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Using CBD Oil for Pain Management: Does It Work?

Cannabidiol (CBD) is a type of cannabinoid, a chemical found naturally in cannabis (marijuana and hemp) plants. CBD doesn’t cause the “high” feeling often associated with cannabis. That feeling is caused by tetrahydrocannabinol (THC), a different type of cannabinoid.

Some people with chronic pain use topical CBD products, in particular CBD oil, to manage their symptoms. CBD oil may reduce:

  • pain
  • inflammation
  • overall discomfort related to a variety of health conditions

The research on CBD products and pain management has been promising.

CBD can offer an alternative for people who have chronic pain and rely on medications, such as opioids, that can be habit-forming and cause more side effects. However, more research is needed to verify the pain-relieving benefits of CBD oil and other products.

Epidiolex, a drug prescribed for epilepsy, is the only CBD product on the market that the Food and Drug Administration (FDA) has approved.

There aren’t any FDA-approved, nonprescription CBD products. They aren’t regulated for purity and dosage like other medications.

Keep reading to learn more about the potential benefits of CBD use for pain. You can also talk with your doctor to see if it’s an option for your condition.

Everyone has a cell-signaling system known as the endocannabinoid system (ECS).

Some researchers think that CBD interacts with a core component of the ECS — endocannabinoid receptors in your brain and immune system.

Receptors are tiny proteins attached to your cells. They receive signals, mostly chemical ones, from different stimuli and help your cells respond.

This response creates anti-inflammatory and pain-relieving effects that help with pain management. This means that CBD oil and other products may benefit people with chronic pain, such as chronic back pain.

One 2018 review assessed how well CBD works to relieve chronic pain. The review looked at studies conducted between 1975 and March 2018. These studies examined various types of pain, including:

Based on these studies, researchers concluded that CBD was effective in overall pain management and didn’t cause negative side effects.

A 2016 study looked at CBD use in rats with arthritis.

Researchers applied CBD gel to rats for four days in a row. The rats received either 0.6, 3.1, 6.2, or 62.3 milligrams (mg) per day. The researchers noted reduced inflammation and overall pain in the rats’ affected joints. There were no obvious side effects.

Rats who received low doses of 0.6 or 3.1 mg didn’t improve their pain scores. The researchers found that 6.2 mg/day was a high enough dose to reduce the rats’ pain and swelling.

In addition, rats who received 62.3 mg/day had similar outcomes to the rats that received 6.2 mg/day. Receiving a substantially larger dosage didn’t result in them having less pain.

The anti-inflammatory and pain-relieving effects of CBD gel could potentially help people with arthritis. However, more human studies are needed.

Some people with cancer also use CBD. Research on mice has shown that CBD can lead to the shrinking of cancerous tumors. However, most studies in humans have investigated the role of CBD in managing pain related to cancer and cancer treatment.

The National Cancer Institute (NCI) has pointed to CBD as a possible option for reducing chemotherapy side effects, such as:

  • pain
  • vomiting
  • lack of appetite

In a 2010 study on cancer-related pain, study subjects received oral sprays of a combination THC-CBD extract. The THC-CBD extract was used in conjunction with opioids. This study revealed that using the extract provided more effective pain relief than using the opioids alone.

A 2013 study on THC and THC-CBD oral sprays had a similar finding. Many researchers from the 2010 study worked on this study as well. More evidence is still needed.

Studies on CBD and migraine are limited. The studies that currently exist also look at CBD when it’s paired with THC, not when it’s used alone.

However, results from a 2017 study indicate that CBD and THC can lead to less acute pain and less intense pain for people with migraine.

In this two-phase study, some participants took a combination of two compounds. One compound contained 9 percent CBD and almost no THC. The other compound contained 19 percent THC. Doses were taken orally.

In phase I, there was no effect on pain when the doses were under 100 mg. When the doses were increased to 200 mg, acute pain fell by 55 percent.

In phase II, participants who received the combination of CBD and THC compounds saw the frequency of their migraine attacks fall by 40.4 percent. The daily dose was 200 mg.

The combination of compounds was slightly more effective than 25 mg of amitriptyline, a tricyclic antidepressant. Amitriptyline reduced migraine attacks by 40.1 percent in study participants.

Participants with cluster headaches also found pain relief with the combination of CBD and THC compounds, but only if they’d had a childhood history of migraine.

CBD doesn’t pose significant risks for users, and most topical CBD products don’t enter the bloodstream.

However, certain side effects are possible, such as:

  • fatigue
  • diarrhea
  • changes in appetite
  • changes in weight
  • certain over-the-counter (OTC) drugs
  • prescription medications
  • dietary supplements

Proceed with caution if any of your medications or supplements contain a “grapefruit warning.” Grapefruit and CBD both interfere with enzymes that are crucial to drug metabolism.

Like other drugs and supplements, CBD may also increase your risk of liver toxicity.

One study on mice concluded that CBD-rich cannabis extract increased their risk of liver toxicity. However, some of the mice had been force-fed very large amounts of the CBD-rich cannabis extract.

While there isn’t conclusive data to support CBD or CBD oil as the preferred method of pain management, researchers agree that these types of products have a lot of potential.

CBD products might be able to offer relief for many people who have chronic pain, all without causing drug intoxication and dependence.

If you’re interested in trying CBD for chronic pain, talk to your doctor. They can help you determine a starting dosage that’s right for you.

Is CBD Legal? Hemp-derived CBD products (with less than 0.3 percent THC) are legal on the federal level, but are still illegal under some state laws. Marijuana-derived CBD products are illegal on the federal level, but are legal under some state laws. Check your state’s laws and those of anywhere you travel. Keep in mind that nonprescription CBD products are not FDA-approved, and may be inaccurately labeled.

Cannabidiol (CBD) oil, made from cannabis, is sometimes used for chronic pain. We’ll review the research on whether CBD oil is effective.

Hemp Is Back: How Some of Ours Is Produced, in Photos

Growing hemp is easy. This fibrous plant needs no pesticides or irrigation and requires low quantities of fertilizer. But turning hemp into fabric is a complicated task that requires an expertise American farmers will need to regain. Photo: Lloyd Belcher

It’s hard not to notice the hype around hemp today. Pick up any lifestyle magazine, enter a pharmacy, talk to a health-food store employee or just the person next to you in yoga class—at some point you’ll learn about its miraculous powers. In particular, near-unbelievable claims swirl around cannabidiol, or CBD, oil derived from hemp: It’s an anti-inflammatory, it cures cancer, helps arthritis, depression, anxiety, multiple sclerosis, insomnia and prevents diabetes.

While virtually all of those claims remain vastly under-supported by scientific rigor (a shortcoming that researchers are scrambling to remedy), the buzz points to an important, much bigger development—that hemp is back in the United States after nearly 80 years of criminalization. And the benefits of hemp as a fiber for making clothes are no mere hype.

Since 1937, when hemp was shortsightedly lumped in with its cannabinoid cousin, marijuana, and 1970, when it was designated a schedule 1 banned substance, it’s been felony to cultivate and sell hemp, no matter its use. But the 2018 Farm Bill finally made industrial hemp legal to be broadly cultivated, sold and transferred again across state lines.

We celebrated this news. At Patagonia, we’ve used legally-sourced hemp fiber in our clothing line since 1997, importing it to make clothes by blending hemp with other fibers such as recycled polyester, organic cotton or spandex. Post Farm Bill, we hope soon to have domestic supplies of hemp to draw upon; we’re already talking to a number of farmers about it. There’s potential here to create new American jobs.

For now, Patagonia’s hemp is sourced in China, a country whose government heavily subsidizes hemp production and has for generations. Hemp is simple to grow, and requires less water than most crops. It’s also considered restorative, bringing nutrients and minerals up from deep in the ground with its enormous taproot structure.

Once processed, hemp yields a beautiful linenlike fiber that’s strong, flame retardant and antimicrobial. We find it makes clothes more durable, breathable, and broken-in from the first time you wear them. And we’re excited to learn more about it.

“We haven’t grown hemp for so many years in the United States that the expertise we used to have, all of that historical knowledge, is just gone,” says Patagonia Material Developer Alexandra La Pierre, who heads up the hemp project for the company. “We’re playing catch-up.”

Along with the opportunity to regain this expertise, the 2018 Farm Bill offers us the chance to recover our heritage. From the sails and rigging of the ships that brought early settlers across the Atlantic, to the first American flag putatively sewn by folk heroine Betsy Ross, to the canvas that covered the wagons that eventually rolled inexorably west — hemp played an integral role in the growth of our republic.

Growing hemp is easy enough, but a complicated set of steps takes hemp from harvest to textile. Harvesting, retting, baling, decortication, degumming, heckling—all part of a process that is as much art as science. And it’s this process that we sent photographer Lloyd Belcher to document in China. He returned with a set of photos that really blew us away. Have a look.

One row at a time, a specialized tractor harvests the tough fibrous stalk of hemp plants. The tractor blades flip the hemp and cut it down 5 inches off the ground. This creates a layer of air underneath that helps the hemp stock dry naturally. This is the first of many steps in the process to usable fiber. Photo: Lloyd Belcher

Dried and bundled, the stalks are cut and stripped of their outer shell—a process known as decortication. Photo: Lloyd Belcher

Hemp stalks are woody and hard to break down. Workers strip them into hairlike fibers and, not unlike in the 1850s, heckle the fiber through large combs or spears. Photo: Lloyd Belcher

After stripping down the exterior fibers, the result is hair-like fibers. Farmers fling them around, tie them in the center and form bundles that look like wigs. They then grab each bundle by its knot, heave it around and throw it in a pile. The fibers now feel like bristled horse hair. Photo: Lloyd Belcher

Next, at another facility, soaking, beating and washing the fibers results in a newly softened fiber that is left to dry on conveyor belts while workers pick out any last impurities. Photo: Lloyd Belcher

Once dried, workers compile the fiber strands, preparing them for another wash. Photo: Lloyd Belcher

The fibers need to be washed several times until they soften. This worker is pulling apart strands of wet fiber, and then running them through a machine that helps further separate the strands . Photo: Lloyd Belcher

After a final wash, the dried fiber is spun through a machine that turns it into yarn. Photo: Lloyd Belcher

One by one, buckets fill up with strings of hemp yarn, now soft and supple enough to spin. Photo: Lloyd Belcher

Massive looms spin the fiber into giant bolts of yarn that will feed into another loom for weaving fabric. Photo: Lloyd Belcher

A spool of thread before it’s woven into a fabric. Photo: Lloyd Belcher

Smaller spools of processed hemp fiber now feed the giant loom to create bolts of yarn prior to weaving. Photo: Lloyd Belcher

It’s hard not to notice the hype around hemp today. Pick up any lifestyle magazine, enter a pharmacy, talk to a health-food store employee or just the