CBD for Chronic Pain

CBD & Chronic Pain

Helping you to live better

Those suffering from chronic pain understand how much it disrupts each and every aspect of your life. No matter the root of your pain, you deserve to find a solution. Diagnosis and treatment of chronic pain is complex, and current drugs and painkillers do not come without their risks and side effects.

At Mee, we understand that finding an effective treatment can take time and effort. We believe that cannabidiol, or CBD, could help to alleviate painful symptoms and reduce stress, improving the quality of life for those living with chronic pain– interestingly, the science seems to agree.

CBD is a natural cannabinoid from the hemp variety of the cannabinoid plant. CBD interacts with the body’s endocannabinoid system (ECS) and has shown to have anti-inflammatory and pain-relieving properties. Within the ECS are cannabinoid receptors, which are particularly abundant in the brain and the immune system. The ECS is therefore heavily involved in inflammation and pain perception, which explains the therapeutic actions of CBD.

There have been numerous studies into the effect of CBD on pain, in both animal models and human patients. In general, patients using CBD-based treatments report lower pain scores than placebo groups, suggesting that CBD may be effective in clinically treating chronic pain. The science has many more hurdles to jump, but the evidence is promising. Be sure to check out our science-based review of the evidence into CBD and pain relief.

Beyond the science, the anecdotal evidence is just as encouraging. In a recent survey, 68% of chronic pain patients reported that CBD use allowed them to reduce their pain medication dose, with 59% claiming that CBD significantly reduced pain levels.

The benefits of CBD are not just limited to pain relief. Regular CBD use can also result in improvements to sleep and mood. Pain can significantly disrupt sleep, with 72% of chronic pain patients experiencing insomnia. Prolonged sleep deprivation can have a negative impact on our wellbeing, exacerbating pain and inflammation. Interestingly, researchers have identified a role for CBD in the treatment of some sleep disorders. As those suffering with chronic pain will know, any improvements to sleep quality will have an immeasurably positive effect on their life. If CBD could help, it may be worth a try.

Physical health and mental wellbeing go hand in hand. It is not uncommon for the stress and hardship of chronic pain to manifest itself as anxiety or depression. In one survey, more than half of chronic pain patients reported symptoms of anxiety and depression, which often correlated with worse pain. In contrast to current pain therapies, such as opioids, many regular CBD users have reported improvements to their mental wellbeing over time. More research is needed into the effect of CBD on mood disorders but, for this reason, CBD may be an advantageous pain relief.

There is still a huge stigma surrounding pain killers and chronic pain. With instances of opioid abuse on the rise, many are reluctant to opt for medicinal treatments. Whatever your opinion, CBD may be the natural alternative, or supplement, for you. CBD is a safe and well-tolerated substance, with very few side effects; as always, be sure to consult your doctor before incorporating CBD into your daily routine. CBD may never be a replacement for medication, but anything to divert your focus away from the pain is sure to help. At Mee, we’re here to help you feel like Mee again.

The science of CBD

A natural relief for chronic pain?

It is estimated that a staggering 28 million UK adults suffer from chronic pain. There are numerous types of chronic pain, often with multifaceted causes. Current pain relief treatments come with their risks and side effects, contributing to the complexity of chronic pain treatment. With the reluctance of healthcare professionals to prescribe strong painkillers, researchers are seeking new avenues for the treatment of pain.

The endocannabinoid system (ECS) is greatly involved in pain perception. Cannabidiol (CBD) acts on various receptors in the ECS to modulate their activity; it has therefore been proposed that CBD could have analgesic, or pain relieving, action.

In one trial investigating the effect of both CBD and THC on chronic pain, CBD alone improved pain levels across a variety of chronic pain patients. A study investigating Sativex, an approved CBD-based drug, showed that it significantly reduced neuropathic pain scores in comparison to the control group. Although Sativex contains psychoactive THC, these results show promise for the use of CBD in pain management.

Inflammation is a major contributor to chronic inflammatory or neuropathic pain. Studies have revealed that CBD has anti-inflammatory properties through its action on multiple cannabinoid receptors. In many animal models, this anti-inflammatory action has translated into pain relief. Following nerve damage in a rodent model of neuropathic pain, CBD was anti-inflammatory and reduced levels of pain. These observations have been replicated across numerous studies, supporting the role of CBD in reducing pain and inflammation.

Researchers have suggested that CBD may be both safer and more effective at treating chronic pain than opioids. CBD is not psychoactive and, unlike opioids, has very little abuse potential. Interestingly, one study into ninety-seven chronic pain patients revealed that introducing a daily dose of CBD reduced or eradicated opioid use in over half of patients.

Additionally, CBD has shown to have other beneficial therapeutic actions. Sleep quality is often disrupted as a consequence of chronic pain. Many individuals choose to supplement with CBD to relieve symptoms of insomnia. Likewise, chronic pain patients have reported improved sleep quality as a positive side effect of CBD use6.

Chronic pain is hugely debilitating and can have a hugely negative effect on a patient’s mental wellbeing. The ECS is also involved in mood regulation; CBD has shown to improve symptoms of anxiety and depression, even amongst chronic pain patients. In one study, an incredible 94% of opioid-using chronic pain patients reported an improvement to their quality of life following the introduction of CBD into their routine6.

Currently, there are no pharmaceutical CBD treatments for chronic pain, which complicates its study. The beauty of science is that there is always more to learn. Studies into the effects of CBD on the human body are still in their early stages; scientists are constantly discovering more about the wonders of the ECS.

With cannabidiol already an established treatment for some health conditions, there is huge promise in the discovery of other therapeutic avenues for CBD. Whilst there is not yet enough evidence to say that CBD can and will cure chronic pain, the science is encouraging; for many, CBD could help to relieve painful symptoms of chronic conditions.

CBD has anti-inflammatory and pain-relieving properties

Researchers have identified that cannabidiol (CBD) acts on cannabinoid receptors in the endocannabinoid system (ECS) to reduce inflammation and pain perception. Many studies into the effect of CBD-based treatments on chronic pain patients have reported that CBD significantly reduces pain levels.

CBD may be more effective than current pain relief treatments

Prescription painkillers, such as opioids, have a high abuse potential. Due to their psychoactive side effects, instances of opioid addiction are on the rise. CBD is a non-psychoactive substance; it is safe, well-tolerated and shows no potential for abuse. Although CBD acts as a more subtle pain relief than painkillers, some researchers argue that its naturally therapeutic properties are a more desirable way to treat chronic pain.

You don’t need to be prescribed CBD to use it

Unlike most strong painkillers, CBD is not a prescription drug. There are numerous CBD products available to buy that contain low levels of THC, which is both completely safe and legal. At Mee, our water-soluble formula even has up to 9x the bioavailability of oil-based CBD products.

CBD could be used to reduce pain-related sleep disturbances

Chronic pain will often compromise sleep quality, which can massively impact the physical and mental wellbeing of those suffering. CBD has a well-researched role in improving symptoms of sleep disorders. Promisingly, multiple studies have shown that CBD improves sleep quality for the majority of chronic pain patients.

Much more research is needed

There is not yet enough scientific evidence to say that CBD can and will cure chronic pain. The existing evidence is hugely promising, but further research is needed into the long-term effects of CBD use on pain symptoms across a variety of chronic conditions.

Research Papers

Bridges et al., 2001: Mechanisms of neuropathic pain

The paper describes that, following nerve injury, there is a significant loss of opioid receptors in the dorsal horn. This observation has not been recorded for cannabinoid CB1 receptors. The preservation of CB1 receptors suggests that cannabinoids may be more effective than opioids at treating chronic, neuropathic pain.

‘Recent advances in the understanding of cannabinoid analgesia appear to indicate a therapeutic advance of cannabinoids over opioids in the management of painful neuropathy.’

‘Cannabinoid CB1 are located in areas of the spinal dorsal intimately associated with nociception’

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Boyaji et al., 2020: The role of CBD in chronic pain management: an assessment of current evidence

This paper reviews studies into CBD-based treatments in the context of various types of chronic pain. There are various summaries of notable studies that can easily be lifted and quoted. Most of the existing evidence into CBD in pain treatment uses drugs that also contain THC. Although this makes it difficult to draw solid conclusions about the effectiveness of CBD on its own, this review highlights the clinical potential of CBD and the need for further research.

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WHITE PAPER 2020: The Critical Role of Hemp-Derived Cannabinoids

This white paper explores the link between the ECS and chronic pain. It also reviews some of the key findings about CBD and chronic pain, including the results of Capano et al., 2019, a very encouraging study for the future of CBD in pain treatment.

‘Preclinical models demonstrate CBD’s ability to decrease relapse risk by reducing opioid seeking behaviour, and early human trials confirm CBD’s potential in reducing opioid withdrawal symptoms. A recent survey study concluded that 44% of hemp CBD users reported it helped reduce the use of their opioid pain medication.’

‘This study was “aim[ed] at investigating the impact of hemp CBD use on opioid use in chronic pain, disability, physical and psychosocial symptoms, sleep, and motivation to taper opioids. This study concluded that using CBD for chronic pain in patients using opioids has a significant effect on reducing opioid intake, reducing pain and improving quality of life (QoL). Over half of the participants who added CBD hemp extract reduced or eliminated opioids over the course of 8 weeks, and almost all CBD users reported improvements in QoL.’

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Capano et al., 2019: Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study

This is a particularly exciting study as the majority of existing research is into CBD products that contain high levels of THC. These results support the evidence that CBD can relieve chronic pain. Note that PSQI equates to sleep quality, PDI represents pain disability, PEG is pain intensity, and PHQ is the ‘patient health questionnaire’.

‘Results: Over half of chronic pain patients (53%) reduced or eliminated their opioids within 8 weeks after adding CBD-rich hemp extract to their regimens. Almost all CBD users (94%) reported quality of life improvements. The results indicated a significant relationship between CBD and PSQI (p = 0.003), and PEG (p = 0.006). There was a trend toward improvement but no significant relationship between CBD use and PHQ and PDI.’

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Argueta et al., 2020: a balanced approach for cannabidiol use in chronic pain

This review explores the evidence for and against the use of CBD to treat chronic pain. The nuanced take on the future of CBD makes their conclusions hugely credible. In general, the authors argue that CBD is a promising pain relief treatment in some contexts but can have adverse effects if used during pregnancy. See Table 1 for a summary of these findings.

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Xiong et al., 2012: Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors

These quotes explain one mechanism by which CBD has anti-inflammatory and pain-relieving (antinociceptive) action.

‘Recent studies have shown that glycine receptors (GlyRs) are an important target for cannabinoids in the central nervous system. For instance, several synthetic and phytocannabinoids, including THC and CBD, can potentiate glycine currents (IGly) in native neurons isolated from the ventral tegmental area, amygdala, hippocampus, and spinal cord and in various heterologous cells expressing recombinant GlyRs’

‘GlyRs are thought to play an important role in the antinociceptive process.’

‘Our findings suggest that the alpha-3 GlyRs mediate glycinergic cannabinoid-induced suppression of chronic pain.’

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Schilling et al., 2021: Cannabidiol as a Treatment for Chronic Pain: A Survey of Patients’ Perspectives and Attitudes

‘Results: A total of 253 participants answered the survey. Participants were 45.4 ± 13.8 (Mean ± SD) years of age. Among participants, 62.0% reported trying a CBD product [including products containing THC]. The majority responded that these products have helped their pain (59.0%) and allowed them to reduce their pain medications (67.6%), including opioids (53.7%). They reported believing that CBD was a good treatment option (71.1%), not harmful (74.9%), and not addictive (65.3%). About half of participants (51.9%) report that they would be more comfortable with their physician prescribing CBD products. The overall attitude and experience of participants regarding CBD is reported as positive, while 91.9% of people expressed a desire to learn more about it.’

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Russo, 2008: Cannabinoids in the management of difficult to treat pain

This paper extensively reviews studies into cannabinoids, primarily CBD and THC, and their effect on pain. The two extracts above provide another scientific explanation for CBDs anti-inflammatory action. TNF-a is a pro-inflammatory mediator so, when inhibited by CBD, this prevents the onset of an inflammatory response. Similarly, the A2A is a receptor in immune cells that, when activated, has primarily anti-inflammatory action.

‘CBD is able to inhibit tumor necrosis factor-alpha (TNF-α) in its own right in a rodent model of rheumatoid arthritis’

‘A new explanation of inflammatory and analgesic effects of CBD has recently come to light with the discovery that it is able to promote signaling of the adenosine receptor A2A by inhibiting the adenosine transporter’

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Fine & Rosenfeld, 2013: The Endocannabinoid System, Cannabinoids, and Pain

‘Cannabidiol agonist activity at CB2 receptors seems to account for its anti-inflammatory proper- ties and both primary and secondary influences on pain. As well, memory impairments associated with THC are not apparent with CBD, and, when combined, CBD reduces the negative impact of THC on memory. This mitigating effect also has been attributed to the inverse agonist effect at CB1 receptors by CBD. Anxiolytic effects of CBD may also be attributed to its agonist effect at the 5-HT1A receptor.’

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Berger et al., 2020: Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia

This paper reviews the research into the use of cannabis in the treatment of fibromyalgia, a primary example of chronic pain. The study concludes that research into CBD alone, compared to high-THC CBD products, is lacking. However, the quotes above provide evidence for why CBD may advantageous in comparison to THC for the treatment of pain.

‘In this study of MS patients, medical cannabis and CBD-derived products produced different side effect profiles. CBD showed a better side effect profile, such as tiredness, diarrhoea, and the change of appetite and weight, when studies were compared for other drugs for epilepsy, such as benzodiazepines, and other anti-epileptics’

‘Other studies suggest that CBD has a protective role in the negative THC effect on hippocampal-dependent memory’

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CBD and Chronic Pain

This is an informative presentation in which Dr Dawn Elise Snipes, a USA-based mental health counsellor, reviews the scientific literature about the use of CBD to alleviate chronic pain.
She uses a very science-based approach and avoids bold claims. She also provides a disclaimer at the end of the presentation that the research, albeit promising, is still in its early stages and there is a lack of concrete evidence.
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