Recognized as the leading cause of disability worldwide, back pain is a common condition that can cause extreme discomfort – not to mention a few missed days of work or physical activity. Evidence suggests that 50% to 80% of adults will experience at least one episode of back pain at some point in their lives.
Back pain can occur for any number of reasons and range in severity, whether it be a simple muscle strain, bad posture, a ruptured disc, arthritis, or even a sign of more serious medical conditions, such as a kidney infection or blood clot.
As research into the benefits of cannabis continues, cannabidiol (CBD) has emerged as a potentially viable treatment for pain relief. CBD is a non-intoxicating cannabinoid found in the cannabis plant, second in abundance only to THC, and is widely perceived to help reduce pain.
Therefore, it stands to reason that someone experiencing back pain might be wondering whether they can effectively use CBD oil for back pain.
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Research overview
More peer-reviewed research is needed, focused specifically on CBD treatment for back pain relief, but numerous studies have already demonstrated the anti-inflammatory and analgesic properties of this cannabinoid.
When CBD interacts with the endocannabinoid system (ECS), which is an internal system that regulates our bodies, it enhances the signaling of anandamide, a pain-regulating compound found in the brain that is linked to feelings of well-being and happiness. By preventing the absorption of this molecule, CBD pushes excess quantities into the bloodstream, reducing pain throughout the body.
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CBD has also demonstrated the ability to reduce pain through the body's TRPV1 receptors, responsible for control functions such as inflammation and the awareness of pain.
The studies
One study, published in the September 2015 edition of the journal Neurotoxicology, found that CBD also inhibits glutamate levels in the brain and spinal cord, which is associated with increased sensations of pain and transmission. Past research also suggests that CBD could be an effective treatment for some of the most detrimental conditions that cause chronic pain, such as neuropathic pain in multiple sclerosis (MS) and intractable cancer pain.
In a 2012 study, also conducted on lab mice, researchers found that CBD targets alpha-3 glycine receptors to suppress chronic inflammatory and neuropathic pain associated with dysfunctional glycine receptors, an important target for pain processing by the spine, without causing any noticeable analgesic tolerance.
There's no definitive answer yet, but a 2016 animal study published in European Journal of Pain found that topical application may be more effective than the sublingual method. The research team discovered that while CBD had poor oral bioavailability in lab rats, topical CBD application provided more constant plasma levels, bypassing gastrointestinal administration and first-pass metabolism, which is a phenomenon where the concentration of a drug is reduced before it reaches circulation.
Arthritis
There is evidence that CBD could reduce pain associated with osteoarthritis, a multifunctional joint disease that causes joint degeneration and inflammation. A 2017 study in the journal Pain found that local application of CBD reduced joint inflammation and prevented pain, suggesting that CBD would be an effective treatment for pain associated with arthritis.
In a 2014 review in the European Journal of Neuroscience that summarized past research on CBD and osteoarthritis, researchers concluded that while clinical evidence is limited, existing studies on CBD use for arthritis treatment have shown promising results.
Spinal injury
CBD has also been examined as a treatment for other conditions that cause intense bouts with back pain. For instance, a 2014 study demonstrated that CBD reduced the severity of damage caused by disc degeneration in the vertebrae. After inflicting lab rates with a spinal injury, the research team injected them with various concentrations of CBD, and concluded that higher doses of CBD provided an anti-degenerative effect and “attenuated the effects of disc injury.”
Sleep
For some, chronic back pain may make it difficult to get a proper night of sleep, but a growing faction of research points to CBD as an effective sleep aid as well. One study, published in the Permanente Journal in January 2019, found that CBD alleviated short-term sleep issues and reduced anxiety in a majority of patients.
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While the initial evidence supports that notion that CBD is a viable treatment for chronic pain, it's important to note that more clinical research is needed to gain a better understanding of the anti-inflammatory and analgesic properties of this non-intoxicating cannabinoid.
Major contributions from Dr. Adie Rae.