Can CBD Help for Pain Relief?
[Comprehensive Study 2023]
Although more evidence is needed, CBD seems to be a promising, safe alternative to standard pain medications and may work for many types of pain.
Gleb OleinikUpdated on March 22, 2023
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Evidence Based 36 references
Checked for Accuracy
Dr. Ashwini Kulkarni
Strength of Evidence
Multiple human studies have demonstrated CBD’s pain-relieving effects.
CBD may significantly reduce pain.
CBD may help relieve various types of pain. Still, much of the evidence comes from animal studies so more human research is needed.
Chronic pain is the most common reason people turn to cannabidiol (CBD) products. ¹
Although more human research is needed, a growing number of studies provide proof of CBD’s pain-relieving effects — particularly when it’s combined with THC and other cannabis compounds.
The wide breadth of research suggests that CBD can help with neuropathic, inflammatory, arthritis, cancer, and other types of chronic pain. ¹
Many people also see CBD as a safer, natural alternative to prescription painkillers, which can lead to addiction and significant side effects that have contributed to the opioid epidemic.
Read on to learn more about the potential benefits of CBD for pain relief.
What is Pain?
Pain is an uncomfortable sensation caused by injury or illness. It’s your body’s way of telling you that something isn’t right.
A fairly complex phenomenon, pain involves nerve fibers sending signals to your brain via the spinal cord, which then interprets them and elicits the feeling of pain.
The perception of pain and an individual’s tolerance to it differs greatly from one person to another. It’s influenced by many factors including your mood, past experiences, and genetics.
Pain is the most common symptom for which people seek relief. In the United States alone, chronic pain affects an estimated 50 million to 116 million adults. ²
What Types of Pain Are There?
It can be helpful to classify pain to better understand what causes it and find the best way to treat it.
Keep in mind that many categories of pain overlap with each other. These include: ³
Pain that lasts anywhere from a few minutes to several months. Acute pain is typically caused by an injury, like cutting your finger or spraining your ankle, or temporary illness, such as the body aches you might experience during the flu.
Ongoing pain that’s typically caused by a persistent or intermittent condition, such as arthritis, migraines, fibromyalgia, cancer, or diabetes. Chronic pain is the main reason people turn to alternative treatments such as cannabis.
Pain that’s caused by damage to your tissues, such as touching a hot stove or stubbing your toe.
Persistent pain that’s caused by damage to the nerves and other parts of the nervous system. This type of pain is often difficult to relieve.
Pain that’s caused by the immune system’s inflammatory response, which can be passing (e.g. when you hurt your knee) or long-lasting in case of inflammatory diseases like rheumatoid arthritis.
Pain that is acute or chronic and activated by nociceptors in the cutaneous or deep tissues.
Pain in your internal organs that’s felt in the pelvis, abdomen, or chest. Visceral pain can be difficult to pinpoint.
Best CBD Products for Pain
cbdMD is by far one of the largest CBD brands currently on the market and they’ve developed a very diverse selection of CBD oils and products.
Most of our understanding of CBD’s analgesic (pain-relieving) effects comes from animal studies, so more clinical evidence is needed.
These investigations suggest that CBD may help with arthritis, inflammatory, neuropathic, cancer, muscle, and other types of pain. ⁴ CBD has even been shown to enhance the pain-relieving effects of morphine. ⁵
Having said that, THC from medical marijuana seems to have stronger analgesic effects. Besides, CBD works in synergy with THC, so using both cannabinoids together is ideal for pain relief.
For example, one animal study found that combining THC with CBD led to a 200-fold increase in their effectiveness at low doses. ⁶
How Does CBD Work?
Research suggests that CBD works by interacting with the body’s inflammation and pain-regulating systems. Out of these, CBD is best known for influencing the endocannabinoid system (ECS).
Composed of cannabinoid receptors, endocannabinoids made in the body, and specific enzymes, it plays an important role in maintaining homeostasis: a healthy state of balance. ⁷
The ECS is involved in regulating vital functions and processes, including pain. In fact, the ECS influences every part of the pain processing pathways, with endocannabinoids acting much like a “brake” that reduces the feeling of pain. ⁸
Additionally, there’s growing evidence that suppressing the enzymes that break down the two major endocannabinoids — anandamide and 2-AG — can be an effective strategy to relieve pain.
For example, a highly cited 2008 study found that suppressing MAGL, the enzyme that breaks down 2-AG, increased its levels and produced analgesia (lessening or absence of pain) in mice. ⁹
A similar study that looked at the effects of blocking FAAH, the enzyme that breaks down anandamide, reported increased anandamide levels and reduction of inflammatory pain. ¹⁰
Interestingly, CBD works through the same mechanism. ¹¹ By suppressing FAAH, CBD seems to increase the levels of anandamide, helping support its pain and inflammation-relieving effects. ¹² ¹³
CBD has also been shown to influence other systems involved in pain and inflammation, including glycine and PPARγ receptors and TRP channels. ¹⁴ ¹⁵ ¹⁶
What Does the Research Say?
Although much of the current evidence is limited to animal studies, emerging human research suggests that CBD can help people manage pain, including specific types of chronic issues.
Studies also indicate that CBD provides the greatest effects when combined with THC and other cannabis compounds, supporting the idea that cannabis works best as a whole-plant preparation.
CBD and Chronic Pain
One 2019 study tested the effects of full-spectrum CBD softgels in chronic pain sufferers that use opioids. A total of 97 people took CBD alongside their opioid medication for 8 weeks. ¹⁷
Over half (53%) of the participants reduced or completely stopped taking opioids within 8 weeks and 94% reported improved quality of life, including less pain and better sleep. ¹⁷
Additionally, several systematic reviews that combine data from dozens of studies have concluded that cannabinoids (like CBD and THC) and cannabis as a whole can help with chronic pain. ¹⁸ ¹⁹
Still, many researchers remain skeptical, stressing the need for further study.
For example, one recent review of CBD for chronic pain concluded that “It is difficult to definitely attribute the therapeutic properties to CBD alone since it is always administered with THC. Based on the available literature, it is difficult to make a recommendation for the use of CBD in chronic pain management.” ²⁰
CBD and Arthritis Pain
There’s also some evidence supporting the use of CBD for specific types of chronic pain, such as arthritis pain.
One 2018 study compared a synthetic transdermal CBD gel to a placebo in 320 patients with knee osteoarthritis. While not everyone showed improvements, patients that were considered “responders” saw a significant reduction in pain. ²¹
Additionally, a 2006 study of a combined 1:1 CBD/THC preparation called Sativex in 58 people with rheumatoid arthritis reported reductions in pain and disease activity. ²²
Studies have also shown that CBD may suppress the (NF)-κB pro-inflammatory pathway, which is involved in rheumatoid arthritis and other inflammatory diseases. ²³ ²⁴
CBD and Neuropathic Pain
One 2020 study looked at the effects of CBD in peripheral neuropathy, a type of neuropathic pain that typically affects the hands and feet.
Twenty-nine people topically applied placebo or CBD oil to their lower extremities. Patients treated with CBD showed a statistically significant reduction in intense pain and sharp pain along with cold and itchy sensations when compared to the placebo group. ²⁵
Similarly, a 2015 study of the CBD/THC drug Sativex in 234 people with peripheral neuropathic pain reported significant reductions in pain severity. More than half of the patients saw a 30% or greater improvement in pain at all time points. ²⁶
CBD and Cancer Pain
CBD may also offer some help for difficult-to-treat cancer pain. One 2010 study looked at 177 patients with advanced cancer pain who didn’t find sufficient relief from opioid medications.
The study found that while THC alone did not outperform placebo for pain relief, the combination of THC and CBD resulted in statistically significant improvement. ²⁷
A follow-up 2013 study in 43 patients found that the combination treatment remained effective during long-term use (5 weeks and longer). ²⁸
A similar 2012 study of Sativex in 263 people with chronic cancer pain reported improvements in some patients. ²⁹
CBD and Migraine Pain
Studies on CBD and migraines are lacking.
However, research suggests that an impaired endocannabinoid system — a condition known as clinical endocannabinoid deficiency — could be the cause of migraines and some other difficult-to-treat conditions. ³⁰
Since CBD at least partially works by elevating endocannabinoid levels, it could help with this deficiency.
On top of that, studies of whole-plant cannabis, where CBD is the second-most abundant active ingredient after THC, have shown promising results. One 2020 study reported a nearly 50% improvement in headache and migraine severity in people using cannabis. ³¹
What’s the Best Way to Use CBD for Pain?
To maximize the benefits of CBD for pain, you should choose the optimal administration route for your specific situation.
In most cases, sublingual CBD oil is the best option thanks to improved absorption and relatively long-lasting, whole-body effects. But the other methods have their uses as well.
If you’re looking for immediate relief, vaping CBD can be a good alternative. Meanwhile, topical CBD products are ideal for localized pain because they only work where you apply them.
Finally, oral products are best used for their convenience, since they have relatively low absorption and therefore won’t be as effective as CBD oil. ³²
We also recommend using full-spectrum CBD products whenever possible. Thanks to the “entourage effect,” CBD’s analgesic effects work best when combined with THC and other cannabis compounds. ³³
Meanwhile, if you need to avoid THC, you should choose broad-spectrum products.
Does CBD Have Side Effects?
According to numerous clinical studies, CBD is a safe, well-tolerated compound in animals and humans with mostly minor side effects. ³⁴
The most common potential side effects are: ³⁵
Tiredness and drowsiness
Diarrhea and nausea
Changes in appetite or weight
Early research also suggests that CBD may interact with some prescription medications. ³⁶
But these side effects are relatively minor and have only been reported by studies using high oral doses of pure CBD.
In contrast, most people take much smaller doses of CBD in the form of oil drops under the tongue and often opt for full-spectrum products. With this method, your chances of experiencing CBD’s side effects are relatively small.
CBD is seen as a safer, natural alternative to prescription painkillers, which can cause addiction and significant side effects that have contributed to the opioid epidemic.
CBD for Pain: A Popular Alternative
Research suggests that CBD may be a solid option for chronic pain relief.
Although more clinical studies are sorely needed to substantiate its benefits, particularly for specific types of pain like arthritis, the evidence is sufficient enough to warrant giving CBD a try. That’s especially true if you haven’t had much success with standard pain medication.
Another advantage of CBD is that it’s a relatively safe, natural substance. In contrast, opioid painkillers are notorious for their significant side effects and a high risk of addiction and withdrawal symptoms.
Besides, early research suggests that CBD could help with addiction to opioids and other substances, meaning it could also help address the opioid epidemic.
Keep in mind that hemp-derived CBD products are legal, although some states have restrictive rules about THC content.
Gleb Oleinik is a freelance CBD & cannabis writer from Vancouver, Canada. He’s read thousands of studies about cannabinoids and other beneficial natural compounds, helping him translate complex science into plain language. He’s also written third-party lab test reports of CBD products and knows the industry inside and out. When he’s not writing, Gleb likes to spend his time in the gym and out in nature.