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Tune in as PeerWell Health occupational therapist, Karen Dwire, gives us a look into the research, effectiveness and regulation surrounding CBD.

Karen Dwire, OT

Read on to learn the answer to the question, ‘is CBD good for my pain?’

“As an occupational therapist, I get asked a lot about CBD for pain and whether it would be a good choice. Before I answer, I try to dig deeper into the reasons why they’re asking me about it in the first place — most of the time, people want to manage their pain.

As a rule, I like to give a patient information on all options for a condition, so I always complete a full health history and a thorough pain assessment, then provide them with research on both the pros and cons of the treatment they’re considering.

With few exceptions (including epilepsy, cancer pain, and end of life situations), there are better options than CBD, especially for musculoskeletal and neurological pain. Usually, I encourage them to explore other options such as diet and lifestyle changes – which have a better track record and fewer side effects.”

– Doctor of Occupational Therapy, Karen Dwire

What is CBD and why is it so popular?

CBD (short for cannabidiol) is a cannabis derivative and comes in many different forms for different purposes. People use CBD for pain, among other things.

Unlike its more popular counterpart, THC, it isn’t psychoactive, so it doesn’t have mind-altering effects. In other words, you won’t get the feeling of being “high” from ingesting or using a CBD product.

A popular product surrounded by some hype, CBD is easy to take and has relatively few researched or known side effects. This is potentially because of its lack of legal status for research until 2015 and its current lack of safety and food regulation.

CBD can be:
  • eaten in the form of edibles, pills or drops
  • absorbed through the skin (topical)
  • taken under the tongue or mouth with a spray or dropper (oral)
  • inhaled, smoked or vaped

thinking about CBD for pain

How effective is CBD at treating pain?

Quite popular among pain patients, according to a poll from the Arthritis Foundation, “29% [of respondents] reported current use of CBD (mostly in liquid or topical form), and nearly 80% of respondents were either using it, had used it in the past, or were considering it.”

Although we’ve known about CBD since 1940 and had isolated and mapped it by the early 1960s, only recently has it become a household term. It’s normal to be curious about CBD for pain — but what does the research say?

Limited research into CBD

With products containing both CBD and THC (the two main cannabinoids in marijuana), there’s a larger, more positive body of research. Several studies show that when used together, marijuana cannabinoids THC and CBD help fight pain. Read more about cannabinoids in general and pain.

Unfortunately, as of yet there aren’t long-term studies with robust, high-quality research that focus on just CBD. Future research on CBD-only products is needed.

Even so, there have been some positive findings regarding CBD’s potential for some conditions.

Research-backed uses for CBD:
  • Seizures and epilepsy:There is an interesting meta-analysis looking at 36 different studies into the effectiveness of CBD on epilepsy symptoms. Several found that seizures became less frequent. Seizure freedom was also achieved with CBD. Children with epilepsy had fewer side effects and had more positive results. In both randomized and non-randomized control trials, CBD was used as an adjuvant (to increase the affect of another drug). None used it as a stand-alone treatment and therefore, we don’t know whether it can be a replacement for conventional treatments.
  • Neurological and psychological conditions: CBD has been touted for certain neurological conditions such as Parkinson’s disease, ALS, and Huntington’s. However, there isn’t much research and what is there is low quality and oftentimes side effects are significant. For instance, a small study with Parkinson’s patients found that while it could improve motor function, there were serious side effects, including liver complications, diarrhea, and other health issues.
  • Anxiety and depression: Similarly, studies on mental and psychological disorders (including anxiety and depression) found little evidence that CBD had a positive impact.
What about CBD for joint pain?

Research into CBD for joint and chronic pain is limited. While there have been promising results shown using animal models, the actual research on humans is scant.

A 2020 review suggests there could potentially be some benefit for sleep, chronic pain and reducing inflammation. It also acknowledged the need for further regulation and research into the topic. The study recommends avoiding blind or indiscriminate use of CBD. It discourages use of CBD as a single or first solution for pain relief.

What else should I know about CBD?
  • Regulation isn’t quite there: Accountability and regulation is quite low in the CBD industry. In recent years, all 50 states have legalized CBD in some form. More and more CBD products are now on the market. Currently, it’s considered a supplement. This means it doesn’t need to comply with FDA regulation or some manufacturing processes for food and drug safety. Without regulation, there’s no way of knowing if the products are labeled properly. It also increases the possibilities of contaminants.
  • Often mislabeled: A recent study into label accuracy of CBD products sold online revealed that almost half of the products tested were mislabeled (84 products sold by 31 different companies). 25% of the products contained less CBD than what was listed on the label. Another study found toxic levels of certain carcinogens in more than 66% of the samples analyzed, and the presence of THC in 60% of the products tested, although no THC was listed on the label.
  • Do your research and check products: It’s wise to research specific CBD products. Make sure safe and ethical manufacturing processes have been followed. If you’d like further information on using CBD for joint pain and how to choose a safe brand, check out this article from Dr. Robert Shmerling.

Should I use CBD? Are there more effective treatments for pain?

If CBD is legal in your state and you’d like to see if it can help manage your pain, purchase it from a reputable shop. Ask questions about the product, follow the ingestion or application instructions closely and test it out with a small sample first.

While there is some evidence to support CBD’s effectiveness in treating some conditions, there still isn’t a lot of long-term evidence.

“CBD should not be the only pain treatment you use. Instead, it should be used in addition to, or in conjunction with proven, formal treatment.”

– Doctor of Occupational Therapy, Karen Dwire

Here’s what we recommend for your pain:
  • Physical Therapy — Your physical therapist hand-selects exercises and stretches to ease your pain and prevent it in the future.
  • Occupational Therapy — Your occupational therapist recommends new ways of setting up your work, home and life to prevent overuse injuries and pain.
  • Diet Changes — Your dietitian recommends healthy diet changes, geared toward goals that contribute to less pain (losing weight, eating an anti-inflammatory diet, etc).
  • Mindfulness and Stress Relief — Mindfulness is a powerful tool to help you work through pain and suffering. Following guided meditations or working with your behavioral therapist helps you treat the emotional aspect of pain. It also changes how you feel about physical pain. Learn more about mindfulness for pain.

Take away

CBD oil – both as a product and as a studied treatment – is still in its infancy. It has a long way to go before it can be considered a first, or stand-alone, treatment for any problem, especially pain.

I recommend looking beyond CBD. Instead, work with your healthcare team. With a whole-person approach, they’ll be able to hone in on a comprehensive and research-backed plan to minimize pain that works for you.

– Doctor of Occupational Therapy, Karen Dwire

To effectively beat muscle and joint pain, choose an effective, safe alternative. Consider physical therapy, occupational therapy, nutrition, mental health help – or a combo of all of them – like we do at PeerWell Health.

Need a complete treatment for your pain?

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Schedule your free appointment with a care coordinator to see how we can help.

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