Compare the Best CBD Oil for Back Pain in 2022

How CBD May Help With Back Pain

Back pain is a medical problem affecting eight out of ten people at some point in their lives⁽¹⁾. The pain can start from a muscle aching to a stabbing sensation that may radiate down one’s leg⁽²⁾. 

Cannabidiol, also known as CBD, is an active compound of cannabis. While CBD is an essential substance of medical marijuana, the compound is mainly derived from hemp plants. 

Currently, there is limited research regarding CBD and its effects on back pain. However, CBD’s pain-relieving properties⁽³⁾ and its activity in the ECS (endocannabinoid system) may elucidate how CBD may help with back pain. 

The ECS is responsible for maintaining bodily balance or homeostasis. 

The system regulates various functions, such as emotional processing, learning, memory, sleep, appetite, temperature control, inflammatory and immune response, and pain control⁽⁴⁾.  

The ECS is composed of a vast network of cellular receptors and chemical signals present throughout the brain and body. 

The cannabinoid receptors type 1 (CB1 receptors) found within the pain pathways of the central nervous system may affect CBD-induced analgesia (loss of pain perception)⁽⁵⁾. 

In addition, CB1 receptors are also responsible for the psychoactive effects of THC (tetrahydrocannabinol)⁽⁶⁾, which is the mind-altering chemical constituent of cannabis plants. 

CBD is believed to behave as a non-competitive negative allosteric modulator of CB1 receptors and thus may reduce THC’s efficacy and potency⁽⁷⁾. THC may act as a partial agonist at cannabinoid receptors. 

A study suggests that allosteric modulators of CB1 receptors like CBD may potentially treat central nervous system diseases and peripheral disorders while helping avoid the adverse effect linked to the agonism of CB1 receptors⁽⁸⁾. 

Agonism is a process where a particular drug activates specific receptors in the brain. 

Meanwhile, CB2 receptors mainly present in immune cells may affect CBD-induced anti-inflammatory properties⁽⁹⁾. 

The therapeutic potential of CBD and its activity in the ECS are promising. However, since CBD and back pain research are still in their infancy, more studies are needed to substantiate reports that CBD may help with back pain. 

Benefits of Using CBD for Back Pain

A 2020 review from the Journal of Opioid Management suggested that hemp-derived CBD in transdermal creams may provide significant symptomatic and pain relief from acute and chronic back pain⁽¹⁰⁾. 

“Transdermal” refers to the administration route where active ingredients like CBD are delivered across the skin for systematic distribution. 

Research regarding the benefits of using CBD for back pain management is still in its infancy. However, there are available studies regarding the effects of CBD on various medical conditions related to pain. 

Some individuals have tried CBD for arthritis pain and reported noticeable pain relief⁽¹¹⁾. Arthritis causes joint pain⁽¹²⁾. 

Meanwhile, a study from Cell Death and Disease suggested CBD’s potential as an adjuvant treatment in rheumatoid arthritis⁽¹³⁾.

Rheumatoid arthritis is an autoimmune disease that causes inflammation and pain in and around the joints, affecting other body organs. 

Meanwhile, an adjuvant refers to a substance that enhances the immune response to an antigen. 

Fibromyalgia, a condition that causes pain all over the body, affects 4 million adults in the United States⁽¹⁴⁾. 

 An extensive online survey published in the Journal of Pain suggested that CBD use is common among individuals with fibromyalgia⁽¹⁵⁾. 

The 2021 survey consisted of 2,701 participants with fibromyalgia, mainly from the U.S. Overall, 32.4% reported current CBD use, while 29.4% reported past CBD use to help manage fibromyalgia symptoms, particularly pain⁽¹⁶⁾.   

More importantly, CBD is relatively safe⁽¹⁷⁾, making it a potential therapeutic candidate for various diseases. 

A review from Current Drug Safety reported that humans may tolerate high doses of up to 1,500 mg of CBD daily⁽¹⁸⁾. 

Although these findings seem promising, they are inconclusive. Therefore, more longitudinal research is warranted to determine the benefits of using CBD oil for pain, particularly back pain. 

How to Use CBD Oil for Back Pain

One of the purported health benefits of CBD is its potential to alleviate chronic pain⁽¹⁹⁾. If you want to use CBD oil and other CBD-derived products for back pain and overall wellness, below are important details to consider: 

Administration Methods

The most common CBD administration methods are as follows:

• Inhalation
• Ingestion
• Sublingual (under the tongue) route
• Topical absorption 

Inhaling CBD using vape pens is the fastest way to benefit from the compound⁽²⁰⁾. The onset time of CBD via the inhalation route is between 2 to 15 minutes, and its effects usually last for 2 to 4 hours⁽²¹⁾. 

However, Mayo Clinic says that smokers are at a high risk of experiencing back pain because smoking prompts more coughing and can decrease blood flow to the spine⁽²²⁾. 

In addition, it is reported that most lung injury cases in the U.S. are linked to vaping⁽²³⁾. 

Unlike smoking, taking CBD sublingually does not expose the lungs to heat. Hence, you can avoid dealing with a smoky taste, dry mouth, and throat irritation⁽²⁴⁾.

The capillaries under the tongue and within the mouth absorb CBD into the bloodstream before being swallowed⁽²⁵⁾. 

You may use a dropper to dispense CBD oil straight into your mouth. 

Usually, the onset time of CBD via the sublingual route is between 15 and 30 minutes, and the effect of CBD may last from 2 to 4 hours⁽²⁶⁾.   

Using CBD oil topically may also provide localized relief. The onset time of CBD via the topical route is between 15 and 30 minutes, and its effects may last for 2 to 4 hours⁽²⁷⁾. 

CBD Dosage

The FDA (Food and Drug Administration) has not approved CBD as a medical treatment for back pain. Thus, there is no standard CBD dosage for such a condition.

However, mid-range doses between 10mg and 100mg of CBD daily may be effective for pain⁽²⁸⁾. 

Meanwhile, a case series and literature review from the Journal of Opioid Management hypothesized that hemp-derived CBD in transdermal creams may provide pain relief for acute and chronic back pain⁽²⁹⁾. 

The study involved two opioid-naive patients with neuropathic and radicular pain. 

Neuropathic pain is experienced when there is damage to the nerves, whereas radicular pain is a sensation radiating from the back and hip into the legs and through the spine.  

The patients used CBD cream containing 400mg of CBD per two ounces and reported symptomatic improvement and pain relief⁽³⁰⁾. 

Still, it is best to talk with a healthcare professional experienced in cannabis use for accurate dosing. 

How Long Does CBD Take to Help With Back Pain?

How long CBD takes to help with back pain depends on several factors, including the administration route, the individual’s body weight, and CBD type. 

For instance, you may feel the effect of CBD via the sublingual route within 15 to 30 minutes⁽³¹⁾. For topical absorption, CBD’s onset time is also between 15 and 30 minutes⁽³²⁾. 

How Long Will CBD Help With Back Pain?

How long CBD’s effects will last after the compound starts to help with back pain depends on its bioavailability.

Bioavailability is the extent to which a particular substance becomes entirely available to its intended biological destinations. 

With high bioavailability, the body absorbs more of the appropriate compound without you having to take higher doses.

The bioavailability of CBD via the sublingual route is between 6% and 20%⁽³³⁾.

Meanwhile, since CBD does not enter the bloodstream when applied to the skin, its bioavailability is zero via topical application⁽³⁴⁾. 

How to Choose the Right CBD Product

Various CBD companies like NuLeaf Naturals, Medterra, CBDistillery, and Charlotte’s Web are dedicated to offering the best CBD product for their customers. 

However, with so many CBD brands promising the best CBD products in the market, it can be challenging to choose the right one for your specific needs. 

Below are a few pertinent factors to consider that may help you sort through CBD items to find the right quality products: 

CBD Extracts

A full-spectrum CBD product contains all compounds of the cannabis plant, including CBD and other cannabinoids, essential oils, flavonoids, and terpenes. 

Full-spectrum CBD oil also has less than 0.3% THC. Additionally, this CBD variant is known to provide the entourage effect due to the presence of all cannabis compounds. 

The entourage effect is a theory where the biologically active compounds of cannabis work better when administered together. 

A Frontiers in Plant Science study hypothesized that, due to the entourage effect,  full-spectrum hemp extracts may produce better therapeutic benefits than pure CBD⁽³⁵⁾. 

Full-spectrum CBD oil has all the cannabis plant compounds, including flavonoids and terpenes.

Flavonoids are active compounds found in cannabis that are believed to have antioxidant, anti-inflammatory, and antiviral actions⁽³⁶⁾. 

On the other hand, terpenes are the components of essential oils responsible for the aroma of cannabis⁽³⁷⁾.

Broad-spectrum CBD oil also has all of the natural compounds of cannabis. However, it is THC-free. Lastly, CBD isolates refer to the type of CBD that contains cannabidiol in its pure form.

Extraction Method 

The extraction method is the process where CBD oil is derived from cannabis. 

Ethanol, solvent, or CO2 extraction (carbon dioxide extraction method) is preferred to create a safe CBD product⁽³⁸⁾. Meanwhile, extraction techniques utilizing hexane or butane may leave harmful residues, like heavy metals and pesticides.

Other Ingredients 

Always opt for CBD products made from U.S.-grown hemp or organic hemp, if possible. Make sure to choose CBD formats made with natural ingredients, non-GMO hemp, or free from gluten.  

Most CBD formats available in the market include tinctures, vapes, CBD topicals, like salves and lotions, and edibles like CBD gummies. 

Carrier Oils 

After extracting CBD from the hemp plant, CBD manufacturers infuse cannabidiol into a carrier oil. 

The most commonly utilized carrier oils are MCT oil (medium-chain triglyceride oil), coconut oil, and hempseed oil⁽³⁹⁾. Although most people interchangeably use hempseed oil and hemp oil, they are different from each other.

Hemp oil is an essential oil that comes from the flowers and leaves of hemp plants, while hempseed oil is made from the pressed seeds of hemp.

Hempseed oil is packed with nutrients and fatty acids. However, it does not contain CBD⁽⁴⁰⁾.  

Third-Party Lab Testing

The best way to check whether a CBD product contains what the brand says it does is to look at the lab reports and COAs (certificates of analysis).   

The COAs or lab test results must be up-to-date and come from a trusted third-party laboratory. Therefore, ensure that the information on the COA matches the claims on the product label.  

Brand Reputation

Many CBD brands are dedicated to offering only high-quality CBD products to their customers. 

Still, make sure to research the CBD company to verify if it is a trusted brand. Read customer reviews to get more insights into the manufacturer and its products. 

Risks and Side Effects of Using CBD for Back Pain

Although CBD has numerous therapeutic potential⁽⁴¹⁾, this non-psychoactive compound may also carry some risks and induce minor side effects, such as⁽⁴²⁾: 

• Dry mouth
• Diarrhea
• Reduced appetite
• Drowsiness
• Fatigue 

Another cause for concern is the probability of drug interactions. CBD at high doses may inhibit the activity of cytochrome P450⁽⁴³⁾, a family of liver enzymes that metabolize most pharmaceutical drugs. 

Over-the-counter pain relievers, including NSAIDs (nonsteroidal anti-inflammatory drugs), may help relieve back pain⁽⁴⁴⁾. 

Meanwhile, antidepressants like duloxetine and tricyclic drugs may be effective with chronic back pain independent of their effect on depression⁽⁴⁵⁾. 

However, NSAIDs use the cytochrome P450 enzyme system and may interact with CBD⁽⁴⁶⁾. 

On the other hand, CYP2D6, an enzyme primarily expressed in the liver, metabolizes antidepressants like tricyclic drugs⁽⁴⁷⁾. Since CBD is a potent inhibitor of this particular enzyme, the compound may increase the serum concentrations of substances that CYP2D6 metabolizes. 

Legality of CBD

The United States Congress ratified the 2018 Farm Bill, decriminalizing the commercial use of industrial hemp and products obtained from hemp plants⁽⁴⁸⁾.

The Farm Bill states that Cannabis sativa L. and other derivatives of cannabis with less than 0.3% THC content on a dry weight basis are considered legal under federal law⁽⁴⁹⁾.

Some states have passed laws allowing the use of recreational and medical marijuana. Nevertheless, these state laws do not change that, under federal law, marijuana is still deemed as a drug with high abuse potential with no accepted medicinal use⁽⁵⁰⁾. 

Rules and regulations regarding medical cannabis may be confusing. Hence, consumers should read various state laws. 

Take California, for example. In October 2021, California Governor Gavin Newsom signed Assembly Bill No. 45 into law⁽⁵¹⁾. 

The bill allows the inclusion of hemp and cannabinoids, extracts, or hemp derivatives in dietary supplements, food and beverages, cosmetics, and processed pet food, provided that they contain no more than 0.3% THC⁽⁵²⁾.

Meanwhile, in Texas, the local government passed laws in June 2019, creating a state industrial hemp program⁽⁵³⁾. 

Under House Bill 1325, the Texas Department of State Health Services is in charge of issuing licenses to people who want to manufacture or sell consumable hemp-derived products in the Lone Star State⁽⁵⁴⁾. 

Colorado is another state that permits recreational and medical marijuana use⁽⁵⁵⁾. The local government decriminalized the use of marijuana by passing Amendment 64 to the Colorado Constitution in November 2012.    

Still, even if a specific state law indicates that CBD use is legal, the only FDA-approved CBD drug is Epidiolex, used to treat rare and severe forms of epilepsy.