Does CBD Work for Inflammation?

  • There is growing evidence of CBD’s suggested benefits on inflammation-related conditions. A 2020 study reported CBD’s analgesic (pain-reducing) properties in patients with pain and mental health symptoms(1).
  • A scientific review noted that CBD may have anti-inflammatory properties useful in the treatment of arthritis pain and inflammatory bowel disease(2).
  • A study in 2019 demonstrated topical CBD’s promise in treating inflammatory skin diseases, such as psoriasis and eczema(3).
  • A 2017 study explored CBD’s neuroprotective and anti-inflammatory activities in neurodegenerative diseases, like Alzheimer’s disease. The authors observed CBD’s potential benefits on Alzheimer’s(4). Future clinical research is required to determine the benefits of CBD, if any, on Alzheimer’s or other inflammatory conditions.

Why People Are Using CBD for Inflammation

Doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, to reduce inflammation, relieve pain, and reduce fever(5)

However, NSAIDs may cause adverse effects, such as gastrointestinal bleeding, renal (kidney) toxicity, and cardiovascular issues(6).

Compared to NSAIDs, cannabidiol (CBD) has a more favorable safety profile. CBD has minimal side effects, like changes in appetite or weight, drowsiness or tiredness, and diarrhea(7).

CBD is the prevalent non-intoxicating, a non-euphoric compound found in cannabis and hemp(8). CBD’s most common form is oil or tincture.

In contrast, tetrahydrocannabinol THC is the Cannabis sativa plant’s active ingredient that causes users’ psychoactive effects.

Most people use CBD for enhancing wellness. A few of CBD’s potential health benefits are its anti-analgesic (pain relieving), anxiolytic (anti-anxiety), antiepileptic, neuroprotective, antipsychotic, and anti-inflammatory properties(9).

A review published in the journal Bioorganic and Medicinal Chemistry stated CBD’s purported anti-inflammatory actions in various animal studies. 

The review included CBD’s anti-inflammatory properties in different conditions, such as arthritis pain, inflammatory bowel disease, and chemically-induced colitis(10).

Acute and Chronic Inflammation

Inflammation is the immune response to irritants, like bacteria, germs, foreign objects, external injuries, or radiation effects(11)

Symptoms of inflammation include:

  • Heat
  • Redness
  • Swelling
  • Pain
  • Loss of function

According to Harvard Medical School, there are two types of inflammation: acute and chronic(12).

Acute inflammation is a type familiar to most people. It is caused by injuries and characterized by warmth, swelling, redness, and pain around the tissues and joints.

Over-the-counter pain relievers or cold compresses may be used in treating acute inflammation. 

Meanwhile, chronic inflammation occurs when the immune system continuously pumps out white blood cells and chemical messengers that prolong the inflammation process. 

Chronic inflammation is dangerous as the body’s white blood cells may eventually attack nearby tissues and organs even if they are healthy. 

This type of inflammation is also associated with several disorders, like diabetes, cancer, arthritis, and inflammatory bowel diseases, like Crohn’s disease and ulcerative colitis.

CBD for Different Kinds of Inflammation 

During inflammation, the body increases blood flow to the damaged tissues to deliver the needed blood cells and proteins. It also removes the unwanted breakdown of substances, debris, or foreign objects(13).

The inflammation process is best exhibited in the skin. During inflammation, the skin appears red and swollen because of blood flow increase and the intense activity of cells.

Atopic dermatitis (eczema) and psoriasis are classified as chronic inflammatory skin diseases(14). These skin conditions are also autoimmune diseases.

In a 2019 study published in La Clinica Terapeutica, 20 patients with eczema and psoriasis were administered CBD-enriched ointments(15)

The test subjects reported that there was a significant improvement in their inflammatory skin disorders and quality of life. Results suggested that CBD may be a safe and effective alternative treatment for the said skin conditions. More extensive research is needed to validate the results.

Inflammation and pain are correlated. Pain may originate from inflammation and the body’s inflammatory response(16).

A study on patients with various mental health and chronic pain-related conditions were given CBD prescriptions(17).

The patients reported that their quality of health became better overall. Pain and mental health symptoms also improved.

In another study, 64 patients with multiple sclerosis were given an oral spray with either CBD and THC or a placebo(18)

The patients who were given the whole-plant cannabis-based medicine reported an attenuation of their central neuropathic pain related to multiple sclerosis. The patients also observed reduced sleep disturbance.

An inflammatory response is essential to wound-healing(19). Inflammation is the body’s response to any kind of injury(20).

A 2019 study has found that CBD may be involved in wound-healing and inflammatory processes in the skin(21). The researchers noted that CBD may be promising in treating inflammation-based skin diseases.

According to the Oxford University Hospitals, when inflammation happens by mistake, inflammatory diseases may occur(22).

When increased blood flow and cells arrive at an inflammation site, they may result in heat, swelling, loss of function, and pain. 

Arthritis, which is the swelling of an individual’s joints, is characterized by joint pain and stiffness. The most common arthritis types are rheumatoid arthritis and osteoarthritis(23).

A study in the journal Pain explored the effects of CBD on rodents with osteoarthritis. The researchers found that CBD reduced acute inflammation in the test subjects’ joints(24).

Moreover, disorders like Alzheimer’s disease and diabetes are said to be connected with inflammation.

A 2017 study showed that CBD combined with THC may have neuroprotective and anti-inflammatory properties that may be useful in treating Alzheimer’s disease. The authors also found that CBD, as an antioxidant, may reduce oxidative stress(25).

Furthermore, in a 2019 study, researchers linked diabetes (type 1 and type 2) to inflammation. They stated that inflammatory pathways are involved in both diabetes types(26).

The authors noted that future research should focus on targeting inflammation to prevent diabetes or control the disease. There is no clear benefit of CBD for Alzheimer’s or other inflammatory or pain conditions as of yet. 

Inflammation may lead to the growth and loosening of artery plaques and eventually trigger blood clots(27). These blood clots are the leading causes of strokes and heart attacks. 

Hence, Johns Hopkins Medicine suggests that fighting inflammation may prevent heart diseases(28).

However, it is necessary that more clinical trials exploring CBD’s effects on the human cardiovascular system be conducted before drawing conclusions.

How CBD Oil Works to Alleviate Symptoms of Inflammation

To understand CBD’s effects on inflammation, one should first understand the endocannabinoid system (ECS). 

The ECS affects the nervous system and is responsible for essential body functions, such as pain perception, mood, appetite, and memory(29)

Cannabinoids interact with the ECS and its receptors, known as cannabinoid receptor 1 (CB1 receptor) and cannabinoid receptor 2 (CB2 receptor), to regulate vital body functions. 

Cannabinoids, like CBD and THC, are called phytocannabinoids, as they come from the cannabis plant. Naturally occurring cannabinoids are called endocannabinoids.  

Cannabinoids have immunomodulatory properties that help them regulate the immune system(30).

According to a study published in Future Medicinal Chemistry, cannabinoids reduce symptoms of diseases related to inflammation by suppressing inflammatory responses(31).  

These immunomodulatory properties include the role of cannabinoids in the induction of apoptosis (cell death) in activated immune cells and the cannabinoids’ ability to suppress cytokines and chemokines in inflammatory sites.

Cell death is essential in the regulation of inflammation. To maintain balance in the body, invading microbial pathogens (viruses) and dying cells should be cleared(32). Failure to remove apoptotic neutrophils may result in a prolonged inflammatory response.

Neutrophils are white blood cells that heal damaged tissues and fix infections. Meanwhile, cytokines refer to signaling molecules. Chemokines are cytokines that attract cells to inflammatory sites(33)

Research has suggested that adenosine receptors suppress overactive immune cells, leading to the protection of several tissues from inflammatory damage. 

CBD has also been suggested to enhance adenosine signaling, resulting in reduced inflammation(34).

How CBD Oil Compares to Alternative Treatments for Inflammation

Steroids and NSAIDs have side effect profiles that may be detrimental to an individual’s health conditions. 

Thus, more people are becoming interested in natural compounds, like dietary supplements and herbal remedies, to reduce inflammation(35).

A study found that omega-3 fatty acids are one of the most effective natural inflammatory agents. This fish oil reduces degenerative enzymes and inflammation(36).

Green tea is also an anti-inflammatory agent with antioxidant, cardiovascular, and cancer-preventing properties(37). Individuals are typically recommended to drink three to four cups a day.

Curcumin or turmeric is believed to have antioxidant and anti-inflammatory effects. It is conventionally used for digestive disorders, wounds, arthritis, neurodegenerative diseases, and cancer(38).

The usual dosage of turmeric powder is 400mg to 600mg, thrice a day. However, long-term use may lead to stomach upset and gastric ulcers.

Unlike some of the alternative remedies mentioned, there is no standard dosage for CBD in treating inflammation.

Still, like curcumin and green tea, CBD may have antioxidant properties(39).

Similar to green tea, CBD may have preventive effects on certain cancers, like colon cancer. It may also be a potential anti-cancer medication(40). More studies are needed to determine any real effects.

How to Choose the Best CBD Oil for Inflammation

A study has shown that CBD combined with THC may have anti-inflammatory effects useful in treating pain caused by rheumatoid arthritis(41). However, THC has mind-altering properties.

CBD and THC come from the cannabis plant. However, CBD is more prominent in cannabis strains that have 0.3% or less THC (hemp plant), while marijuana has 13 to 30% of THC(42).

Based on the 2018 Farm Bill, CBD products with 0.3% or less THC is federally legal(43). However, the US Food and Drug Administration (FDA) has yet to regulate CBD products. 

The only FDA-approved CBD-infused drug is Epidiolex, an anti-seizure drug that aims to treat Dravet’s syndrome and Lennox-Gastaut syndrome(44). CBD is not approved to treat, mitigate, prevent, or cure any other disease.

For individuals seeking inflammation therapy through the use of both CBD and THC may purchase full-spectrum CBD products. 

A full-spectrum CBD oil uses all the active ingredients of the cannabis plant, including terpenes, flavonoids, essential oils, fatty acids, and traces of THC, in compliance with federal laws. 

It is believed that these active ingredients synergize to generate the maximum therapeutic benefits from the Cannabis sativa plant through a mechanism known as the entourage effect.

However, note that while the THC content is limited to trace amounts, there is a chance that a drug test may generate a positive result. 

Individuals who prefer THC-free CBD products for their chronic inflammation may use broad-spectrum CBD instead. This type of CBD has all the ingredients of a full-spectrum CBD except THC. 

Meanwhile, those who want pure CBD extract may opt for CBD isolates.

Hemp oil may refer to CBD oil extracted from the flowers and leaves of the hemp plant. Hemp oil may also refer to hempseed oil, which is derived from hemp seeds. Hempseed oil contains little to no CBD.

Buyers who would like to purchase high-quality CBD products for inflammation should remember the following guidelines when looking for the right CBD.

    1. The laws on CBD vary per state. Check if the laws in your state permit CBD use.
    2. Look for non-GMO and certified organic hemp-derived CBD products manufactured by reputable brands. 
    3. Always check the hemp source. Some areas in the United States, such as Colorado, have some of the best hemp farms that practice sustainable farming.
    4. Verify if an online CBD brand is authorized by the US government to manufacture and sell CBD. For more insights on a product, read product reviews online.
    5. Research how the CBD oil was extracted. Several extraction methods available, such as ethanol, solvent, or lipid extraction.
    6. The US FDA recognizes the CO2 extraction process as a safe process in pharmaceutical manufacturing(45). Carrier oils used in CBD products include medium-chain triglycerides oil (MCT oil) from coconut oil, hempseed oil, and extra-virgin olive oil. 
    7. Check a CBD product’s certificate of analysis (COA). These lab analyses come from independent laboratories that conduct third-party testing. COAs verify the ingredients, potency, and quality of a CBD product.
    8. Consult with a doctor before making any CBD purchase.

CBD Dosage for Inflammation

There is no standard dosing for CBD use in treating inflammation and other inflammatory disorders. However, the main rule with CBD dosing is to go low and slow at first.

Begin with low doses and observe reactions. If there are no adverse effects, the dosage may be increased until CBD’s effects are felt.

When taking CBD, individuals should document their reactions to the substance by writing a journal. These notes may be brought during consultations with a medical professional.

Individuals are encouraged to seek professional advice before taking CBD for inflammation.

How to Take CBD for Inflammation

There are various CBD formats and formulations. For inflammation, CBD may be taken through tinctures (droppers).

When using CBD tinctures, the oil may be applied sublingually (under the tongue) for around a minute before swallowing. This format is useful as it is easily adjustable when changing the CBD dosage.

For pain relief and management, CBD topicals, such as balms, may be applied to the affected areas and rubbed or massaged for added therapeutic effects. Some CBD products have flavorings that may be soothing, such as peppermint.

Other topicals, like salves, lotions, and ointments, may be used for inflammatory skin diseases, like psoriasis and eczema. CBD topicals should not be applied directly to broken skin, as it may result in adverse reactions.

CBD oils may be used for arthritis. They may be massaged into the inflamed areas. 

CBD may also be ingested. CBD oils may be mixed with food and beverages if they are unflavored. Gummies, gelcaps, pills, and CBD edibles are available.

Some CBD manufacturers offer vegan CBD formulations for those who prefer CBD formats free from animal products. Gluten-free options are also available.

Individuals who want to experience instantaneous CBD effects may wish to consider using CBD vape pens. This format delivers CBD directly to the bloodstream through the lungs.

However, when vaping CBD, it may be challenging to determine how much CBD is inhaled. Vaping may also cause lung problems and increase the risk of lung infections(46).

Conclusion

There is growing evidence that CBD may be useful in treating inflammation and related medical conditions. 

However, these health issues, including pain, wounds, inflammatory skin diseases, several types of arthritis, neurodegenerative diseases like Alzheimer’s, diabetes, and heart diseases, such as heart attacks and stroke, require future human studies to be confirmed. 

Compared to conventional anti-inflammatory medications like NSAIDs, CBD’s safety profile is more favorable. 

NSAIDs may cause bleeding in the gastrointestinal tract, renal toxicity, and heart problems. Meanwhile, CBD’s most common side effects are minimal, including appetite or weight changes, tiredness, and diarrhea(47).

CBD may have other therapeutic benefits, such as its suggested neuroprotective and cardioprotective properties(48).

Before using CBD for inflammation, it is recommended that individuals seek professional medical advice from a qualified healthcare provider.


  1. Gulbransen, G., Xu, W., & Arroll, B. (2020, April 01). Cannabidiol prescription in clinical practice: An audit on the first 400 patients in New Zealand. Retrieved from https://bjgpopen.org/content/4/1/bjgpopen20X101010
  2. Burstein, Sumner. (2015). Cannabidiol (CBD) and its analogs: A review of their effects on inflammation. Bioorganic & Medicinal Chemistry. 23. 10.1016/j.bmc.2015.01.059. 
  3. Palmieri, B., Laurino, C., & Vadalà, M. (2019). A therapeutic effect of CBD-enriched ointment in inflammatory skin diseases and cutaneous scars. La Clinica Terapeutica, 170(2), e93–e99. https://doi.org/10.7417/CT.2019.2116
  4. Watt, G., & Karl, T. (2017). In vivo Evidence for Therapeutic Properties of Cannabidiol (CBD) for Alzheimer’s Disease. Frontiers in pharmacology, 8, 20. https://doi.org/10.3389/fphar.2017.00020
  5. What Are NSAIDs? – OrthoInfo – AAOS. (n.d.). Retrieved from https://orthoinfo.aaos.org/en/treatment/what-are-nsaids/
  6. Wongrakpanich, S., Wongrakpanich, A., Melhado, K., & Rangaswami, J. (2018). A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly. Aging and Disease, 9(1), 143–150. https://doi.org/10.14336/AD.2017.0306
  7. Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034
  8. Konieczny, E., (2018), Chapter 5: What is Cannabidiol?, pp. 99 – 109, retrieved from https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  9. World Health Organization, (June 2018), Cannabidiol, retrieved from https://www.who.int/medicines/access/controlled-substances/WHOCBDReportMay2018-2.pdf
  10. Burstein, S. op. cit. 
  11. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What is an inflammation? 2010 Nov 23 [Updated 2018 Feb 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279298/
  12. Publishing, H. (2020, April). Understanding acute and chronic inflammation. Retrieved from https://www.health.harvard.edu/staying-healthy/understanding-acute-and-chronic-inflammation
  13. (n.d.). Retrieved July 26, 2020, from https://www.ouh.nhs.uk/oxparc/information/diagnoses/inflammatory-diseases.aspx
  14. Chovatiya, R., & Silverberg, J. I. (2019). Pathophysiology of Atopic Dermatitis and Psoriasis: Implications for Management in Children. Children (Basel, Switzerland), 6(10), 108. https://doi.org/10.3390/children6100108
  15. Palmieri, B. op. cit. 
  16. Omoigui S. (2007). The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 – inflammatory profile of pain syndromes. Medical hypotheses, 69(6), 1169–1178. https://doi.org/10.1016/j.mehy.2007.06.033
  17. Gulbransen, G. op. Cit
  18. Rog, D. J., Nurmikko, T. J., Friede, T., & Young, C. A. (2005). Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology, 65(6), 812–819. https://doi.org/10.1212/01.wnl.0000176753.45410.8b
  19. Hart, J. (2002). Inflammation. 1: Its role in the healing of acute wounds.. Journal of wound care. 11. 205-9. 10.12968/jowc.2002.11.6.26411.
  20. Phases Of Wound Healing: Wound Care Education From CliniMed. (n.d.). Retrieved from https://www.clinimed.co.uk/wound-care/wound-essentials/phases-of-wound-healing
  21. Sangiovanni, E., Fumagalli, M., Pacchetti, B., Piazza, S., Magnavacca, A., Khalilpour, S., Melzi, G., Martinelli, G., & Dell’Agli, M. (2019). Cannabis sativa L. extract and cannabidiol inhibit in vitro mediators of skin inflammation and wound injury. Phytotherapy research: PTR, 33(8), 2083–2093. https://doi.org/10.1002/ptr.6400
  22. (n.d.). Retrieved July 26, 2020, from https://www.ouh.nhs.uk/oxparc/information/diagnoses/inflammatory-diseases.aspx
  23. Arthritis. (2019, July 19). Retrieved from https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772
  24. Philpott, Holly T.; O’Brien, Melissa; McDougall, Jason J.* Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis, PAIN: December 2017 – Volume 158 – Issue 12 – p 2442-2451 doi: 10.1097/j.pain.0000000000001052
  25. Watt, G. op. cit. 
  26. Tsalamandris, S., Antonopoulos, A., Oikonomou, E., Papamikroulis, G., Vogiatzi, G., Papaioannou, S., . . . Tousoulis, D. (2019, April 14). The Role of Inflammation in Diabetes: Current Concepts and Future Perspectives. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523054/
  27. Fight Inflammation to Help Prevent Heart Disease. (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/wellness-and-prevention/fight-inflammation-to-help-prevent-heart-disease
  28. Ibid.
  29. Manzanares, J., Julian, M., & Carrascosa, A. (2006). Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. Current Neuropharmacology, 4(3), 239–257. https://doi.org/10.2174/157015906778019527
  30. Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349. https://doi.org/10.4155/fmc.09.93
  31. Ibid.
  32. Yang, Y., Jiang, G., Zhang, P. et al. Programmed cell death and its role in inflammation. Military Med Res 2, 12 (2015). https://doi.org/10.1186/s40779-015-0039-0
  33. Turner, M., Nedjai, B., Hurst, T., & Pennington, D. (2014). Cytokines and chemokines: At the crossroads of cell signalling and inflammatory disease. Retrieved July, from https://www.sciencedirect.com/science/article/pii/S0167488914001967
  34. Burstein, S. op. Cit.
  35. Maroon, J. C., Bost, J. W., & Maroon, A. (2010). Natural anti-inflammatory agents for pain relief. Surgical neurology international, 1, 80. https://doi.org/10.4103/2152-7806.73804
  36. Ibid.
  37. Ibid.
  38. Ibid.
  39. Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2019). Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants (Basel, Switzerland), 9(1), 21. https://doi.org/10.3390/antiox9010021
  40. Massi, P., Solinas, M., Cinquina, V., & Parolaro, D. (2013). Cannabidiol as potential anticancer drug. British journal of clinical pharmacology, 75(2), 303–312. https://doi.org/10.1111/j.1365-2125.2012.04298.x
  41. D. R. Blake, P. Robson, M. Ho, R. W. Jubb, C. S. McCabe, Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis, Rheumatology, Volume 45, Issue 1, January 2006, Pages 50–52, https://doi.org/10.1093/rheumatology/kei183
  42. Konieczny, E., (2018), Chapter 2: A Brief History of Cannabis, p. 28-30, retrieved from https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  43. Congressional Research Service, (March 2019), Defining Hemp: Fact Sheet, retrieved from https://fas.org/sgp/crs/misc/R44742.pdf
  44. FDA,(n.d.), FDA Approves first drug comprises active ingredient derived from marijuana, Epidiolex, retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms 
  45. Kankala, Ranjith Kumar et al. “Solution-enhanced dispersion by supercritical fluids: an ecofriendly nanonization approach for processing biomaterials and pharmaceutical compounds.” International journal of nanomedicine vol. 13 4227-4245. 23 Jul. 2018, doi:10.2147/IJN.S166124
  46. Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products. (2020, February 25). Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
  47. Goldstein, J. L., & Cryer, B. (2015). Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies. Drug, healthcare and patient safety, 7, 31–41. https://doi.org/10.2147/DHPS.S71976
  48. Stanley, C. P., Hind, W. H., & O’Sullivan, S. E. (2013). Is the cardiovascular system a therapeutic target for cannabidiol?. British journal of clinical pharmacology, 75(2), 313–322. https://doi.org/10.1111/j.1365-2125.2012.04351.x
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