Cannabidiol, or CBD, is now one of the most popular supplements for pain. Derived from industrial hemp plants, it has an uplifting and relaxing effect, and reduces pain perception with none of the adverse effects associated with medical marijuana, or cannabis.

What is CBD oil for pain?

CBD, or cannabidiol, is an active substance extracted from the leaves, flowers and stems of industrial hemp plants. Hemp is a non-marijuana strain of the cannabis plant and does not contain appreciable amounts of the psychoactive substance, THC (tetrahydrocannabinol). As cannabidiol products do not contain THC, they do not produce the ‘high’ associated with marijuana, are not habit forming, and are not regulated as controlled drugs. CBD does have beneficial medicinal effects in its own right, however, and CBD oil is effective for pain relief.

Once extracted, cannabidiol (CBD) is usually blended with olive oil, coconut oil or hemp seed oil to aid its absorption, as it is fat soluble. This blend is what is known as CBD oil or non-psychoactive cannabis oil.

CBD formulations available to relieve pain include capsules, oral sprays, oil drops and gummies. CBD can also be absorbed through the skin to relieve pain, and a variety of cannabidiol creams and salves are also available, while a cannabidiol patch has been developed in the US.

How CBD reduces pain

CBD interacts with your own endocannabinoid system and has positive effects on how the brain interprets pain signals. Unlike medical marijuana, CBD does not activate the receptors that produce psychoactive effects (CB₁) but instead appears to enhance the effects of natural brain substances, such as serotonin, dopamine, and anandamine. 

Cannabidiol also interacts with peripheral receptors (CB₂) and helps to suppress inflammation and reduce activation of pain receptors. The combined effects allow cannabidiol to promote relaxation, generate feelings of wellbeing and reduce pain perception through a natural analgesic effect.

CBD not only reduces the level of pain signals reaching the brain but alters the way you respond to them, changing your reaction to pain and helping you feel and cope much better. In addition, CBD reduces anxiety and stress, improves sleep and lifts mood.

How topical CBD salves reduce pain

CBD creams, salves, lotions and ointments are absorbed through the skin and interact with cannabinoid receptors (CB₂) to suppress inflammation and help relieve localised pain, itching, irritation, soreness or other symptoms.

CBD skin lotions, balms and salves are popular for easing muscle and joint aches and pains. CBD salves can be used at the same time as taking CBD oil capsules to aid relaxation and reduce discomfort and fatigue.

CBD safety and side effects

CBD is recognised as safe and well tolerated, with few side effects at usual doses. Some people feel sleepy with higher doses, and sleep more deeply. A few people experience vivid dreams but it is more common to find you don’t recall dreams.

If you have a medical condition, always talk to your doctor before taking CBD. It is also important to check for drug supplement interactions if you are taking any prescribed or over-the-counter drugs. CBD interacts with liver enzymes that breakdown many drugs, which can lead to higher or lower than expected levels of the prescribed drug which could increase the risk of side effects or reduce their effectiveness.

High (medical) doses have been associated with diarrhoea, and changes in appetite with reduced weight.

Best CBD oil for pain

It’s important to select a quality CBD product that has been independently tested to ensure it contains a known amount of active cannabidiol (so it’s effective) and is free from impurities including psychoactive THC (so it is legal). Products containing CBD that is   cold extracted, using carbon dioxide (CO₂) ensure the full spectrum of cannabinoids and other active substances, such as terpenes, are preserved in their active form.


UK CBD supplements

This is the cannabidiol supplement I currently take (Disclaimer: I act as a consultant to Healthspan) but you can also get good quality pharmaceutical products from Amazon.co.uk or Amazon.com.

I prefer taking capsules or gummies, as natural cannabidiol oil has an earthy taste which takes some getting used to. However, sprays and drops are also available.

CBD dose

When taking cannabidiol by mouth, start with a relatively low dose and to build up to find the level that works best for you. A typical starting dose is 6mg taken one to three times a day, building up to 10mg to 15mg taken twice a day.

The effects of CBD last for around 3 to 5 hours, so to treat pain it works best taking at regular intervals, two or three times a day, for continuous relief.

Doses of up to 200mg per day are used as a food supplement. Higher doses of CBD (over 200 mg per day) may be used medically to treat refractory pain but this should always be under the supervision of a healthcare professional.

CBD salves

The topical CBD products I have trialled and can therefore recommend, contain only natural ingredients with no synthetic fragrances or artificial preservatives, and are treat for soothing burns, bites, stings, irritated or sore skin conditions such as eczema and psoriasis, as well as dry, chapped skin or lips and, of course acne blemishes.

Carun Active Hemp Ointment

Based on petroleum jelly, hemp seed oil and olive oil, with a gentle fragrance of natural lemon, peppermint and lavender oils, this ointment is infused with hemp leaf and stem extracts to provide CBD at a strength of 3% (ie a 100ml pot contains 300mg CBD).  Carun Active Hemp Ointment has a soft, melting texture at room temperature. Available from Amazon.co.uk

A range of CBD ointments and creams are also available on Amazon.com some of which combine CBD with Arnica for additional healing benefits.

How Effective Is CBD Oil For Pain?

Cannabidiol is highly effective for treating many types of pain, including headache, joint pain, endometriosis pain and neuropathic pain (due to nerve damage).

CBD for joint pain

Osteoarthritis cause inflammation and pain in the joints that can be relieved by taking cannabidiol CBD oil, or rubbing on a CBD salve if the joint is tender. Preclinical studies show that CBD oil reduces joint inflammation and pain. It is also effective when used to prevent joint pain and appears to protect nerves from damage. CBD is effective against joint pain when taken as an oral supplement, or when applied as a topical cannabidiol gel or salve. From personal experience, I find that akign CBD at night helps me sleep deeply, and wake up without muscle or joint aches or pains (I also take turmeric and omega3 fish oil which provide additional benefits).

CBD for neuropathic pain

Pain caused by irritation of a nerve (eg after a Herpes virus infection) or nerve damage (as can occur with diabetes) is often difficult to treat as the nerve itself is over-responding to normal stimulation (eg touch) or falsely triggering pain within itself due to damage.

A recent Cochrane review of 10 studies involving cannabis-derived painkillers, including 10 studies investigating a product that combined THC with cannabidiol (CBD) concluded that extracts from cannabis and hemp are more effective than placebo in producing a significant reduction in pain (50% or greater pain relief). This form of medical marijuana is a currently a controlled drug, however, that is only available on prescription for specific indications.

Cannabidiol is available on its own as a food supplement, however, to provide pain relief without the psychoactive effects of THC. This was shown in a study involving neuropathic pain caused by chemotherapy (paclitaxel). Normally, this pain would result in as many as 40% of patients having to receive a lower, less effective dose, or cause them to stop their chemotherapy altogether. A preclinical study found that taking cannabidiol (CBD oils) could prevent this form of neuropathic pain from developing.

CBD for endometriosis pain

CBD is under investigation as a treatment for endometriosis pain as cannabinoid receptors have been found in nerve fibres within endometriosis lesions.  The only way to know if it will help your endometriosis pain is to try it.

CBD for headache

Try massaging a little CBD salve into your temples to relieve a tension headache.

Hemp seed oil

Hemp oil is extracted from hemp seeds but is different to cannabidiol CBD oil extracted from hemp leaves, stems and flowers. If you’re looking for pain relief, it’s important to use cannabidiol or CBD oil, not hemp seed oil which, although a nutritionally excellent oil, contains very little CBD.