Can You Use CBD for Chronic Pain? What the Science Says
Chronic pain can emerge from many sources, and nearly all of the most common medical conditions have some chronically painful component. As a result, the treatment of pain is a massive worldwide industry, but there’s a notable lack of safe and effective therapies.
In recent years, CBD has received dramatically increased consumer attention. What has occurred to the layman has not been lost on the scientist, though: At the same time, researchers around the world have been hard at work uncovering the secrets of CBD, inspired by the anecdotal reports they’ve encountered and the dire need for a medical breakthrough in the sector of chronic pain.
This guide will unveil some of the most compelling recent research that has been conducted on the subject of using CBD for chronic pain. At the end, we’ll use what we’ve learned to answer our core question: Is CBD a useful treatment for chronic pain?
CBD for Chronic Pain: Overview
1. Relief from chronic pain is one of the main uses of CBD
2. The potential pain-reducing properties of CBD are supported by empirical evidence
3. Dozens of studies have been conducted to determine the usefulness of CBD for pain
4. More research on CBD’s usefulness for pain continues to be published every year
5. Mechanisms by which CBD might impact pain have been identified
6. The side effects of CBD have been thoroughly assayed and are considered mild
7. To draw conclusions, though, more research must be conducted
Most Recent Research on CBD and Chronic Pain
2023: Dramatic efficacy of cannabidiol on refractory chronic pain in an adolescent with sickle cell disease
This compelling case study presents the story of a 15-year-old person of African descent who suffered from sickle cell disease (SCD, previously called “sickle cell anemia.”) SCD causes considerable chronic pain, and in this single case, “[t]wo weeks were enough to observe a complete regression of pain in the lumbar spine, thorax, and right knee.” Abdominal pain remained, but the study facilitators attributed this to chronic constipation. No side effects were noted, providing impressive evidence that CBD should be investigated further as a potential chronic pain treatment.
2022: Efficacy, Safety, and Regulation of Cannabidiol on Chronic Pain: A Systematic Review
As a research review, the authors of this paper looked at all the available studies on the subject of using CBD for chronic pain, deriving their results from a wide overview of all the presently known data. Noting that available research shows “benefits of CBD not only for chronic pain but also for sleep improvement and quality of life,” the authors conclude that “CBD is an excellent alternative to an opioid in chronic pain.” If CBD were anything but what it seems to be, this exhaustive level of research would have uncovered the truth.
2021: Cannabidiol effectively reverses mechanical and thermal allodynia, hyperalgesia, and anxious behaviors in a neuropathic pain model
Providing an idea of why CBD might offer its apparent pain-relieving benefits, this animal experiment found that male rats showed lower sensitivity to cold and pain while also exhibiting reduced anxiety when given CBD. Alterations to the activity of both TRPV1 and CB1 receptors were noted, which lines up with other research on the subject. CBD does not activate the intoxicating CB1 receptor; instead, it reduces its activation, which could somehow play a role in pain regulation. Alongside TRPV1, the 5-HTP1 receptor has also been identified as playing a role in the apparently antinociceptive effects of CBD.
CBD for Chronic Pain Human Trials
2023: The Effectiveness and Safety of Pharmaceutical-Grade Cannabidiol in the Treatment of Mastocytosis-Associated Pain: A Pilot Study
As the most recent clinical study into using CBD for chronic pain, this research is highly relevant to our inquiry. Consisting of 44 patients observed over a substantial period of two years, the study noted massive decreases in reported pain levels, allowing 34% of patients to “discontinue all their previous antalgic medications.” In conclusion, the researchers found that CBD “might be a safe, effective treatment for… pain.”
Hardly any side effects were noted, but one of the 44 patients was found to have elevated liver enzyme levels at the end of the two-year treatment window. Sufficient controls were not established to determine that these elevated enzymes were due to CBD usage and not some other cause.
2018: Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in Uruguay
This study is older and only consisted of seven patients, but its results are intriguing nonetheless. Starting at 100mg CBD per day, doses were reduced in some patients due to nausea. However, CBD was found to be well-tolerated overall, and usage of a post-transplant drug was reduced in some patients. Overall, CBD was found to have merit, but the researchers concluded that “longer follow-up is required.”
Additional CBD for Chronic Pain Studies
2021: Cannabidiol as a Treatment for Chronic Pain: A Survey of Patients’ Perspectives and Attitudes
This study consisting of survey responses has received quite a lot of attention over the last few years. With a total of 253 participants surveyed, it is one of the largest studies into CBD and pain involving human participants. Fifty-nine percent of participants indicated that CBD improved their pain, and 67.6% said that the cannabinoid allowed them to reduce their pain medication intake.
Discussion: Should CBD Be Used for Chronic Pain?
It would be fair to say that the usefulness of CBD for chronic pain remains inconclusive. In this review, we omitted a few studies that yielded inconclusive results, quite possibly due to their design. It’s also possible that some as-yet-unknown mechanism limits the anti-nociceptive benefits of CBD under certain circumstances.
What's clear is that there is enough evidence for the pain-relieving properties of CBD to merit further inquiry into the subject. If it's true that CBD helps with chronic pain, why does it do so? If CBD doesn’t always help with chronic pain, why is it so commonly reported to provide nearly miraculous levels of relief?
On the subject of CBD and chronic pain, mysteries certainly remain. Rather than lament these mysteries, however, the path forward is clear: Design your experiments carefully, and allow your peers to review the results. The scientific method has gotten us this far; we can also rely on it to answer the question of whether CBD is a viable treatment for chronic pain.
Sources
1. Mayrand, L., De Saint Hardouin, A. T., Maciel, T., Rignault‐Bricard, R., Taylor, M., Brice, J., De Montalembert, M., Hermine, O., Greco, C., & Allali, S. (2023). Dramatic efficacy of cannabidiol on refractory chronic pain in an adolescent with sickle cell disease. American Journal of Hematology, 98(11). https://doi.org/10.1002/ajh.27049
2. Villanueva, M. R. B., Joshaghani, N., Villa, N., Badla, O., Goit, R., Saddik, S. E., Dawood, S. N., Rabih, A. M., Niaj, A., Raman, A., Uprety, M., Calero, M. J., & Khan, S. (2022). Efficacy, safety, and Regulation of cannabidiol on Chronic Pain: a Systematic review. Cureus. https://doi.org/10.7759/cureus.26913
3. Silva-Cardoso, G. K., Lazarini-Lopes, W., Hallak, J. E. C., De Souza Crippa, J. A., Zuardi, A. W., Garcia‐Cairasco, N., & Leite‐Panissi, C. R. A. (2021). Cannabidiol effectively reverses mechanical and thermal allodynia, hyperalgesia, and anxious behaviors in a neuropathic pain model: Possible role of CB1 and TRPV1 receptors. Neuropharmacology, 197, 108712. https://doi.org/10.1016/j.neuropharm.2021.108712
4. Rossignol, J., Hatton, S., Ridley, A., Hermine, O., & Greco, C. (2023). The Effectiveness and Safety of Pharmaceutical-Grade Cannabidiol in the treatment of Mastocytosis-Associated Pain: a pilot study. Biomedicines, 11(2), 520. https://doi.org/10.3390/biomedicines11020520
5. Cuñetti, L., Manzo, L. M., Peyraube, R., Arnáiz, J., Curi, L., & Orihuela, S. (2018). Chronic pain treatment with cannabidiol in kidney transplant patients in Uruguay. Transplantation Proceedings, 50(2), 461–464. https://doi.org/10.1016/j.transproceed.2017.12.042
6. Schilling, J. M., Hughes, C. G., Wallace, M., Sexton, M., Bačkonja, M., & Moeller-Bertram, T. (2021). Cannabidiol as a Treatment for Chronic pain: A survey of Patients’ perspectives and attitudes. Journal of Pain Research, Volume 14, 1241–1250. https://doi.org/10.2147/jpr.s278718
