- An animal study using a rat model suggested that CBD may provide neuroprotective benefits by alleviating inflammation in the brain(1).
- CBD may help attenuate or prevent chemotherapy-induced neuropathic pain(2).
- The Food and Drug Administration or FDA has not recognized CBD as a medical treatment despite the research.
- CBD is generally safe for use(3). However, it may interact with other drugs like NSAIDs or non-steroidal anti-inflammatory drugs(4).
Does CBD Help With Nerve Pain?
CBD (cannabidiol) interacts with the ECS (endocannabinoid system)(5). The ECS is present in most parts of the body(6).
The endocannabinoid system consists of natural components, such as cannabinoid receptors (CB1 and CB2)(7).
CB1 receptors play a pivotal role in pain sensation and mediate various immune system effects(8-9). Meanwhile, CB2 receptors work by inhibiting inflammatory hypersensitivity(10).
CBD displays a low affinity for these cannabinoid receptors. However, evidence has emerged that CBD may still interact with CB1 and CB2 at reasonably low concentrations(11).
Furthermore, CBD may antagonize CB1 and CB2 receptors in the presence of THC (tetrahydrocannabinol) and regulate pain perception(12).
CBD’s purported health benefits include relief from chronic pain, inflammation, insomnia, anxiety, and addiction(13).
This chemical compound found in the cannabis plant is also thought to have anticonvulsant (antiseizure) and analgesic properties without the psychoactive effects of THC(14).
A number of studies have examined the effects of CBD on nerve pain or neuropathic pain. This type of pain happens when the nervous system is not working accordingly(15).
Damaged nerve fibers may send wrong signals to pain centers. Hence, nerve function may change at the site of the nerve damage and areas in the central nervous system(16).
A February 2020 animal study suggested that CBD may provide neuroprotective benefits by alleviating inflammation in the brain(17).
Neuroprotection is an effect that may lead to the recovery or regeneration of the nervous system, including its cells, structures, and functions(18).
A clinical trial hypothesized that CBD may inhibit paclitaxel-induced neuropathic pain via 5-HT1A receptors without reducing nervous system function or chemotherapy efficacy(19).
Paclitaxel or PAC is associated with chemotherapy-induced neuropathic pain. Neuropathic pain is a burning pain that is often chronic.
Meanwhile, 5-HT1A is a serotonin receptor. CBD may interact with this receptor and help reduce stress and anxiety(20).
Serotonin is a hormone that stabilizes mood.
The clinical trial showed that adjunct treatment with cannabidiol may be safe during PAC chemotherapy. CBD may also help attenuate or prevent chemotherapy-induced neuropathic pain(21).
Still, more longitudinal research and human studies are warranted to determine whether CBD may help with nerve pain.
CBD Oil and Neuropathy
Neuropathy is caused by numerous conditions, such as diabetes, tumors, and autoimmune diseases(22).
Studies on CBD’s purported therapeutic benefits examined how the compound may help with autoimmune diseases, including rheumatoid arthritis and multiple sclerosis.
A 2020 study from the journal Cureus mentioned that CBD may attenuate various pro-inflammatory responses in cell models. Hence, CBD may help with pain associated with rheumatoid arthritis by affecting immune cells(23).
Meanwhile, a study from Frontiers in Neurology suggested that CBD may help improve the mobility of people with multiple sclerosis(24).
Multiple sclerosis is a possibly disabling disease of the brain and spinal cord.
A 2020 systematic review from Frontiers in Pharmacology mentioned that CBD may help with chronic pain associated with kidney transplants. Topically administered CBD may also help patients with peripheral neuropathy of the lower extremities(25).
In a human study of cannabidiol used for pain, researchers hypothesized that CBD pain relief is driven by pharmacological action and psychological placebo effects(26).
The placebo effect happens when an individual’s mental or physical health appears to improve after taking a placebo or dummy medication(27).
Cannabidiol vs. Other Alternative Treatments for Nerve Pain
A study from Therapeutic Advances in Neurological Disorders indicated that 8% topical capsaicin may help with neuropathic conditions(28).
Capsaicin is found in chili peppers and has purported analgesic properties(29).
Amino acids may also help with peripheral neuropathy(30).
Hempseed is a valuable source of essential amino acids, fatty acids, vitamins, minerals, and fiber(31).
Although hempseed oil and hemp oil (CBD oil) are sometimes used interchangeably, they are different.
Hemp oil is an essential oil that comes from the flowers and leaves of hemp plants. Meanwhile, hempseed oil is made from the pressed seeds of hemp plants and does not contain CBD(32).
Why Some People Choose CBD Oil for Neuropathy
CBD is deemed well tolerated and generally safe for use(33). CBD’s good safety profile may be a reason why some people choose CBD oil for neuropathy.
Anecdotal experiences of CBD use are also found online. Some individuals claimed that although CBD cannot cure shingles, it may help with some of its symptoms, including pain(34).
Shingles is a viral infection that produces painful blisters.
According to the CDC or Centers for Disease Control and Prevention, long-term nerve pain (postherpetic neuralgia) is the most common shingle complication(35).
The Pros and Cons of CBD for Neuropathy
The Pros
- CBD is believed to have pain-relieving properties(36). These properties may help with neuropathy symptoms like a burning pain(37).
- CBD is non-psychoactive(38).
- CBD is relatively safe for use(39).
- CBD is available in various forms and concentrations.
The Cons
- The FDA has not recognized CBD as a medical treatment.
- CBD may cause minor side effects, including changes in appetite, dry mouth, diarrhea, drowsiness, and fatigue(40).
- CBD may interact with other medications like antibiotics, antidepressants, and over-the-counter NSAIDs(41).
- Most studies on how CBD oil works to help with pain are limited. Although some evidence exists regarding CBD’s therapeutic effects on nerve pain, most research was done on animals.
CBD Dosage for Nerve Pain
There is no standard CBD dosage for nerve pain. The FDA does not recognize cannabidiol as a medical treatment.
However, a study from Current Drug Safety stated that constant use and high doses of CBD up to 1,500mg per day are well tolerated in humans(42).
Meanwhile, mid-range doses between 10mg to 100mg of CBD daily may help with inflammation and pain management(43).
Still, individuals considering CBD for nerve pain must ask their physician for medical advice.
How to Use CBD Oil for Neuropathy
Several types of CBD products are available on the market, such as:
- Vapes
- Edibles, like CBD gummies
- Tinctures
- Topicals, like balms, lotions, salves, and CBD creams
- Strips and sprays
Inhaling CBD using vape pens may provide users with instant relief(44). Individuals who smoke or vape cannabidiol may feel the effects of CBD between 2 to 15 minutes and may last from 2 to 4 hours(45).
However, extra caution is recommended when vaping because this method may damage the lungs(46).
Individuals may also consider using topical CBD products like balms, lotions, salves, and creams.
The content of topicals is not absorbed into the entire body compared to other formats(47). Therefore, topical CBD products may be safer, considering how little is known about the long-term safety of cannabidiol(48).
Things to Look for When Choosing CBD Oil for Nerve Pain
Individuals must choose high-quality CBD products to maximize the benefits of CBD. When selecting the best CBD oil for nerve pain, below are a few things to consider:
The Spectrum of CBD
Individuals must check the active ingredients list of CBD oil and other CBD-infused products if they want to use CBD for overall wellness or a specific health condition. CBD extracts can be categorized as:
- Full-spectrum CBD oil
- Broad-spectrum CBD oil
- CBD isolates
A CBD oil product is considered to be full-spectrum if all components of the cannabis plant, including CBD, essential oils, terpenes, flavonoids, and other cannabinoids, are utilized, and the THC concentration is less than 0.3%(49).
Terpenes are organic molecules responsible for flower aroma(50). Meanwhile, flavonoids aid in the plant’s responses to UV radiation and sunlight(51).
Broad-spectrum CBD is somewhat similar to full-spectrum CBD. However, it is almost THC-free. Meanwhile, CBD isolates contain pure CBD(52).
Research from Frontiers in Plant Science hypothesized that the entourage effect coming from full-spectrum hemp extracts may produce better health benefits than pure CBD(53).
The notion behind the entourage effect is that the phytochemicals (compounds produced by plants) in marijuana (sometimes called cannabis) and hemp, particularly terpenes and cannabinoids, work better together(54).
Third-Party Testing and Certificates of Analysis
A third-party lab must test all CBD products to determine the accuracy of their potency and components. Meanwhile, consumers must also look for COAs (Certificates of Analysis) and any disclaimer.
Organic CBD Products
Organic hemp extract is produced without chemical fertilizers and added preservatives. Most CBD brands also sell gluten-free and non-GMO products.
What Is CBD Oil?
CBD oils are made by infusing the CBD extract into a carrier oil, such as olive oil, coconut oil, and hempseed oil(55).
Safety and Side Effects of CBD Oil
The WHO or World Health Organization reported that CBD is well tolerated with a good safety profile(56).
However, according to Mayo Clinic, CBD may still carry risks and a few minor side effects, including(57):
- Fatigue
- Reduced appetite
- Dry mouth
- Diarrhea
- Drowsiness
What Is Nerve Pain?
Nerve pain or neuropathic pain is experienced when a particular health condition affects the nerves that transmit sensations to the brain(58).
Common Nerve Pain Symptoms
Nerve pain may be associated with numerous symptoms, including(59):
- Spontaneous pain: A type of pain that comes without stimulation
- Evoked pain: Pain triggered by non-painful stimuli like cold and gentle brushing against the skin
Abnormal heart rate or decreased blood pressure is also a common nerve pain symptom(60).
Traditional Treatments for Nerve Pain
When chronic pain emanates from the nerves, traditional treatment options, including non-steroidal anti-inflammatory drugs and pain relief medications like paracetamol and opioids, may not work(61).
Opioids are pain-relieving substances that may be dangerous when taken in higher doses(62).
Aside from conventional painkillers, healthcare providers may give prescription drugs for nerve pain. Anticonvulsants, antidepressants, and serotonin may also be prescribed(63).
What Causes Neuropathy?
Neuropathy (peripheral neuropathy) comes from damage to the nerves situated outside of the spinal cord or brain(64).
Peripheral neuropathy may arise from infections, traumatic injuries, exposure to toxins, inherited causes, and metabolic issues(65).
CBD Glossary
- Cannabis is a complex plant with primary compounds, such as THC (tetrahydrocannabinol) and CBD (cannabidiol) that have opposing effects. Cannabis is also called marijuana(66).
- Cannabinoids are compounds found in cannabis. Two well-known cannabinoids are CBD and THC(67).
- Cannabidiol is a non-psychoactive cannabinoid that falls under the definition of hemp(68).
- Tetrahydrocannabinol is the primary psychoactive chemical in cannabis, responsible for the euphoric high that marijuana users experience(69).
Frequently Asked Questions
-
Will CBD make a person high?
No. CBD is non-psychoactive(70). Hence, it will not make a person high.
-
Can a person use CBD oil for diabetic neuropathy or nerve damage?
Diabetic neuropathy refers to nerve damage that arises when a person has diabetes.
A randomized controlled trial suggested that topical CBD oil may help with neuropathic pain(71).
Still, it is best to talk with a physician before using CBD for diabetic neuropathy.
-
Is medical cannabis legal in Colorado?
Medical cannabis (medical marijuana) is legal in Colorado. However, under House Bill 21-1317, a medical marijuana retailer cannot sell more than 8g of marijuana concentrate to a patient in one day(72).
Before, patients’ daily concentrate purchase limit was 40g(73).
- Immune Responses Regulated by Cannabidiol
https://www.liebertpub.com/doi/10.1089/can.2018.0073 - Cannabidiol Inhibits Paclitaxel-Induced Neuropathic Pain Through 5-HT(1A) Receptors Without Diminishing Nervous System Function or Chemotherapy Efficacy
https://pubmed.ncbi.nlm.nih.gov/24117398/ - Cannabidiol (CBD)
https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf - Healing With CBD, pages 115-116.
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - The Endocannabinoid System, Our Universal Regulator
https://www.jyi.org/2018-june/2018/6/1/the-endocannabinoid-system-our-universal-regulator - Ibid.
- The Endocannabinoid System and Cannabidiol’s Promise for the Treatment of Substance Use Disorder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390812/ - Cannabinoids and Pain: New Insights From Old Molecules
https://www.frontiersin.org/articles/10.3389/fphar.2018.01259/full - The Role of CB1 in Immune Modulation by Cannabinoids
https://pubmed.ncbi.nlm.nih.gov/23261520/ - Cannabinoids and Pain: New Insights From Old Molecules
https://www.frontiersin.org/articles/10.3389/fphar.2018.01259/full - The Diverse CB1 and CB2 Receptor Pharmacology of Three Plant Cannabinoids: Δ9-Tetrahydrocannabinol, Cannabidiol and Δ9-Tetrahydrocannabivarin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219532/ - Cannabinoids and Pain: New Insights From Old Molecules
https://www.frontiersin.org/articles/10.3389/fphar.2018.01259/full - Cannabidiol (CBD)-What We Know and What We Don’t
https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 - Cannabinoids and Pain: New Insights From Old Molecule
https://www.frontiersin.org/articles/10.3389/fphar.2018.01259/full - Neuropathic Pain
https://my.clevelandclinic.org/health/diseases/15833-neuropathic-pain - Ibid.
- Immune Responses Regulated by Cannabidiol
https://www.liebertpub.com/doi/10.1089/can.2018.0073 - Neuroprotection and Neurodegenerative Disease
https://pubmed.ncbi.nlm.nih.gov/11749009/ - Cannabidiol Inhibits Paclitaxel-Induced Neuropathic Pain Through 5-HT(1A) Receptors Without Diminishing Nervous System Function or Chemotherapy Efficacy
https://pubmed.ncbi.nlm.nih.gov/24117398/ - The Endocannabinoid System and Cannabidiol’s Promise for the Treatment of Substance Use Disorder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390812/ - Cannabidiol Inhibits Paclitaxel-Induced Neuropathic Pain Through 5-HT(1A) Receptors Without Diminishing Nervous System Function or Chemotherapy Efficacy
https://pubmed.ncbi.nlm.nih.gov/24117398/ - Peripheral Neuropathy
https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061 - Cannabidiol: A Brief Review of Its Therapeutic and Pharmacologic Efficacy in the Management of Joint Disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7176325/ - Cannabidiol to Improve Mobility in People with Multiple Sclerosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874292/ - A Balanced Approach for Cannabidiol Use in Chronic Pain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204604/ - Research Shows Pain-Relieving Effects of CBD
https://www.sciencedaily.com/releases/2021/04/210423130221.htm - Placebo Effect
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect - Capsaicinoids in the Treatment of Neuropathic Pain: A Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3886382/ - Capsaicin
https://pubchem.ncbi.nlm.nih.gov/compound/Capsaicin - Peripheral Neuropathy
https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/diagnosis-treatment/drc-20352067 - A Review of Hemp as Food and Nutritional Supplement
https://pubmed.ncbi.nlm.nih.gov/33614949/ - Hemp Seed Oil Properties
https://extension.okstate.edu/fact-sheets/hemp-seed-oil-properties.html - Cannabidiol (CBD)
https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf - Cannabidiol for Viral Diseases: Hype or Hope?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347053/ - Complications of Shingles
https://www.cdc.gov/shingles/about/complications.html - Research Shows Pain-Relieving Effects of CBD
https://www.sciencedaily.com/releases/2021/04/210423130221.htm - Neuropathy (Peripheral Neuropathy)
https://my.clevelandclinic.org/health/diseases/14737-neuropathy - Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246936/ - Cannabidiol (CBD)
https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf - What Are the Benefits of CBD — And Is It Safe to Use?
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700 - Healing With CBD, pages 115-116.
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent
https://pubmed.ncbi.nlm.nih.gov/22129319/ - CBD: A Patient’s Guide to Medicinal Cannabis, page 129.
https://drive.google.com/file/d/1MILU_6ZjYkII-XMUPHLFPiPQbrz__5Sh/view - How to Safely Use CBD: Should You Inhale, Spray, Apply, or Eat It?
https://www.consumerreports.org/cbd/how-to-use-cbd-inhale-spray-apply-eat/ - Healing With CBD, page 190.
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products
https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html - How to Safely Use CBD: Should You Inhale, Spray, Apply, or Eat It?
https://www.consumerreports.org/cbd/how-to-use-cbd-inhale-spray-apply-eat/ - Ibid.
- Cannabidiol Primer for Healthcare Professionals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340472/ - Cannabinoids and Terpenes: How Production of Photo-Protectants Can Be Manipulated to Enhance Cannabis sativa L. Phytochemistry
https://www.frontiersin.org/articles/10.3389/fpls.2021.620021/full - Ibid.
- Ibid.
- The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: No “Strain,” No Gain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334252/ - Healing With CBD, pages 124 and 125.
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Healing With CBD, page 205.
https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view - Cannabidiol (CBD)
https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf - What Are the Benefits of CBD — And Is It Safe to Use?
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700 - Nerve Pain (neuralgia)
https://www.healthdirect.gov.au/nerve-pain - Neuropathic Pain
https://my.clevelandclinic.org/health/diseases/15833-neuropathic-pain - Neuropathy (Peripheral Neuropathy)
https://my.clevelandclinic.org/health/diseases/14737-neuropathy - Nerve Pain Medication
https://www.healthdirect.gov.au/nerve-pain-medication - What Are Opioids and Why Are They Dangerous?
https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/expert-answers/what-are-opioids/faq-20381270 - Drugs That Relieve Nerve Pain
https://www.health.harvard.edu/pain/drugs-that-relieve-nerve-pain - Neuropathy (Peripheral Neuropathy)
https://my.clevelandclinic.org/health/diseases/14737-neuropathy - Peripheral Neuropathy
https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061 - Cannabis, a Complex Plant: Different Compounds and Different Effects on Individuals
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736954/ - FDA and Cannabis: Research and Drug Approval Process
https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process - Ibid.
- What Is Marijuana?
https://www.drugabuse.gov/publications/research-reports/marijuana/what-marijuana - Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246936/ - The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities
https://pubmed.ncbi.nlm.nih.gov/31793418/ - HOUSE BILL 21-1317, page 17.
https://leg.colorado.gov/sites/default/files/2021a_1317_signed.pdf - Ibid.