CBD for Back Pain | CBDnerds.com
Scientific Confidence Grade
Effect Size Rating
CBD may relieve back pain. However, most of the evidence comes from studies looking at other types of chronic pain, so targeted research in people with back pain is lacking.
Multiple human studies have demonstrated CBD’s pain-relieving properties.
CBD may significantly reduce back pain.
CBD for Back Pain: Can It Help? (January 2021)
Research has shown that CBD can relieve various types of pain, suggesting that it may also be beneficial for back pain. Still, studies looking specifically at the use of CBD in back pain sufferers are needed.
There’s some evidence for CBD’s pain-relieving effects, which may help reduce various types of acute and chronic pain. More specifically, there's a lot of potentials when it comes to CBD for back pain.
Besides, CBD is a relatively safe, natural compound, which makes it an attractive alternative to prescription medications.
CBD can be taken in many forms, including CBD oil, capsules, and topical products that are applied directly to the painful part of the body. But does it work?
Here’s what medical research tells us about using CBD for back pain.
Back Pain Overview
Back pain is one of the most common reasons people see their doctor. Although it typically affects the lower back, it can also occur in the middle or upper parts of the back.
Back pain can be acute but for many sufferers, it’s a chronic issue that significantly reduces their quality of life.
According to studies, an estimated 23% of the world’s adults suffer from chronic low back pain, and as many as 84% will experience it at some point in their lives.1
There are many causes of back pain, including muscle or ligament strain, a bulging or herniated disk in your spine, osteoporosis, arthritis, and other conditions that don’t necessarily affect the back, such as pneumonia.
Back Pain Subtypes
Based on what causes it, back pain can be roughly broken down into five categories: 2
- Mechanical: This type of back pain is caused by damage to the spine or soft tissues. One common example is a herniated disk, a condition where the inner portion of the rubbery cushions (disks) between your spine’s vertebrae slip out.
- Degenerative: Back pain caused by a disease that tends to progress and get worse over time, such as osteoarthritis.
- Inflammatory: Back pain caused by some sort of inflammation, such as sacroiliitis (inflammation of the sacroiliac joint).
- Oncologic: Back pain caused by cancer, including bone marrow cancer and cancer lesions in the spine.
- Infectious: Back pain due to an infection or abscess in the spine or nearby muscles and other soft tissues.
Back Pain Symptoms & Pathology
Back pain is characterized by a painful sensation that can be described as a muscle ache or burning, shooting, or stabbing pain.
Back pain may also be worse during certain movements, such as bending, standing, walking, or lifting something. In some cases, back pain can also radiate down into your leg.
Can You Use CBD for Back Pain?
CBD may help relieve back pain in multiple ways.
First off, its analgesic (pain-relieving) properties3 can reduce back pain directly, regardless of the cause. Additionally, CBD’s anti-inflammatory4 effects may help with cases of back pain caused by inflammation.
Research also suggests that anxiety and depression may be associated with lower back pain.5 6 CBD may help here as well, as it’s known for its anxiolytic (anxiety-relieving) effect and may have antidepressant properties.7 8
A growing list of animal studies have shown that CBD can alleviate pain and provide related benefits when used internally or externally:
- One 2017 study in rats with osteoarthritis found that CBD prevented the development of neuropathic joint pain.9
- In a 2016 study, topically applied transdermal CBD gel reduced joint pain and inflammation in mice with rheumatoid arthritis.10
- A 2014 study in rats found that CBD protected against damage caused by intervertebral disc degeneration, one of the most common causes of chronic low back pain.11
The Endocannabinoid System and Pain
One of the main ways that CBD can relieve back pain is by interacting with your endocannabinoid system (ECS).
This system regulates many processes, including inflammation, stress, mood, sleep, and pain, to maintain a balanced internal state called homeostasis.12
The ECS is made up of endocannabinoids, cannabinoid receptors, and special enzymes.
Endocannabinoids are cannabinoids naturally made in the body that stimulate the ECS by binding to specific cannabinoid receptors.
Most notably, CBD can inhibit the effects of FAAH, an enzyme that breaks down anandamide, one of the two main endocannabinoids produced by your body. In doing so, it can enhance anandamide’s effects, which include pain and inflammation relief.13 14
There’s already ample evidence showing that drugs that inhibit FAAH may be an effective way to relieve pain. For example, one highly cited study found that giving mice a FAAH inhibitor increased their anandamide levels and significantly lowered inflammatory pain.15
Another mouse study found that genetically removing the FAAH enzyme or using a drug to block its effects both reduced the animal’s pain from rheumatoid arthritis.16 Similarly, a study of a FAAH inhibitor in mice with osteoarthritis reported an improvement in chronic joint pain.17
Other Ways CBD Can Help With Back Pain
CBD may also relieve back pain by interacting with other systems in your body.
For example, there’s evidence that CBD can act on TRP receptors,18 which are involved in regulating pain and inflammation, as well as other receptors with similar functions, such as PPARγ receptors.19
An animal study also found that CBD may relieve inflammatory and neuropathic (nerve) pain by acting on a3 glycine receptors.20
Additionally, studies have shown that CBD can suppress the pro-inflammatory (NF)-κB pathway,21 which is involved in many inflammatory conditions, including those that may cause back pain, such as osteoporosis and osteoarthritis.22
What Does the Research Say?
While there isn’t much human research looking specifically at the use of CBD for back pain, multiple studies have shown that CBD has pain-relieving properties.
In one 2020 study, 29 people with peripheral neuropathy — a type of nerve pain that usually affects the hands and feet — applied placebo or CBD oil to their lower extremities.
Unlike the placebo group, the CBD group reported a significant reduction in pain as well as unwanted cold and itchy sensations.23
Meanwhile, a 2019 study examined the impact of adding full-spectrum CBD softgels to the regimen of 97 chronic pain sufferers for 8 weeks.
More than half (53%) reduced or completely stopped taking prescription painkillers (opioids), and 94% of the study participants reporting improved quality of life, particularly in terms of pain and sleep.24
Another 2018 trial looked at the effects of a synthetic transdermal CBD gel versus a placebo in 320 people with knee osteoarthritis. Although not everyone in the CBD group saw notable improvements, those that did experience a significant reduction in pain.25
Furthermore, a 2015 review paper that examined the findings of 79 clinical studies concluded that “there was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain…”26
In summary, there’s a large volume of evidence showing that CBD can relieve pain but high-quality studies looking specifically at the use of CBD for back pain are still needed.
Tips on Using CBD for Back Pain
If you’re interested in using CBD for back pain, you have two main options:
- Take CBD internally in the form of CBD oil, capsules, gummies, vape e-liquid, or a similar product
- Use CBD externally, as a cream or another topical preparation that’s applied directly to the affected area of the back
The major difference between the two is that topical CBD only provides benefits where you applied it (unless you’re using a transdermal product). Meanwhile, taking CBD internally produces body-wide effects. It’s best to use both if you’re looking for optimal pain relief.
Another way to make sure you’re getting the best possible effects is to opt for products made with full-spectrum or broad-spectrum CBD.
These whole-plant extracts contain not just CBD but multiple phytocannabinoids, terpenes, and other beneficial active compounds found in hemp.
Research suggests that all of these substances work together to produce a synergistic “entourage effect,” which means whole-plant CBD products may offer greater benefits than those containing CBD alone.27
How Much CBD Should I Take for Back Pain?
There’s no established dosage of CBD for back pain. Firstly, there isn’t enough research evidence to make dosage recommendations, secondly, the dosage can also vary drastically from person to person.
The right amount of CBD to take depends on many variables, including body weight, genetics, the severity of your back pain, and the kind of CBD product you’re taking.
As a result, most experts recommend the “start low and go slow” method.28
This means starting with a small dose of CBD (10-15 mg), waiting a few hours to see the effects, and gradually increasing as needed until you achieve the desired relief.
Note that if you’re using a topical product, it can be a bit more difficult to figure out the dosage.
One helpful tip is to divide the total amount of CBD in the container by the volume so you know how much CBD is in one ml. For example, a 30 ml cream with 600 mg of CBD would provide 20 mg per ml (600 mg ÷ 30 ml = 20 mg/ml).
Are There Any Side Effects?
Research suggests that CBD is a generally safe, well-tolerated substance with mostly minor side effects.
The following side effects have been reported by studies:29
- Dry mouth
- Low blood pressure
- Changes in appetite or weight
However, most of these effects are mild and were only found in studies using high doses of pure CBD.
This means the average CBD user is unlikely to experience these side effects.
Also, if you’re using a topical CBD product, it’s even less likely to cause side effects because it’s difficult for CBD to penetrate deep enough into the skin to reach the bloodstream.
There isn’t yet any direct evidence supporting the use of CBD for back pain.
Still, many animal and human studies have shown that CBD can relieve various types of pain and researchers have uncovered multiple mechanisms through which it works.
The bottom line is that CBD oils may help reduce back pain and neck pain, even though more rigorous studies are needed.
If you want to use CBD for back pain, you can take it internally, apply it externally in the form of a topical product, or both.
CBD is a natural and relatively safe compound that’s unlikely to cause any significant side effects, which isn’t the case for standard prescription painkillers and opioids in particular.
If you find that CBD isn't helping, there are health options with tetrahydrocannabinol (THC), another cannabinoid found in the cannabis plant. Keep in mind that this substance isn't legal everywhere in the United States, unlike hemp-derived CBD. With that, you may need to seek medical advice from a doctor before obtaining THC.
5. Sagheer, Muhammad Amir, Muhammad Farhan Khan, and Salman Sharif. "Association between chronic low back pain, anxiety and depression in patients at a tertiary care centre." J Pak Med Assoc 63.6 (2013): 688-90.
8. Sales, Amanda J., et al. "Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels." Progress in Neuro-Psychopharmacology and Biological Psychiatry 86 (2018): 255-261.
9. Philpott, Holly T., Melissa O'Brien, and Jason J. McDougall. "Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis." Pain 158.12 (2017): 2442.
16. Kinsey, Steven G., et al. "Fatty acid amide hydrolase blockade attenuates the development of collagen-induced arthritis and related thermal hyperalgesia in mice." Pharmacology Biochemistry and Behavior 99.4 (2011): 718-725.
17. McDougall, Jason J., et al. "Early blockade of joint inflammation with a fatty acid amide hydrolase inhibitor decreases end-stage osteoarthritis pain and peripheral neuropathy in mice." Back Pain Research & Therapy 19.1 (2017): 1-9.
21. Kozela, Ewa, et al. "Cannabinoids Δ9-tetrahydrocannabinol and cannabidiol differentially inhibit the lipopolysaccharide-activated NF-κB and interferon-β/STAT proinflammatory pathways in BV-2 microglial cells." Journal of biological chemistry 285.3 (2010): 1616-1626.
23. Xu, Dixon H., et al. "The Effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities." Current Pharmaceutical Biotechnology 21.5 (2020): 390-402.
24. Capano, Alex, Richard Weaver, and Elisa Burkman. "Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study." Postgraduate Medicine 132.1 (2020): 56-61.
26. Häuser, W., F. Petzke, and M. A. Fitzcharles. "Efficacy, tolerability and safety of cannabis?based medicines for chronic pain management–An overview of systematic reviews." European Journal of Pain 22.3 (2018): 455-470.