While the potential of CBD for pain management is extremely promising, our products remain in the “wellness” category. They are not intended to cure, treat or replace medication. CBD and pain:
Pain is not easy to characterize because it is personal and subjective. The mechanisms causing pain are the same for everyone but everyone will have their own feelings.
Let’s start with the official definition of the International Association for the Study of Pain (IASP): “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage […]”.
According to INSERM, pain is responsible for two thirds of medical consultations. It is therefore legitimate to wonder what the contribution of CBD could be in its daily or occasional management.
Pain is the result of two phenomena: perception (physical sensory phenomenon transmitted to the brain) and sensation (process of interpretation of this electrical signal by our brain). This results in several types:
Inflammatory pain (joint / infectious pain)
Neuropathic pain (associated with damage to the nervous system). The perception here is distorted by the lesions.
Mixed pain, which combines the two previous ones. For example, surgery can damage nerve endings and cause inflammation.
Dysfunctional pain (fibromyalgia, functional intestinal disorders, etc.) without identifiable lesion.
So we have a nerve signal coming from the nociceptors translating a signal for the brain to convert it into pain or not. This signal can be the result of external stimulation or nerve damage. The second part of pain is how the person feels. This explains why pain is experienced differently depending on the individual. The same person can also be more sensitive to pain depending on their condition (fatigue, stress, etc.). What happens when the pain sets in over time?
Acute pain is a warning signal. It is supposed to disappear when the painful stimulus ceases. But sometimes, the pain persists (nerve damage, inflammation, diseases…); pain is said to be chronic when its duration exceeds 3 months.
The occurrence of these chronic pains increases with age (more frequent pathologies), with a female predominance. The link between inflammation and chronic pain is also widely studied because the two are often linked (phenomenon of inflammatory nociceptive pain).
A large aspect of pain affects emotions: this corresponds to what we feel when we are in pain (“it is unpleasant”, “painful”, “worrying”, even “unbearable”). The mental reaction to pain corresponds to our way of managing it, interpreting it, giving it meaning, trying to forget it or live with it. We can therefore clearly see the daily mental load and the hardship that results from it. These pains can also impact our personal and professional relationships.
The consequences of prolonged pain are multiple for the body. Both mentally and psychically. They are often accompanied by a disturbed sleep cycle which can have an impact on the production of cortisol (pro-inflammatory hormone), but also on other hormonal cycles (could explain the predominance of women with certain inflammatory diseases), recovery…and the management of our already damaged emotions. This vicious circle often leads to hyperalgesia and social withdrawal.
How does CBD work on pain?
CBD could act both mentally and physically on pain by making its daily management less cumbersome. Since the molecule has been studied for a short time, several avenues still need to be explored. Its anti-inflammatory, anxiolytic and analgesic properties are explored.
Reminder: The most well-known cannabinoid receptors in the body are CB1 and CB2. CB1 is rather present in the central nervous system while CB2 is found in the peripheral nervous and immune system. These receptors are activated by endocannabinoids produced by the body (anandamide and 2-Arachidonoylglycerol, or 2-AG) or plants (CBD, THC, etc.) called phytocannabinoids.
Unlike THC, CBD will not directly interact with CB1 and CB2, which explains its lack of psychotropic effects. CBD would rather decrease the degradation of endocannabinoids, thus increasing their time of action and their effects. The analgesic properties would be the result of interactions with the endocannabinoid system but also the inflammatory and nociceptive system, even if they are not yet fully understood. As inflammation and chronic pain are linked, this could explain part of the effects perceived by users. The effects of CBD on stress and sleep will complement its action, making it more robust in use because it combines physical and psychic effects, where some “classic” treatments focus only on physical symptoms.
What the studies say
Much of the research is related to the management of chronic diseases, and therefore to inflammation and pain. For example, we can cite the uses of CBD oil in the management of arthritis pain (of inflammatory origin).
The tracks also lead to its use in the hospital. Its lesser side effects than some opioids or THC make it a possible postoperative alternative (pain management, quality of sleep and therefore recovery). Possible effects against addictions are also studied.
CBD lowers pain scores: it makes the pain more bearable without making it go away. It remains to be seen whether it will complement an existing treatment or be taken alone because it is quite powerful. It could at least reduce the intake of certain medications. Indeed, morphine can cause serious addictions. The opioid addiction epidemic in the United States is one of the causes of interest in CBD.
Studies highlight the complex management of the pain phenomenon: a comprehensive approach is necessary. It will thus be necessary to improve one’s diet, to continue physical exercise (accompanied or not by a physiotherapist), not to place all one’s hopes in a single molecule as well. CBD is a promising natural alternative, but it is not a miracle cure. Especially since the conclusions of many studies will be long in coming. Indeed, taking CBD without THC remains rare (even more so in humans), hence the difficulty of isolating the effects of CBD.