Does CBD Oil Work for Carpal Tunnel Syndrome?
- Carpal tunnel syndrome (CTS) occurs when inflamed surrounding tissues compress the carpal tunnel. Studies have shown that modulating the endocannabinoid system has therapeutic strategies for inflammation and pain (1).
- A study acknowledged CBD’s ability to target endocannabinoid receptors, which might influence in blocking inflammation caused by entrapment neuropathy, such as carpal tunnel syndrome (2).
- A study shared in Annals of the Rheumatic Disease mentioned that inflammation in the joints and surrounding areas can cause CTS (3).
- Studies demonstrated how oral (4) and topical (5) CBD treatments on animal subjects reduced inflammation in the nerves and joints.
- Carpal tunnel syndrome is caused by pressure on the median nerve. There is a lack of clinical studies on how CBD might affect the median nerve and its surrounding tissues.
The carpal tunnel is a narrow pathway containing the median nerve. Ligaments and bones surround the tunnel in the palm side of the hand. This area is prone to pressure due to occupational and lifestyle activities.
Carpal tunnel syndrome (CTS) is caused by inflammation of the surrounding soft tissues of the median nerve. The compression of the median nerve results in inadequate oxygen and blood flow (6).
CTS symptoms often include intense pain, itching, burning, and tingling sensation on the fingers. The common treatments for CTS can be a nonsteroidal anti-inflammatory drug (NSAID) or a surgical procedure called the carpal tunnel release.
Some individuals cannot tolerate the side effects of pain relievers, while others do not wish to undergo an invasive procedure like the carpal tunnel release.
These factors are why cannabidiol (CBD) has been a popular topic among researchers who are searching for alternative solutions.
Studies have acknowledged that CBD might possess anti-inflammatory and analgesic properties(7).
These therapeutic promises may provide evidence on CBD’s ability to act as an anti-neuropathic agent.
CBD vs. Nerve Inflammation
CTS is a form of entrapment neuropathy (suppression of the nerve). The goal of CTS treatment is to reduce inflammation of the tissues surrounding the nerve.
A study shared in the European Journal of Pharmacology demonstrated CBD’s substantial immunomodulatory and anti-inflammatory effects (8).
Researchers administered oral CBD treatment on rats with induced sciatic nerve constriction and inflammatory pain. Like CTS, sciatic nerve constriction is another form of entrapment neuropathy.
Study results showed that CBD treatment reduced hyperalgesia (sensitivity to pain stimuli) and reduced inflammation on the animal subjects (9).
Another study published in Current Pharmaceutical Biotechnology conducted a clinical study on 29 patients with peripheral neuropathy (10), a condition involving nerve damage that is not in the brain.
The double-blind study (using topical CBD and placebo) used the neuropathic pain scale to assess mean change from start to end of the treatment period.
The result showed that topical CBD administration significantly reduced intense pain, cold, and itchy sensations among patients.
The authors concluded that transdermal CBD application might reduce pain and other disturbing sensations caused by peripheral neuropathy (11).
The authors also added that CBD was well-tolerated and proved to be more effective than conventional treatment for the nerve condition (12). However, peripheral neuropathy is different from CTS so the same results may not apply.
Furthermore, the efficacy of transdermal CBD administrations is still limited to animal studies. More data is needed to verify if CBD might be an effective anti-inflammatory topical agent for humans.
CBD vs. Joint Inflammation
Some studies have observed the incidence of CTS among individuals with rheumatoid arthritis.
Arthritis is the inflammation and tenderness of joints. Prolonged arthritis is a risk factor for CTS. The inflammation brought by arthritis can interrupt sensory and motor function pathways in the wrist (13).
Prompt treatment of rheumatoid arthritis may help prevent the prevalence of CTS (14).
Several studies have shown that CBD might inhibit systemic inflammation in rat models induced with rheumatoid arthritis (15).
An animal study posted in the European Journal of Pain mentioned that CBD might have therapeutic potential as a topical agent for arthritis (16).
In the experiment, the rat models received transdermal CBD administration. The results displayed a significant reduction in the swelling of the joints.
The authors added that CBD improved limb posture and reduced pain rating scores. This improvement was observed after a single transdermal dose of CBD (17).
Another cross-study observed that oral CBD administration reduced edema and hyperalgesia (pain sensitivity) in rat models’ paws (18).
The authors continued that CBD is an attractive alternative to cannabis use due to its non-euphoriant and non-intoxicating characteristics.
Currently, existing studies on how CBD might affect arthritis inflammation and pain are limited to animal models. Researchers have yet to share definitive studies on how human arthritis might react to CBD.
Fortunately, some clinical studies are underway. The BMJ Open published an article that called on volunteers to test the efficacy and tolerability of CBD and THC (19).
The double-blind study (CBD and placebo) aims to investigate how the cannabinoids may help reduce chronic pain and inflammation caused by rheumatoid arthritis over 36 weeks of use.
If the study produces positive results, this may be an advancement in CBD’s many therapeutic promises.
How CBD Oil Works to Help With Carpal Tunnel Syndrome
The human endocannabinoid system (ECS) is composed of G-protein-coupled receptors, cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2).
Many studies recognize the ECS’s modulatory function, which may play a role in producing several therapeutic benefits (20).
Also, researchers acknowledge that CB1 and CB2 stimulation using cannabinoids, such as cannabidiol (CBD) and tetrahydrocannabinol (THC), has modulatory effects on conditions and diseases (21).
CB1 and CB2 receptors are mostly present in the central nervous system (CNS), peripheral nervous system, and immune system.
The ECS modulates the inflammatory response by suppressing immune cell activation and immune cell apoptosis (cell death).
In a study, the administration of a cannabinoid receptor agonist resulted in reduced macrophages (white blood cell accumulation) during in vivo and in vitro studies (22).
Also, the ECS may reduce cytokines (signaling proteins) activity. Cannabinoids, such as CBD, have the mechanism to dysregulate cytokine production of immune cells. This activity may help regulate inflammation (23).
The reduction in macrophages and cytokines may influence the inflammatory response, attenuating chronic inflammatory pain and other sensations felt in conditions such as neuropathy (24).
Moreover, an animal study shared by the Journal of Experimental Medicine suggested that manipulating the peripheral endocannabinoids might have therapeutic value in pain management (25).
The authors also added that CBD, despite its low affinity to the cannabinoid receptors, was able to modulate glycine receptors. Glycine receptors are responsible for neurotransmission of pain perceptions.
The study concluded that CBD’s modulation of glycine receptors resulted in analgesic potency in both inflammatory and neuropathic pain (26).
Moreover, studies have also recognized the therapeutic benefits of other minor phytocannabinoids.
A study in Life Sciences mentioned that CBC is the third most abundant cannabinoid in hemp. Studies have recognized CBC for its anti-inflammatory and analgesic properties (27).
Also, according to another study, CBG has a minor affinity to the cannabinoid receptors, making it a more potent analgesic than THC (28).
Currently, studies on how cannabinoids might stimulate the ECS are limited to in vitro and animal studies. More research is needed to show how cannabinoids may influence the ECS in humans.
The Pros and Cons of CBD Oil for Carpal Tunnel
- CBD might modulate receptors in the ECS, which might block inflammation caused by entrapment neuropathy, such as carpal tunnel syndrome (29).
- Studies demonstrated how oral treatment on animal subjects reduced neuropathic pain (30).
- CBD has been reported to significantly reduce intense pain, cold, and itchy sensations following transdermal administration on human subjects with neuropathic pain (31).
- CBD has been acknowledged as well-tolerated and safe for daily use (32).
- There are no existing clinical (human) studies on how CBD might affect individuals suffering from CTS.
- CBD might cause adverse effects, such as dry mouth, diarrhea, drowsiness, and loss of appetite (33).
- According to the US Food and Drug Administration (FDA), extremely high CBD doses might lead to liver injury, among other side effects (34).
- There is a lack of knowledge on the effects of prolonged CBD use.
How CBD Oil Compares to Alternative Treatments for Carpal Tunnel Syndrome
People have been turning to alternative treatments due to a lack of available medication or the inability to tolerate side effects from painkillers.
Many alternative medicines are available in the form of herbs. These herbs have been used as anti-inflammatory agents for decades.
The Devil’s claw (Harpagophytum procumbens) and the Indian Olibanum (Boswellia serrata) are traditionally used for several conditions, such as inflammatory bowel disease, polyarthritis, rheumatoid arthritis, and asthma(35).
The herbs are chopped, boiled, and strained for their extracts.
Currently, there is a lack of study on the herbs’ efficacy as analgesic and anti-inflammatory agents.
CBD is also derived from plants (Cannabis sativa or hemp). Like the herbs, CBD is known for its anti-inflammatory and analgesic properties (36). CBD oil extracts are available commercially in tinctures, capsules, and vapes.
Another alternative option for CTS is cayenne pepper. Cayenne pepper contains capsaicin, a common component found in hot peppers.
Capsaicin is known for relieving peripheral nerve pain (37). It is also a common ingredient in topical ointments and creams.
Some transdermal CBD products contain capsaicin in their formula. Some manufacturers aim to deliver the best possible results, which means adding extra benefits to the product that are believed to aid in pain relief and anti-inflammation.
Full-spectrum CBD oil contains all the cannabinoids present in hemp plants, such as CBD, cannabichromene (CBC), cannabigerol (CBG), cannabinol (CBN), and THC (0.3% or less).
This type may be the most recommended for CTS due to the presence of other cannabinoids in the concentration.
A study published in Therapeutics and Clinical Risk Management mentioned that other minor phytocannabinoids might also be relevant in anti-inflammatory activities (38).
The author explained that CBC and CBG might also provide some therapeutic properties.
Broad-spectrum CBD oil also contains all the major and minor cannabinoids from hemp, except for THC. Some individuals prefer not to have traces of THC in their system.
Both full-spectrum and broad-spectrum CBD oil produce the “entourage effect.”
The entourage effect means that an individual takes all the supposed benefits of all the cannabinoids in one dose.
For individuals who cannot tolerate other cannabinoids, they may opt for CBD isolates, containing only pure CBD.
CBD isolates may be recommended if full-spectrum and broad-spectrum CBD oil produce adverse effects.
Some additional things to consider before choosing the CBD product:
- Check the certificate of analysis (COA), a third-party lab test result.
- Topical gels may contain essential oils or fragrances. Individuals must be careful to avoid ingredients that can trigger an allergic reaction.
- Always check testimonials and product reviews for more information on how the product works.
CBD Dosage for Carpal Tunnel
There is no standard CBD dosage specific for CTS. However, a 2018 review from the British Journal of Pharmacology recommended a typical dosage of less than 1 to 50 milligrams per kilogram per day (<1-50mg/kg/d) (39).
According to the authors, the recommended dosage was evaluated from 1,038 scientific articles that tested CBD’s dosing on human subjects.
This dosage range was enough to produce significant improvements. It can be increased once the body gets to CBD.
Existing studies on transdermal CBD administration have only tested dosings on animal subjects. Currently, there are no known scientifically-recommended dosages for topical CBD.
How to Take CBD Oil for Carpal Tunnel
When taking CBD oil to relieve pain and inflammation, the fastest administration is through vaping. A 2018 study mentioned that the lungs are a very efficient mechanism for drug delivery (40).
The study continued that CBD inhaled through vaporization and aerosols can deliver plasma concentrations that may be felt within 10 minutes or less (41).
Vaping is also advocated by many CBD users for its accessibility. Vape products, such as vape pens and cartridges, are designed to be efficient and mobile.
However, there are several reports that vaping can cause harm, such as allergic reactions, chemical irritation, chest pains, and shortness of breath (42).
CBD topicals are available in gel, cream, and ointments. Transdermal administration is recommended for individuals who do not want to ingest CBD into their system orally.
Lastly, CBD may also be taken through oral or sublingual (under the tongue) delivery, such as CBD tinctures, capsules, and gummies. The oral administration may take longer to deliver plasma concentrations into the body. However, this method allows for optimal absorption (43).
Individuals suffering from CTS or other medical conditions must discuss their options with a licensed physician before using CBD.
Is It Carpal Tunnel Syndrome or Arthritis?
Some individuals might confuse CTS as arthritis and vice versa. These two conditions can target the same area, which is the wrist.
CTS is an injury of the median nerve due to inflamed surrounding tissues. Arthritis is inflammation of ligaments and joints. Usually, one can tell the difference between the conditions’ range of symptoms.
Symptoms of carpal tunnel syndrome (44):
- Tingling sensation on the hands and fingers
- Pain in hand and fingers
- A weak hand or difficulty gripping objects
Symptoms of wrist arthritis (45):
- Joint pain
- Stiffness and limited range of motion
Individuals may treat both of these conditions with over-the-counter NSAIDs. More potent analgesic and anti-inflammatory medications require a prescription from a licensed physician.
If arthritis is left untreated, the wrist joint’s swelling can put pressure on the median nerve, which may lead to CTS.
If one starts experiencing any of these symptoms, it is recommended that they seek consultation and get a proper diagnosis and start treatment. Untreated CTS may lead to loss of function or permanent nerve damage (46). Wrist surgery may be needed to relieve the pressure on the median nerve to prevent loss of function in extreme cases.
Are There Natural Treatments for Carpal Tunnel Syndrome?
Anything that squeezes or puts pressure on the median nerve can cause CTS.
Individuals must know that the best natural remedy for CTS is to rest their hands. Occasional breaks from laborious tasks that involve the hands are essential in the prevention of the condition.
Natural treatment options may include the following (47).
- Avoid activities that require long and repetitive flexing of the wrist (typing on the computer, working with vibrating tools, working in an assembly line).
- Apply ice to reduce inflammation.
- Wearing a wrist splint can provide support for the hands and prevent tingling sensations.
- Sudden weight gain or obesity can cause CTS. Losing weight may help relieve the median nerve from pressure.
Are CBD Oil and Medical Marijuana the Same?
CBD oil is a compound that can be found in cannabis plants (hemp).
Manufacturers extract the compound from hemp to create a more concentrated version without the psychoactive effect one gets from medical marijuana or medical cannabis.
In the US, CBD products are prohibited from containing more than 0.3% THC.
THC is commonly found in cannabis products. It is the compound responsible for causing the psychoactive effect.
Depending on the cannabis strains used by the dispensary, some medical marijuana strains, like girl scout cookies, may contain as much as 25-28% THC (48). According to US federal law, only 11 states are allowed recreational and medicinal use for cannabis (49).
Cannabis treatments are not recommended for CTS due to a lack of knowledge of how it might affect the individual.
CBD is legal in almost all US states and territories. In 2018, the Hemp Farming Act was incorporated into the United States Farm Bill (50).
The farm bill legalized the manufacturing and sale of hemp-derivatives, such as CBD oil, hemp oil, and hempseed oil.
However, the CBD oil industry remains highly unregulated. Individuals are advised to buy their products with caution due to mislabeling of products and lack of accountability from some manufacturers.
Individuals may find legitimate brands by checking the company’s transparency. A good CBD brand shares the certificate of analysis (COA) with buyers.
The COA is a third-party laboratory test result that determines cannabinoid concentration. The COA also informs the buyer if the product is free from heavy metals and other harmful contaminants.
Researchers have yet to conduct definitive studies on CTS. However, existing data show that CBD may be useful for the condition.
A double-blind human study has shown that CBD reduced peripheral neuropathy symptoms, such as pain, itching, burning, and tingling sensations (51). Individuals with CTS are also experiencing these same symptoms (52).
Also, animal studies demonstrated that CBD might serve as a promising alternative for reducing inflammation and pain in joints and extremities (53).
However, more data is needed to prove CBD’s clinical value.
Only clinical studies without limitations may verify if CBD might be an effective treatment for CTS and other conditions that might cause CTS.
Meanwhile, researchers recognize that CBD’s many promises deserve merit. Aside from its potential analgesic and anti-inflammation properties, CBD has been acknowledged for its inherent therapeutic benefits.
Additionally, some studies suggest that CBD may be useful in neurodegenerative conditions, such as Alzheimer’s and Parkinson’s disease (55).
Lastly, CBD is currently the main active ingredient in Epidiolex, an FDA-approved medication to treat rare forms of child epilepsy (56).
Still, individuals with CTS must first consult and discuss treatment options with a medical professional before including CBD in their daily regimen.
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