Does CBD Help With Surgery Recovery?
- A study archived in Transplantation Proceedings showed that cannabidiol (CBD) might help treat chronic pain in kidney transplant patients(1).
- A clinical study in 2019 found that CBD and other phytocannabinoids were as effective as antibiotics in the post-surgery healing process(2).
- A 2019 survey was presented during the 2019 Society of Anesthesia and Sleep Medicine Annual Meeting. It stated that the surveyed surgeons expressed interest in using CBD as a potential medication for post-surgical pain management(3).
- Still, CBD should not be used with other medications, like anesthesia or over-the-counter painkillers, because it might have drug interactions with these medicines(4).
- More research is warranted on CBD’s effects on humans and its health benefits on the post-surgery recovery process.
Why People Are Turning to CBD for Surgery Recovery
To manage post-surgical pain in patients, doctors typically prescribe analgesics, such as opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and other painkillers(5).
While these medications offer pain relief, they may also have side effects that may be detrimental to patients.
Meanwhile, the use of opioids may cause vomiting, nausea, urinary retention, constipation, impaired thinking skills, drowsiness, and reduced respiratory function(7).
Opioid misuse among users is also a concern. Findings from the National Institute on Drug Abuse state that one of the most commonly misused prescription medications are opioids(8).
According to a survey conducted at the Hospital for Special Surgery (HSS), surgeons expressed an interest in using CBD as a potential pain management medication after surgery(9).
The survey results were also presented during the 2019 Society of Anesthesia and Sleep Medicine (SASM) Annual Meeting.
Clinicians and researchers have been seeking ways of relieving post-operative pain without resorting to opioid use because of the supposed harmful side effects of these anti-pain medications(10).
HSS researcher Alexandra Sideris, PhD, said, “We found that the surveyed surgeons expressed generally positive attitudes toward the use of CBD and expressed a desire for further study to address safety and efficacy of CBD in their patients.”
In a 2019 clinical study, six patients with third-molar extraction were given antibiotics, CBD, and other phytocannabinoids(11).
The researchers observed pain, swelling, and tolerance in the test subjects. They concluded that phytocannabinoids, like CBD, had the potential to be used in dental clinic practices for oral diseases and wound-healing prophylaxis (a preventive measure against diseases).
They also compared the use of antibiotics and phytocannabinoids, like CBD, and noted that the treatments had no significant differences.
A 2018 study archived in the journal Transplantation Proceedings showed that CBD might help with the treatment of chronic pain(12).
The researchers gave 50mg of CBD to seven kidney transplant patients twice a day for three weeks. During the study, the dosage was gradually increased to 150mg of CBD.
They also acknowledged that NSAID use in kidney transplant patients might result in kidney toxicity.
Two participants reported pain improvement, four had a partial positive response to CBD treatment in the first 15 days, while one test subject said there was no change after the use of CBD.
The authors observed that CBD had side effects, including dry mouth, dizziness, nausea, drowsiness, and intermittent heat episodes. Still, they acknowledged the benefits of CBD and concluded that CBD was well-tolerated by users.
A 2019 study investigated CBD’s effects on 131 chronic pain patients who were using opioids(13).
Over half of the study sample reported that they were able to reduce the use of or eliminate opioids after eight weeks of adding CBD to their medication regimen. Almost all CBD users reported improvements in their quality of life.
The authors concluded that CBD could significantly reduce opioid use and improve chronic pain and sleep quality in individuals using opioids for pain management.
According to Johns Hopkins Medicine, individuals who have undergone surgery may experience nausea and vomiting due to the anesthesia. They may also report soreness, pain, and swelling around the incision site, and restlessness or sleeplessness(14).
CBD for Nausea and Vomiting
A study found in the British Journal of Pharmacology stated that CBD reduced vomiting and nausea in rats and shrew test subjects(15).
Another study suggested that CBD and other cannabinoids might be useful in treating nausea and vomiting that result from chemotherapy and other treatments(16).
Cannabinoids are substances that may come from the Cannabis sativa plant. The cannabinoid tetrahydrocannabinol (THC) mainly comes from a variant of the cannabis plant, known as the marijuana plant.
Meanwhile, CBD primarily comes from the hemp plant, which is also from cannabis plants. Unlike CBD, THC has psychoactive effects that could get users high.
Cannabinoids help the endocannabinoid system (ECS) maintain homeostasis (natural balance) in the body(17). They interact with the ECS through endocannabinoid receptors, which are found throughout the body.
CBD for Pain
Authors of a study in the journal Therapeutics and Clinical Risk Management suggested that cannabinoids, like CBD, had analgesic and anti-inflammatory properties that might be useful in treating intractable (hard to control) pain(18).
Another study published in the journal Clinical Rehabilitation reported that CBD and THC helped improve the intractable pain of patients with medical conditions related to the central nervous system(19).
The patients had multiple sclerosis, brachial plexus damage, spinal cord injury, and limb amputation because of neurofibromatosis.
Brachial plexus refers to the nerve network responsible for sending signals from the spinal cord to the arms, shoulders, and hands(20). Meanwhile, neurofibromatosis is a genetic disorder of the nervous system that affects how nerve cells form and grow(21).
CBD for Sleep
Research done in 2019 investigated CBD’s effects on 103 adults and found that the substance reduced the participants’ anxiety and improved their sleep(22).
A 2017 systematic review in the journal Current Psychiatry Reports suggested that CBD might be useful in treating sleep disorders, like insomnia and rapid eye movement (REM) sleep behavior disorder(23).
REM sleep behavior disorder is characterized by acting out vivid and unpleasant dreams during REM sleep(24).
How CBD Oil Works to Alleviate Symptoms of Surgery Recovery
According to research, CBD’s purported antiemetic (vomit-reducing) and anti-nausea effects are due to the substance’s indirect activation of the 5-HT1A receptors in the dorsal raphe nucleus(25).
The dorsal raphe nucleus is one of the most sensitive sites in the brain that is responsible for processing rewards or pleasures(26).
5-HT1A receptors are serotonin receptor subtypes. Meanwhile, serotonin is a hormone that helps regulate happiness, anxiety, and mood(27).
Clinical studies in animal models suggested that CBD’s analgesic and anxiety-reducing effects result from its interaction with the serotonin receptor 5-HT1A(28).
The Pros and Cons of CBD Oil for Surgery Recovery
- Human and animal studies previously mentioned reported the therapeutic effects of CBD on individuals undergoing surgery recovery and the associated symptoms.
- Compared to NSAIDs and other analgesic drugs, CBD’s safety profile is more favorable(29).
- Dependence on CBD is unlikely in humans and animals(30). Hence, individuals recovering from surgery should not worry about developing a CBD addiction.
- More research is needed on CBD’s direct effects on post-operative recovery and related conditions.
- Despite CBD’s promise as an effective treatment for post-surgery conditions, the substance has reported side effects, including changes in weight or appetite, diarrhea, and tiredness(31).
- The United States Food and Drug Administration (US FDA) does not support CBD use for conditions other than epilepsy.
- Using CBD oil before a surgical procedure is not recommended. Similar to blood thinners, CBD has purported anticoagulant (blood clot-preventing) effects(32). Prevention of blood-clotting may result in increased bleeding.
- CBD should also not be used with anesthesia and other types of medications. CBD inhibits the enzyme family cytochrome P450(33). These are the same enzymes that metabolize most anesthesia and pain medications, among others(34).
Hence, CBD and these medications may have drug interactions that would affect these medicines’ efficacy.
How CBD Oil Compares to Alternative Treatments for Surgery Recovery
Curcumin may help with post-surgery symptoms. A 2014 study reported that curcumin alleviated post-operative pain and helped promote recovery from surgery(35).
The researchers also supported the use of curcumin alone or as an adjunct therapy to surgery recovery.
How to Choose the Right CBD for Surgery Recovery
As previously mentioned, THC may help alleviate pain. However, cannabis use, even medical cannabis or medical marijuana, is not allowed in all US states(36).
A full-spectrum CBD oil contains trace amounts of THC and other parts of the cannabis plant, such as terpenes, flavonoids, fatty acids, and essential oils.
It is believed that these ingredients synergize to generate the Cannabis sativa plant’s full therapeutic potential. This synergy is called the entourage effect.
However, THC from full-spectrum oils may still be detected by some drug exams. Some individuals may also experience mild mind-alterations because of the THC content.
Those who want to ensure that their CBD is non-psychoactive may use broad-spectrum CBD products. This type of CBD contains all the ingredients of full-spectrum products, except for THC.
For pure, isolated cannabidiol, individuals may purchase CBD isolates.
Full-spectrum CBD oil is recommended for post-operative recovery. However, even consumers buying products online should choose only high-quality products sourced from credible manufacturers and dispensaries.
More importantly, before taking CBD, consult with a doctor first.
CBD Dosage for Surgery Recovery
There is no standard CBD dosage chart for individuals undergoing surgery recovery.
Individuals are encouraged to begin with small amounts or doses. If no adverse effects are observed, the dosage may be gradually increased.
However, before using CBD, consult with a healthcare professional first.
How to Take CBD for Surgery Recovery
CBD may be ingested via CBD gummies, gelcaps, and pills. They may also be applied under the tongue via CBD oil and CBD tinctures.
Individuals may add CBD oil to their food or drinks to mask CBD’s naturally grassy taste.
CBD topicals, such as creams, balms, and lotions, may also be used. These CBD products may be applied to the painful areas.
Some balms and lotions have menthol and other soothing ingredients, such as peppermint, which may bring additional relief for post-operative pain.
CBD oil may be massaged into the affected areas for added pain relief. However, caution should be exercised when applying CBD directly to the incision areas.
For instantaneous effects, CBD may be taken via vape pens.
However, vaping CBD makes it challenging to determine how much of the substance has been taken. Vaping is also known to cause lung problems in some individuals(37).
CBD has many purported health benefits. Previous studies showed that CBD might help with surgery recovery.
The use of NSAIDs, opioids, and other pain killers, whether short-term or long-term, may also have detrimental side effects on individuals.
CBD is generally safe to use. Some surgeons have expressed their interest in prescribing CBD as a pain management medication for individuals recovering from surgeries and other procedures.
These surgeons have also voiced concerns regarding opioid use, hence their search for alternative approaches, like CBD use.
Previous research cited showed that CBD might have potential benefits in the post-surgery setting. It also has properties that might help with conditions that occur after surgical procedures, such as nausea, vomiting, pain, and difficulty sleeping.
The effects of cannabis on individuals experiencing pain are positive. However, the use of cannabis is illegal in the US.
Meanwhile, CBD use is safe and legal. However, it is essential to note that CBD should not be used before a surgical procedure.
Studies have shown that CBD might have anticoagulant effects, which could prevent blood-clotting and result in increased bleeding.
There are several ways to take CBD post-surgery. The choice of format and administration method depends on an individual’s lifestyle and preferences.
CBD is available in formats, like gummies, pills, tinctures, oils, lotions, balms, salves, and ointments.
When using CBD for post-surgical recovery, seek the advice of medical professionals first.
- Cuñetti, L., Manzo, L., Peyraube, R., Arnaiz, J., Curi, L., & Orihuela, S. (2018). Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in Uruguay. Transplantation Proceedings, 50(2), 461–464. https://doi.org/10.1016/j.transproceed.2017.12.042
- Puisys, A., Auzbikaviciute, V., Kubilius, R., Linkevicius, R., Razukevicius, D., & Linkevicius, T. (2019, March 11). Postoperative Healing Assessment Using Cannabinoids in Oral Surgery. Retrieved from https://www.ecronicon.com/ecde/pdf/ECDE-18-00953.pdf
- (2019, October 18). Surgeons Interested in Using Cannabidiol (CBD) as a Potential Pain Management Strategy After Surgery. Retrieved from https://news.hss.edu/surgeons-interested-in-using-cannabidiol-cbd-as-a-potential-pain-management-strategy-after-surgery/
- Rong, C., Carmona, N. E., Lee, Y. L., Ragguett, R. M., Pan, Z., Rosenblat, J. D., Subramaniapillai, M., Shekotikhina, M., Almatham, F., Alageel, A., Mansur, R., Ho, R. C., & McIntyre, R. S. (2018). Drug-drug interactions as a result of co-administering Δ9-THC and CBD with other psychotropic agents. Expert opinion on drug safety, 17(1), 51–54. https://doi.org/10.1080/14740338.2017.1397128
- Mayo Clinic Staff. (2020, February 22). Pain medications after surgery. Retrieved from https://www.mayoclinic.org/pain-medications/art-20046452
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). (n.d.). Retrieved from https://my.clevelandclinic.org/health/drugs/11086-non-steroidal-anti-inflammatory-medicines-nsaids
- Mayo Clinic Staff. op. cit.
- Summary of Misuse of Prescription Drugs. (2020, June). Retrieved from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/overview
- Surgeons Interested in Using Cannabidiol (CBD) as a Potential Pain Management Strategy After Surgery. op. cit.
- Puisys, A. op. cit.
- Cuñetti, L. op. Cit.
- Capano, A., Weaver, R., & Burkman, E. (2019, November 12). Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: A prospective cohort study. Retrieved from https://www.tandfonline.com/doi/full/10.1080/00325481.2019.1685298
- After Surgery: Discomforts and Complications. (n.d.). Retrieved from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/after-surgery-discomforts-and-complications
- Rock, Erin & Bolognini, Daniele & Limebeer, Cheryl & Cascio, Maria & Anavi-Goffer, S & Fletcher, Paul & Mechoulam, Raphael & Pertwee, Roger & Parker, LA. (2011). Cannabidiol, a non-psychotropic component of cannabis, attenuates vomiting and nausea-like behavior via indirect agonism of 5-HT1A somatodendritic autoreceptors in the dorsal raphe nucleus. British journal of pharmacology. 165. 2620-34. 10.1111/j.1476-5381.2011.01621.x.
- Parker, L. A., Rock, E. M., & Limebeer, C. L. (2011). Regulation of nausea and vomiting by cannabinoids. British journal of pharmacology, 163(7), 1411–1422. https://doi.org/10.1111/j.1476-5381.2010.01176.x
- Human Endocannabinoid System. (n.d.). Retrieved from https://www.uclahealth.org/cannabis/human-endocannabinoid-system
- Russo E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245–259. https://doi.org/10.2147/tcrm.s1928
- Wade, D. T., Robson, P., House, H., Makela, P., & Aram, J. (2003). A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical Rehabilitation, 17(1), 21–29. https://doi.org/10.1191/0269215503cr581oa
- Mayo Clinic Staff. (2020, April 15). Brachial plexus injury. Retrieved from https://www.mayoclinic.org/diseases-conditions/brachial-plexus-injury/symptoms-causes/syc-20350235
- Neurofibromatosis. (2019, October 31). Retrieved from https://medlineplus.gov/neurofibromatosis.html
- Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente Journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
- Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current psychiatry reports, 19(4), 23. https://doi.org/10.1007/s11920-017-0775-9
- Mayo Clinic Staff. (2018, January 18). REM sleep behavior disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/rem-sleep-behavior-disorder/symptoms-causes/syc-20352920
- Rock, E. op. cit.
- Luo1, M., & And, J. (1970, January 01). Minmin Luo. Retrieved from http://learnmem.cshlp.org/content/22/9/452.full.html
- Serotonin. (n.d.). Retrieved from https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/serotonin
- De Gregorio, D., McLaughlin, R. J., Posa, L., Ochoa-Sanchez, R., Enns, J., Lopez-Canul, M., Aboud, M., Maione, S., Comai, S., & Gobbi, G. (2019). Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain, 160(1), 136–150. https://doi.org/10.1097/j.pain.0000000000001386
- Iffland, Kerstin, and Franjo Grotenhermen. “An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies.” Cannabis and cannabinoid research vol. 2,1 139-154. 1 Jun. 2017, doi:10.1089/can.2016.0034
- World Health Organization (2018 June). CANNABIDIOL (CBD) Critical Review Report. Retrieved from: https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
- Iffland, K. op. cit.
- Coetzee, C., Levendal, R. A., van de Venter, M., & Frost, C. L. (2007). Anticoagulant effects of a Cannabis extract in an obese rat model. Phytomedicine : international journal of phytotherapy and phytopharmacology, 14(5), 333–337. https://doi.org/10.1016/j.phymed.2006.02.004
- Rong, C. op. cit.
- Friedericy, H., & Bovill, J. (2005, October 17). 4 The role of the cytochrome P450 system in drug interactions in anaesthesia. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0950350198800299
- Zhu, Qing & Sun, Yuehua & Yun, Xiaodi & Ou, Yuntao & Zhang, Wei & Li, Jun-Xu. (2014). Antinociceptive effects of curcumin in a rat model of postoperative pain. Scientific reports. 4. 4932. 10.1038/srep04932.
- States with Legal Cannabidiol (CBD) – Medical Marijuana – ProCon.org. (n.d.). Retrieved from https://medicalmarijuana.procon.org/states-with-legal-cannabidiol-cbd/
- “Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping Products.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Feb. 2020, www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html