Inflammation occurs as a natural protective response when the body is harmed. There are two types of inflammation: acute and chronic.
Acute inflammation occurs following an injury, infection, or illness. The immune system unleashes immune cells to the affected area to protect it, causing redness and swelling.
Chronic inflammation refers to a prolonged inflammatory response in the body. When inflammation lingers, it can detrimentally impact tissues and organs due to the increased production of free radicals, which results in oxidative stress, an imbalance between antioxidants and free radicals.
Inflammation and oxidative stress are involved in many diseases. Chronic inflammation may be caused by autoimmune disorders, untreated infections, or illnesses, and often plays a role in conditions such as asthma, cancer, and diabetes. Factors such as smoking, obesity, or stress may also contribute to chronic inflammation.
Photo by: Gina Coleman/WeedmapsImage lightbox
While inflammation is necessary to help protect the body as it heals, a state of ongoing or chronic inflammation is undesirable and can be a source of significant pain and anxiety, and is sometimes linked with depression. CBD shows potential as a plant-derived anti-inflammatory without the side effects of medications.
Research overview
Research on CBD in animal models abounds and the cannabinoid seems to be able to interact with the immune system, reduce inflammation, and reduce pain from a number of conditions. Studies date back as far as 2009 but the most recent are highlighted here.
A 2015 review published in Bioorganic and Medicinal Chemistry discussed the anti-inflammatory properties of CBD. The reviewers found that CBD reduces inflammation through several pathways in the body, and represents an effective potential treatment for a range of conditions characterized by inflammation.
A 2016 study published in Clinical Hemorheology and Microcirculation investigated CBD as a treatment for early pancreatic inflammation in diabetic mice. Pancreatic inflammation can lead to diabetes due to an invasion of immune cells that destroy insulin-producing cells. The mice who received 10 weeks of treatment with CBD developed diabetes later than the mice that didn't receive the treatment. CBD-treated mice also showed a significant reduction in immune-cell activity.
A 2017 study in the journal Pain examined the effects of CBD in male rats with osteoarthritis. After two weeks, acute inflammation of the joints was reduced by local CBD treatment applied to the area. The administration of CBD was also found to prevent the development of nerve damage and joint pain.
Photo by: Gina Coleman/WeedmapsImage lightbox
Research using animal models has shown that CBD may be able to modulate the immune system. While CBD does not have much affinity for the body's cannabinoid receptors, it does affect other receptors and targets. According to a 2018 study published in Neurology, CBD binds to and desensitizes receptors known to mediate pain and sensory perception, inflammation, and body temperature.
While these results are promising and most FDA-approved medication is initially tested on animals, rigorous clinical trials on humans are needed to move CBD from alternative treatment to approved medication.
Patient perspectives
Amy Orr, author of the book “Taming Chronic Pain,” has been using CBD oil for three years to treat the inflammation and pain associated with irritable bowel disease, an autoimmune illness.
“I have had IBD for over 20 years, and had been on a range of medications, from steroids to opioids,” Orr told Weedmaps. “The steroids helped a lot with inflammation but not with the pain, and the Oxy was like trying to crack a nut with a sledgehammer — brutal side effects. It made me feel awful due to bad nausea and extreme fogginess.”
Orr first experimented with medical marijuana with mixed results, then discovered CBD. “I've found more long-term success with fewer side effects from CBD oil,” Orr stated.
“I'd say switching to CBD oil was like a 'eureka' moment for me, and I couldn't really believe that something this good and simple hadn't been available to me from the get-go.”
For Orr, CBD was immediately more effective that both opioids and steroids, and even better than edibles. “I'm able to titrate my dose very exactly, and can vary the amount depending on how bad a day I'm having.”
Photo by: Gina Coleman/WeedmapsImage lightbox
“I've had a variety of experiences with different doctors, as well as with different ingestion methods. However, I have genuinely found CBD oil to be transformational and am committed to increasing awareness for other autoimmune and IBD sufferers.”
Adam Kemp is a professional basketball player who turned to CBD products after breaking a bone in his back at the beginning of the 2017 season.
“I was able to undertake my whole recovery from the back injury by using only CBD products, and now I continue to use them to help with inflammation and other muscle pains,” Kemp said.
However, not everyone who has turned to CBD to help with their inflammation has experienced benefits.
Lucy Blythe, whose name has been changed for this article, has experimented with CBD to help treat her chronic fatigue syndrome, Lyme disease, and fibromyalgia — all of which are autoimmune illnesses characterized by chronic inflammation in the body.
“I have taken CBD to fight inflammation and have tried four different brands,” Allen explained. “I didn't notice a difference with any of the brands. So, I prefer to use my other anti-inflammatories, like Plaquinel, low-dose naltrexone, and turmeric.”
What the experts say
Jeremy Riggle, Ph.D. is the Chief Scientist at Mary's Medicinals, a brand specializing in CBD products for the treatment of pain and inflammation.
“Overall, the research literature indicates that cannabinoids, including CBD, could potentially be very effective anti-inflammatory agents for nervous tissue inflammation, inflammatory bowel disease, arthritis, vascular inflammation and certain types of cancers that are triggered by chronic inflammation,” Riggle told Weedmaps.
He cautions, however, that there is still a long way to go before scientists fully understand how CBD attenuates inflammation.
“Inflammation is an extremely complex and varied process, and the effect of CBD and other cannabinoids is not completely understood at this time,” Riggle explained.
Riggle emphasizes that the mechanisms by which CBD acts on the body, its specific applications, and appropriate doses require further study. That being said, he acknowledges that CBD represents a low-risk, high-reward treatment for inflammation, as it is non-toxic and has minor side effects.
Stacia Woodcock, a pharmacist at Curaleaf New York, which sells CBD products, points out that it may take some time for CBD oil to exert its anti-inflammatory effects on the body.
“Based on my experience, I think that CBD may offer some relief if dosed properly, such as a minimum of 50 milligrams a day to start, but it may take a few weeks to see a good result,” said Woodcock.
Photo by: Gina Coleman/WeedmapsImage lightbox
She recommends sublingual tinctures, since they can be easily adjusted for dose, are absorbed quickly, and last 4 to 6 hours. Vaping lasts only a few hours, but can help with breakthrough symptoms. The two are best combined for long-term relief.
Woodcock emphasizes that while CBD seems to have potent anti-inflammatory qualities, THC does, too, and the two often work more effectively together. In her opinion, a full-spectrum medical cannabis product containing both THC and CBD will work faster due to THC's direct effects on the receptors which control inflammation on the body.
Woodcock asserts that, compared with other anti-inflammatory medications such as ibuprofen or naproxen, CBD represents a safe alternative. “CBD provides inflammation relief without the blood-thinning or stomach ulceration side effects that traditional over-the-counter anti-inflammatories can cause.”
She notes that she has seen patients successfully transition from anti-inflammatories and steroids to medical cannabis, but that this should only be done under the supervision of a doctor or pharmacist.
Bottom line
There is already a large body of scientific literature and anecdotal evidence that supports CBD's potential for the treatment of inflammation.
It is critical to remember, however, that many of these existing studies have been animal studies, and that human trials are needed to understand more comprehensively how CBD works in humans.
Major contributions from Dr. Adie Rae.