Since there are a few different types of pain, we will talk about cannabis’ usefulness for pain in relation to the type of pain it is about.
What is chronic pain?
Chronic pain is pain that lasts for a long period of time. It is a widespread problem that affects large sections of the population. Many different diseases can lead to chronic pain. Prolonged pain is difficult to treat and often common painkillers work poorly.
Chronic pain is a strong pain that lasts for a long period of time. Some doctors define it as a pain that lasts for over 12 weeks, others call pain that lasts for more than 6 months chronic.
The pain is so strong that it affects the affected person negatively, often with reduced mobility as a result. Chronic pain is a collective name for a variety of ailments. The cause behind the pain varies.
There is no way for healthcare to measure chronic pain and the diagnosis is therefore strongly dependent on the patient’s subjective perception. The patient himself must explain to the doctor how the pain is experienced, where it hurts, and when the pain is at its strongest. About 10 percent of the population suffers from chronic pain and almost 60 percent of those on long-term sick leave have this problem.
Different types of pain
Pain can be classified in different ways, but some of the most common types of pain are:
- Inflammatory pain
- Nociceptive pain
- Acute pain
- Neuropathic pain
- Idiopathic pain
How does CBD work in the treatment of pain?
Some studies have shown that CBD can help reduce chronic pain through its anti-inflammatory effect and by interacting with the neurotransmitter. Researchers believe that CBD affects the CB2 receptors, which leads to reduced inflammation and pain. Alternatively, it may be because CBD causes the body to produce cannabinoids naturally.
A study done on rats showed that CBD injections reduced pain during surgery. Another study in rats found that CBD ingested by mouth drastically reduced pain and inflammation caused by sciatica. One study showed that rats treated with CBD felt less inflammatory pain because CBD affected the pain receptors.
If joints or muscles are damaged, inflammation can occur in soft tissues. The pain is experienced as aching or dull and is easy to locate. Common areas that suffer from inflammatory pain are the hands, hips, lumbar spine, and shoulders.
Inflammation of various kinds can lead to chronic pain. Inflammation is one of the body’s defense mechanisms. You often get inflammation as a result of infection, but it can also occur as a result of injury, allergy or illness. If the immune system fails to fight an attack, it leads to inflammation. The area of the body that suffers from inflammation often has poorer function and mobility. Common symptoms are that it hurts, becomes swollen, the body part becomes hot and gets a red or pink color.
Chronic back pain
Back pain is the most common form of chronic pain. There are many different causes of back pain. It can occur as a result of arthritis, spinal cord injury, shingles, fibromyalgia, and MS. Chronic back pain can also be one of the symptoms of various forms of cancer.
If the body is injured, nociceptive pain acts as a warning signal. An example of nociceptive pain is the pain that occurs with osteoarthritis, joint pain or low back pain. This type of pain can also occur during surgery or in connection with sports injuries.
Menstrual cramps are a type of pain that affects many women. It is chronic in the sense that it occurs regularly in connection with the menstrual cycle. The women who suffer from severe menstrual pain have such severe pain that it becomes difficult to carry out ordinary work and daily chores. In some severe cases, injections are needed to reduce the symptoms.
Acute pain and CBD oil
Acute pain is the type of pain we experience when, for example, we happen to put our palm on a red-hot stove. It is thus about the pain that arises suddenly and that has to do with the fact that we have just injured ourselves or are about to injure ourselves.
There are usually good reasons why we experience this type of pain and people whose function for acute pain is put out of action live dangerously. Without acute pain, we would keep our hand on the stove until it started to smell burnt. Acute pain also allows us to learn not to repeat the behavior that directly caused the pain; most of us have at one time or another burned ourselves on a stove, but that also means that we are now extra careful when we are near red hot hobs.
Acute pain is thus usually not a problem, but rather something we should be grateful for that we experience. Sometimes, however, there can be good reasons to make sure to avoid acute pain, such as when we need to pull out a tooth or undergo some type of surgery. However, CBD oil does not seem to be effective against acute pain but can be helpful in some cases when it comes to the other four categories of pain we will talk about next.
Neuropathic pain and CBD oil
If the nervous system is affected by disease or injured, neuropathic pain can occur. This type of pain is often experienced as rushing, stinging, or burning. It is different when the pain occurs – from a few days to several weeks after the injury. The pain often occurs in relapses whose intensity and frequency vary. Sometimes no specific cause for the neuropathic pain is found.
Neuropathic pain is pain that occurs with joint inflammation such as sciatica and carpal tunnel syndrome. HIV, MS (Multiple Sclerosis), diabetes, and various types of physical trauma also cause neuropathic pain.
Here, too, it is usually a matter of the body signaling to us that something is wrong. Lucky as we are, we live in modern times. This means that pain from, for example, carpal tunnel syndrome will hopefully eventually lead to us seeing a doctor and can have an operation that makes us get rid of both the problem and the pain.
When it comes to neuropathic pain, there are usually – compared to the general case of acute pain – good reasons to try to relieve or get rid of the pain as soon as it makes us (or our doctor) understand what is wrong and what we can do about it. Going and suffering unnecessarily while we wait to be operated on feels a bit pointless, for example.
Unfortunately, it is also the case that certain types of underlying causes of neuropathic pain cannot be addressed as much (for example with regard to certain autoimmune diseases). If there is nothing to do about the cause of the pain, it is of course of even greater importance that we can manage to alleviate or get rid of it completely.
According to drugs.com, there are a few studies that have shown that cannabis reduced the pain level by over 30 percent for patients with chronic neuropathic pain. However, it seems that in many cases it can be THC that works as a painkiller. However, THC (unlike CBD) is psychoactive, which means that it is not a good alternative in all situations. If one of the points of the painkiller, for example, is that you should be able to work, it might not be so good if you also get high.
A study in mice has shown that cannabis oil seems to have an anti-inflammatory effect. (source). Another study in mice with rheumatism has shown that cannabis oil seems to reduce both joint inflammation and pain. (Source).
A study from 2013 also showed that cannabis can relieve pain that occurs due to MS. (source)
Disc herniation in the back can cause the sciatic nerve to compress. This leads to pain in the body, a symptom which is then called sciatica. The body parts that can be affected are the thighs, feet, and lower legs.
The pain itself occurs partly through mechanical pressure on the sciatic nerve, and partly through a chemical change in the nerve and its surroundings. There are various explanations for sciatica. Common causes are damage to a cartilage disc, spinal cord stenosis, or pelvic fracture. Sometimes it is difficult to find out what the cause is. Sciatica can be treated with surgery, rehabilitation and medication.
Arthritis, or arthritis pain as it is also called, is a condition that tends to worsen over time. Arthritis often causes pain and swelling in the joints. The patient may experience stiffness and reduced mobility. Arthritis is treated with medication and physiotherapy and some patients need surgery.
Two types of arthritis are common: osteoarthritis and rheumatoid arthritis. Osteoarthritis affects the entire joint and especially the articular cartilage. It is a disease that can be alleviated through exercise. If you have rheumatoid arthritis, or rheumatoid arthritis as it is also called, you get an inflammation that makes the joints stiff.
CBD oil for osteoarthritis and MS. Can CBD help?
Several studies in humans and animals have shown that a combination of CBD and THC can reduce the pain of MS and osteoarthritis. In several countries, a spray containing CBD and THC is used to reduce pain caused by MS.
A study of 47 MS subjects treated with Sativex spray, which contains CBD and THC, showed significant pain relief and reduced spasms compared to the placebo group. (source).
Another study found that this spray significantly reduced pain during both exercise and rest and led to a better quality of sleep in 58 subjects with chronic rheumatoid arthritis. (source).
A review conducted in 2014 of previous study results argued that CBD may be effective against osteoarthritis in experimental animals. Researchers showed in 2016 that topical use of CBD can potentially relieve pain and inflammation in osteoarthritis. A study from 2017 indicated that CBD seems to be both effective and safe in treating osteoarthritis.
Despite promising clinical results, there is currently insufficient evidence to establish that CBD for osteoarthritis is an effective treatment for humans.
Multiple sclerosis, usually just called MS, is a disease that affects the central nervous system. MS often occurs in relapses where the symptoms decrease after a week or month. A disability that is permanent often develops. Those who suffer from MS get damage to the nerve cells’ so-called myelin.
In addition, patients suffer damage to the blood-brain barrier. Research suggests that it is an autoimmune disease in which the immune system attacks the body’s own tissue. Genetic inheritance and certain environmental factors can lead to MS. Common symptoms of MS are weakness, spasms, tremors, balance difficulties, loss of sensation, abnormal fatigue, and urinary incontinence.
CBD and treatment of ALS
A study at the Universidad Complutense de Madrid in Spain showed that mice who had ALS and received treatment with CBD oil developed the disease more slowly. (source).
Another study showed that CBD oil can have a positive effect on the nervous system’s ability to handle the chemical compounds involved in muscle movements. Since ALS patients have motor problems, this gives hope that the mobility of these people could be improved with CBD oil. (Source).
What is ALS?
ALS is a disease that causes the nerve cells in the spinal cord and brain to break down, leading to paralysis. The symptoms of ALS vary greatly from person to person. It usually begins with paralysis in a part of the body, such as a hand or a foot. Then the paralysis spreads and finally, it reaches the respiratory muscles. A variant of ALS first affects speech and then the ability to swallow. There is currently no cure for ALS but treatment focuses on prolonging survival and treating the symptoms.
Idiopathic pain and CBD oil
Last but not least, we also have idiopathic pain, which is pain where we can not find anything that seems to cause it. This seems to be about something that is wrong with various pain signaling systems rather than the body signaling real damage or inflammation.
Examples of idiopathic pain are migraine, tension headache, and fibromyalgia (often characterized by chronic fatigue and muscle aches).
When it comes to idiopathic pain, the fault of the pain signaling system is often inaccessible. Prio number one is therefore often to find an effective way to relieve or completely get rid of, pain and aches in the long term – preferably with as few and mild side effects as possible.
The same study from 2013 we mentioned earlier regarding MS also showed that cannabis can also help with fibromyalgia. (source).
It is not possible today to say exactly how effective CBD oil is against migraines and tension headaches, but the “anecdotal evidence” is many and it is therefore something that researchers are still interested in. In a research report from 2017, the researchers behind the report said that the preliminary research results that are now available are sufficient to motivate more studies. (Source).
Migraine is a type of headache that differs from regular headaches by being much more intense and painful. It is not chronic in the sense that it lasts a long time, but it is a latent threat to the victim because it can be triggered at any time. It is not entirely known why some people get migraines, but it is often triggered by stress, lack of sleep, temperature changes, and certain types of food.
Some people who suffer from migraines get a so-called aura before the headache comes. Auran is a visual phenomenon that appears in different ways. Details in the center of the field of view may disappear, you may see flashes, zigzag patterns or double vision. You can also get fluttering visual impressions or flickers. When the aura subsides, the headache comes. Migraines affect women more often than men. Almost every fifth woman but only one in ten men suffer from migraines.
CBD in connection with cancer treatment
There are indications that CBD in combination with THC may reduce pain in cancer patients. According to a study, patients experienced greatly reduced pain if they were given extracts with both CBD and THC, compared to the control group who only received THC extracts. CBD can also help reduce nausea and vomiting during chemotherapy, which is very common in cancer treatment. (source).
Another study showed that oral CBD-THC spray reduced dizziness and nausea in patients undergoing chemotherapy. (source).
A test study showed even more remarkable results in the fight against cancer. It showed that concentrated CBD increased cell death among breast cancer cells. (source).
Another study demonstrated the ability of CBD to counteract the spread of aggressive breast cancer cells in mice. However, from test-tube studies to a full-fledged clinical study with subjects, the distance is long and it may take time before any possible medical conclusions can be drawn. (source).