Opioid pain relief can cause nausea, constipation and addiction. Standard anti-inflammatory meds carry the risk of stomach issues, including bleeding. The limited options prompt many folks to try creams and lotions containing cannabidiol (CBD).
Our knees ache, our backs hurt, our feet throb. Pain is one thing everybody wants gone. Unfortunately for chronic pain sufferers, many treatments come with unwanted side effects.
Topical CBD creams can treat pain, discomfort and inflammation. Here’s what science knows about how they work.
Consumers need to be educated, as well, says Cather. She works to develop a trusting relationship with her patients, so that they’ll feel comfortable talking about using CBD. She also urges her patients to find companies that document what’s actually in the bottle or jar. Asking the company about their quality control, such as how often they document ingredients, can help also vet the product.
By the time you feel any annoying itch or prick of pain, CB1 and CB2 receptors on your skin cells have already fired off signals to help dampen those unpleasant vibes. These receptors — part of the body’s endocannabinoid system — spend their workdays responding to chemical messages that help our skin nurture a healthy balance. CBD cream bypasses the CB1 and CB2 receptors and heads straight for a neurotransmitter middleman that blocks signals for pain and itch by working through agents called anandamide and 2-AG.
Researchers have confirmed that CBD works against pain and inflammation , and they’re still finding new ways that it works in the body . They're also working to nail down the proper dose of topical CBD needed for pain relief. For example, the dose that brings relief to achy joints may be insufficient to effectively treat nerve damage in feet. While rubbing topical CBD onto the skin seems to work, researchers still need to figure out how much skin coverage is most effective. Some skin creams also contain menthols, which carry their own pain relief and anti-inflammatory properties, possibly masking any effect from the CBD itself.
All of this points to how hard it is to study the specific effects of CBD on its own—which might be why it’s tempting to claim that it’s the cure for everything without a whole lot of research to actually back up all of those claims.
But at this point, we have no idea how deep the commercially available creams are penetrating. And even if they’re getting to that sweet spot in your skin, we don’t know how much CBD is getting there or how much is necessary to provide an effect.
What is CBD?
The studies we do have about CBD for pain are all animal studies. For example, in a 2017 study published in Pain, researchers gave rats an injection into one of their knee joints to model osteoarthritis. Rats then either received doses of CBD or saline directly into an artery in the knee joint. Results showed that, after receiving CBD, rats showed less inflammation in the joint area and fewer pain-related behaviors (like shaking or withdrawing the affected paw or not being able to bear weight in that paw) compared to those that received saline.
More recent research suggests that many of CBD’s effects may occur outside of CB receptors, Jordan Tishler, M.D., medical cannabis expert at InhaleMD in Boston, tells SELF. In fact, according to a recent review published in Molecules, CBD may have effects on some serotonin receptors (known to play a role in depression and anxiety), adenosine receptors (one of the neurological targets for caffeine), and even TRPV-1 receptors (more commonly associated with taste and the sensation of spiciness).
“It might be that cannabidiol by itself is helpful for pain, but at this point we don’t know that,” Cooper says.