as oilstopicals, capsules, edibles, and vape pens, so you should choose a delivery method and dosage that suits your needs.
  • Dosage: Finding the right dose and administration method can be a trial-and-error process as results can vary significantly from person to person. Start with a low dose and gradually increase it while monitoring its effects.
  • Source and Quality: Choose CBD derived from organically grown hemp, as this ensures minimal exposure to harmful chemicals. You should also look for third-party laboratory reports to verify how pure and potent your product is, and to ensure there are no contaminants.
  • Irritants: Check the product’s ingredients list for terpenes, fragrances, and other allergens, such as nuts and nut oils, that can make some painful skin conditions – like eczema – worse.
  • Individual Variability: The effectiveness of CBD may vary from person to person; what works for one individual may not work for another.

At best, pain is uncomfortable, and at its worse, it can be incapacitating and stressful. Although there is a slew of pharmaceutical products aimed at easing pain, they can be accompanied by a range of unpleasant side effects, and for some individuals, they bring no relief. Thankfully, there are alternatives.

CBD shows great promise as an alternative treatment for pain relief, with both scientific and anecdotal evidence suggesting it can help manage chronic pain of various different types. One of the key benefits of using CBD is that it isn’t intoxicating or addictive, and has a much lower potential for side effect than many other pain medications. However, more research on humans is required. In addition to this, people should consult with their doctor if using CBD for the first time, and ensure their chosen product is high-quality and regulated to avoid adverse side effects.

Need additional help? Take our CBD Quiz for product recommendations in minutes, or read our full guides on How to Choose the Right CBD Product and The Different Types of CBD. Want to learn more? Read our blog post on CBD Instead of Alcohol: Why CBD Mocktails Will Replace Alcohol.

We are Purity Hemp, the UK’s #1 Online CBD provider. Backed by science, and built on the principles of traceability, transparency & trust, we are dedicated to improving the health & wellness of people around the world. We are proud to be one of the only companies to guarantee full traceability from seed to shelf with our premium range of CBD products, tested by third-party, independent quality control analysts.

Date Published: September 21, 2020

Last Updated: January 5, 2024

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