Year on year, researchers uncover more about the therapeutic wonders of cannabis. Both clinical and cultural interest in this plant is on the rise – and could CBD, a natural cannabinoid with an impressive safety profile, have what it takes to help hundreds of thousands of people in the UK living with debilitating nerve pain?
What is nerve pain?
Our nervous system is responsible for carrying messages to and from the brain and body. It takes in information from the world around us, processes it in the brain, and subsequently controls our movements and automatic reflexes. Nerves (or neurons) are the “electrical wiring” that transmits these signals. When these are damaged, this can have severe consequences.
Nerve pain, also known as neuropathic pain or neuropathy, is a form of chronic pain that results from a damaged or dysfunctional nervous system. Affecting 8% of all UK adults, nerve pain can be felt in different ways. The main symptoms include:
- Numbness or tingling in the hands and feet
- Burning, stabbing or shooting pain throughout the body
- Loss of balance
- Muscle weakness, especially in the feet
Nerve pain can be complex to manage. Treatment is dependent on the underlying cause, not all of which are curable. Standard painkillers often do not work, so patients are typically prescribed a specific antidepressant or certain antiepileptic drugs. In recent years, more and more people are turning to CBD to ease their chronic pain. With significantly milder side effects than existing drugs, it seems to be a great natural alternative – but does it work?
CBD and the ECS
Cannabidiol, better known as CBD, is a non-psychoactive cannabinoid found in the Cannabis sativa plant. It interacts with our endocannabinoid system (ECS), a complex cell-signalling network that is responsible for regulating our mood, appetite, sleep, pain levels, immune health, and much more. By coordinating these biological functions, the ECS strives to maintain stability in the body.
The ECS acts as a messenger between the nervous system and the immune system. It does this through the activity of cannabinoid (CB) receptors, CB1 and CB2, which span the brain and peripheral nervous system, respectively.
Cannabinoids, like CBD, can modulate the activity of these receptors and, in turn, influence how our ECS functions. CBD can also bind to other vital receptors throughout the body and has widespread effects on our health and wellbeing as a result.
In recent years, research has established that CBD can help manage seizures in rare forms of epilepsy. It shows promise in treating anxiety and inflammatory disorders. There is even growing evidence to suggest that CBD could directly target nerve pain, potentially helping people all over the UK to manage their debilitating chronic pain.
Could CBD help with nerve pain?
Despite an abundance of testimonials claiming that CBD can effectively manage chronic pain, there is currently very little clinical evidence to support this. That said, the results from recent small-scale studies are hugely promising.
In 2020, researchers investigated the effects of CBD oil on 29 people with neuropathic pain. They found that participants who received 250 mg of CBD experienced a significant reduction in pain compared to those given a placebo.
Another small-scale trial, this time with 55 participants with diabetes-induced neuropathy, found that taking 20 mg CBD tablets three times a day provided significant pain relief. Clinical trials using larger sample sizes are necessary, but these results indicate that CBD could reduce nerve pain.
Numerous animal model studies have produced similar results. In 2014, a study found that doses of 2.5 – 10 mg per kilogram of CBD significantly reduced chemotherapy-induced neuropathic pain in rats. A 2017 study also found that various doses of CBD prevented the development of pain and nerve damage in rats with osteoarthritis.
Although these findings need to be replicated in humans, they suggest that CBD could be effective at reducing nerve pain associated with many other health conditions.
What about cannabis?
Research into the effects of CBD when administered alongside tetrahydrocannabinol (THC), the cannabis plant’s psychoactive cannabinoid, has produced even more promising results. A study published in 2013 found that vaporised cannabis, even at low doses, offered significant pain relief to people with neuropathic pain.
Another study, published in the Journal of Neurology in 2014, investigated the long-term effects, tolerance, and safety of a THC/CBD oral spray in 380 participants. They found the cannabinoids to be “beneficial for the majority of patients” with nerve pain associated with diabetes or allodynia.
How does it work? Whilst it is known that THC can directly activate CB1 and CB2 receptors and, in turn, modulate the activity of nerve cells, it’s not known exactly how CBD may help to relieve nerve pain – but several hypotheses have been offered. A 2021 review paper suggests that its ability to indirectly increase levels of the endocannabinoid anandamide may have knock-on effects on our pain receptors, subsequently dampening the sensation of pain.
Although more research into CBD and cannabis-based products on nerve pain is needed, “recent meta-analyses of clinical trials that have examined the use of medical cannabis in chronic pain present a moderate amount of evidence that [cannabinoids] exhibit analgesic activity, especially in neuropathic pain,” according to one 2018 review.
Is CBD safe?
Due to the lack of evidence supporting the use of CBD to manage chronic nerve pain, many consumers worry about the safety of doing so. Since CBD is being researched in countless conditions, there is an abundance of robust safety data available. If you’re keen to try CBD but have your concerns, allow us to put your mind at ease.
The World Health Organisation (WHO) has declared that CBD is “generally well tolerated with a good safety profile,” but it has shown to cause mild side effects in some people. This could include nausea, appetite changes, and fatigue, but these side effects are typically remedied with the correct dosage and are mild in comparison to existing drugs used for chronic pain.
If you are on other medication, it is important to consider the risk of drug interactions whilst using CBD. If you’re keen to try CBD to manage nerve pain, do not replace your current medicines. Instead, you should consult a doctor or medical professional before adding CBD to your treatment plan.
How to take CBD for pain
Although CBD is not currently an approved treatment for nerve pain, high-quality commercial products are widely available for those who think CBD could help. Unlike THC, which is only legally available on prescription in the UK, CBD is completely legal to buy and use, providing the product contains less than 1mg of THC per container.
Here, we go over just a handful of the many ways to take CBD and how each could be used to specifically target nerve pain.
Oils are a hugely popular way to take CBD. When dropped under the tongue, CBD oils have a high bioavailability and rapid onset of action. This way, the effects can be felt almost immediately. The dropper also gives you control over your dosage, allowing you to take more on days that you need it most. To help decide which CBD is right for you, take a look at our guide to CBD oil.
Capsules are another way to experience the benefits of CBD oil without the taste. Since the encapsulated oil needs to go through the digestive system, the effects take slightly longer to kick in (between 30 minutes and 2 hours). There is, however, some evidence to suggest that CBD stays in the body longer when consumed orally, so CBD capsules may offer longer-lasting relief.
For those seeking targeted pain relief, CBD-infused balms, creams, and gels may be a good option. When applied to the skin, CBD can penetrate the skin surface and get right to the source of pain. One small-scale study even found that “the transdermal application of CBD oil can achieve significant improvement in pain” in people with neuropathy.
Vaping is another quick way to get higher doses of CBD into the bloodstream. As a vape is also portable, it can provide immediate relief on the go. Evidence suggests that vaporised cannabinoids only provide short-term pain relief, so it may be that CBD vapes are only beneficial for pain relief “top-ups” throughout the day. Another thing to note is that the long-term effects of vaping on our health are not fully understood, so approach this method with caution.
Although the initial evidence is hugely promising, far more well-designed clinical trials in larger patient populations are necessary before any solid conclusions can be drawn about CBD and nerve pain.
CBD may not remedy every ailment, but it is already helping thousands of people with chronic pain all over the world. If you’re keen to give it a go but don’t know where to start, take a look at our beginner’s guide to CBD.