The Truth About Using CBD Oil For Pain

CBD has great potential for relieving many types of pain. Learn how CBD relieves pain on all levels, from the body to the brain.

Statistics show that between 11 and 40% of adults in the United States live with chronic pain.

For many of these patients, the medications currently available do not provide complete relief. Additionally, pain relievers usually have side effects that may limit their usefulness.

Preliminary data shows that CBD can be a safe and effective way to manage pain for a variety of causes.

However, although CBD has shown beneficial effects under experimental conditions, few clinical trials in humans have been conducted to date, and its effectiveness in managing pain in humans is still largely unproven.

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How does CBD work? How well can it help manage pain?

In this article, we'll explore the role of CBD in pain management, what the research says, and discuss some of its limitations.

Two types of pain and the potential effects of CBD

While pain can be described by its qualities, such as sharp or dull, hot or cold, tingling, numb, etc., for the purposes of treatment, pain is often divided into two categories, depending on its cause:

1. Inflammatory pain

Inflammation is a function of the immune system and is your body's initial response to irritation or damage to tissue in the body - such as when the area around a scratch turns red and puffy.

The inflammatory process can occur in response to infection or physical injury (bumps, bruises, fractures) as well as metabolic, degenerative, and autoimmune conditions.

When you have an acute injury, such as a sprained ankle, the inflammation is very noticeable. But when inflammation occurs inside the body at lower levels in chronic conditions like irritable bowel syndrome, heart disease, or diabetes, the signs can go unnoticed, which can lead to significant tissue damage.

There are two types of inflammatory pain:

A) Acute inflammatory pain

Acute inflammation is the first stage of inflammation. It clicks on quickly and should ideally go away quickly once the tissue is repaired. Inflammation of fewer than three weeks is considered acute.

This type of inflammatory pain includes swelling, inflammation, and migration of white blood cells to the affected area.

During this phase, pro-inflammatory molecules called cytokines are released, triggering a cascade of reactions that result in swelling, redness, and heat in the injured area.

These same cytokines also activate pain receptors, which send pain signals to your brain.

B) Chronic inflammatory pain

This form of pain sets in when the inflammation does not go away after a few weeks. When this happens, pain sensors often become hyper-responsive, resulting in increased sensitivity at lower pain levels. Which means the pain signal is triggered much sooner than it normally would be.

Chronic inflammatory pain can result from autoimmune diseases, cardiovascular disease, type 2 diabetes, gastrointestinal disorders, and others [2].

Stopping chronic inflammation is an important step in the relief of chronic pain and a major target in the development of pharmaceutical drugs. CBD has been shown to directly increase the levels of anti-inflammatory cytokines (messenger molecules) and decrease the levels of pro-inflammatory cytokines - thereby reducing inflammation.

2. Neuropathic pain

This type of pain occurs when there is damage to the peripheral nerves, that is, nerves outside the spinal cord and the brain. Peripheral nerve damage can lead to persistent impairment of nerve function even after the nerve has recovered from its original injury.

Causes of nerve damage can include:

Trauma or injury

Exposure to neurotoxic substances

Metabolic disorder (such as diabetes or cardiovascular disease)

Autoimmune diseases (such as rheumatoid arthritis).

Like chronic inflammatory pain, neuropathic pain can cause hypersensitivity to pain signals.

In contrast, while chronic inflammatory pain generally responds well to anti-inflammatory drugs, neuropathic pain does not. Instead, opioid-type drugs (Oxycontin, morphine), anticonvulsants, anesthetics, and antidepressants are often used to manage neuropathic pain.

These drugs can have serious side effects that may be intolerable for some patients, including:

  • Dizziness
  • Drowsiness
  • Coordination disorders
  • Vision disturbances
  • Memory loss
  • Speech disorders
  • Increased susceptibility to viral infections [4, 18 ].
  • How CBD Can Help Relieve Neuropathic Pain

    The endocannabinoid system controls the transmission of nerve pain to many different places along the pain pathway.

    A) Reduce the transmission of pain

    Control occurs in the sensory nerves responsible for transmitting the first pain signals from damaged tissue, as well as in areas of the central nervous system that control the intensity of pain reaching the brain.

    One of the ways that CBD and other cannabinoids reduce pain transmission is by activating glycine receptors in the spinal cord, which has inhibitory effects on pain messages.

    If fewer pain signals reach the brain, we feel less pain.

    B) Protect nerve tissue against damage

    CBD also offers protective effects on the nerves, which can prevent or reduce nerve damage. This has been shown in research on the protective effects of CBD on nerve damage induced by chemotherapy.

    C) Reduce inflammation

    Additionally, the anti-inflammatory effects of CBD may prevent inflammatory conditions from causing nerve damage - which, again, leads to less neuropathic pain.

    D) Support of microglia in the spinal cord

    CBD inhibits the activity of the brain and spinal cord cells called microglia.

    These cells derived from the immune system are responsible for protecting and supporting nerve cells and are known to accumulate in neuropathic pain syndromes. By inhibiting microglia, CBD can prevent the neuropathic pain response from escalating.

    Unlike some conventional pain relievers, CBD is not addictive, a process whereby the same dose becomes less effective over time, causing the user to gradually take higher doses.

    Pain and your brain - how pain is amplified by the central nervous system

    When pain persists and becomes chronic, the interpreting mechanisms in your brain may go out of order - leading to hypersensitization, amplification of pain messages, and worsening of chronic pain symptoms.

    This process can cause physical changes in the brain, which has been shown by neuroimaging studies showing reduced connectivity between areas of the brain and spinal cord where pain messages are processed.

    This basically means that the more pain you feel the easier it is to feel the pain again i.e. the threshold is lowered so small stimuli can lead to inappropriate pain reactions.

    Impaired communication with the nervous system reduces your body's ability to interpret pain and respond to it appropriately, resulting in increased activity of the inflammatory cascade. Laboratory tests reveal high levels of pro-inflammatory signaling molecules and reduced levels of pain-inhibiting molecules, such as IL-10 [6], as evidenced by laboratory test results.

    These changes are more evident in the case of neuropathic pain syndromes but have also been found to occur in the case of chronic inflammatory conditions. For these types of conditions, pain may persist even after the inflammation is under control.

    Pain and Your Emotional State: How Anxiety and Depression Cause and Worsen Chronic Pain

    Pain, anxiety, and depression are inextricably linked - they often occur together.

    While it's easy to see how chronic inflammatory or neuropathic pain can lead to anxiety and depression, the reverse can also happen. These negative emotional states can cause physiological changes in the brain and body that promote pain.

    This makes pain management much more complicated since the emotional aspect must now be taken into consideration as well.

    Anxiety and pain: stoking the flame

    People with chronic pain often become anxious about their condition. Once anxiety sets in, it activates the stress response, resulting in elevated levels of stress chemicals, including cortisol and pro-inflammatory cytokines.

    Studies show that these anti-stress chemicals can make areas of the brain and spinal cord that process pain hypersensitive to pain messages - a condition known as anxiety-induced hyperalgesia.

    This basically means that when we are stressed we feel more inflammation and pain.

    Depression and Pain: A Self-Sustaining Cycle

    The mutuality of the relationship between depression and chronic pain may be strengthened.

    Chronic pain can cause depression by inhibiting the secretion of dopamine [25], a neurotransmitter responsible for feelings of reward and accomplishment - such as when you do well at school or at work, or when you do a marathon (or a 5K).

    Conversely, it has been found that depression, i.e. a low level of dopamine suppresses activity in certain areas of the brain which inhibits pain messages, resulting in increased pain perception.

    In summary, pain causes depression by lowering dopamine levels - and a low amount of dopamine causes pain by suppressing areas of the brain responsible for pain control.

    How CBD Can Help Relieve Anxiety and Depression

    There is encouraging evidence that CBD offers benefits in the treatment of painful, complex syndromes involving anxiety and depression.

    A large clinical study in psychiatric patients with anxiety and sleep disturbances found that anxiety decreased and sleep quality improved significantly within the first month of CBD supplementation.

    CBD has also been shown to decrease symptoms of depression in laboratory animal studies.

    However, there is still a lot to learn about the complex cause and effect relationship between pain, anxiety, and depression, and CBD may be helpful for some people in this regard, but less so for others.

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