It’s always advisable to start with a low dose and gradually increase it by 5 mg after a week until the desired effects are achieved. You might also want to look for a brand’s quality certifications, which help indicate high manufacturing standards. This document confirms the product’s CBD and THC levels and ensures it is free from contaminants such as heavy metals, pesticides, and harmful microbes. One key benefit of oral CBD is its longer-lasting effects compared to other methods. Despite these concerns, neither CBD nor THC has been shown to cause serious side effects, and both are generally considered safe. Currently, the only CBD product approved by the Food and Drug Administration is a prescription oil called Epidiolex. Finally, product labelling needs to be studied and evidence-based regulation should be put in place, nationally, to protect the public and older adults who use CBD. Community advisory boards for studies have been influential in setting effective recruitment procedures that can also be used for CBD research (Manning & Bouchard, 2021). Future research is likely to reveal further that CBD is a relatively safe alternative to opioids and other analgesic agents for pain management in older adults. Studies have also shown that CBD may suppress the (NF)-κB pro-inflammatory pathway, which is involved in rheumatoid arthritis and other inflammatory diseases. Still, many researchers remain skeptical, stressing the need for further study. CBD has also been shown to influence other systems involved in pain and inflammation, including glycine and PPARγ receptors and TRP channels. Additionally, there’s growing evidence that suppressing the enzymes that break down the two major endocannabinoids — anandamide and 2-AG — can be an effective strategy to relieve pain. In fact, the ECS influences every part of the pain processing pathways, with endocannabinoids acting much like a “brake” that reduces the feeling of pain. Cannabidiol as a Treatment for Chronic Pain: A Survey of Patients’ Perspectives and Attitudes Enter your email below to get access to our newsletter for the best deals, expert reviews, and latest product news straight from us to your inbox. He’s read thousands of studies about cannabinoids and other beneficial natural compounds, helping him translate complex science into plain language. Gleb Oleinik is a freelance CBD & cannabis writer from Vancouver, Canada. A recent study of 84 CBD products bought online showed that more than a quarter of the products contained less CBD than labeled. Racial and ethnic minority populations must be included in any pain management studies to reduce health disparities in research, and these older adult and ethnic and racial minority populations require over-recruitment. 2) Educate patients about the use, risks, anticipated effects and adverse effects, and dosing of CBD for pain management (see Table 2). Identify preconceived notions of cannabis products and explore expectations the patient may have about CBD and their condition (Highet et al., 2020). The following explanation and Figure 1 illustrate how CBD is positioned among the armamentarium of cannabis products. In 2018, the Farm Bill federally legalized CBD products containing a concentration of less than 0.3% delta-9 THC, without distinguishing between medical and recreational use (Hawes et al., 2020; Dill & Kurkowski, 2020). Widespread efforts to reduce opioid medications for chronic pain (Dowell et al., 2016) markedly decreased the number of opioid prescriptions (Schieber et al., 2019) leaving older adults with unmet needs for treating their pain (Ritchie et al., 2020). There is inconsistency in the labeling of over-the-counter CBD products that can result in safety issues and will require more federal quality control. Patients were generally referred by primary-care physicians and specialists for an assessment on the suitability of medical cannabis to treat refractory symptoms. In Canada, CBD is controlled under the Cannabis Act as are all cannabinoids, cannabis, and cannabis-derived products (Canada Go 2021). This favorable safety profile has led to the recent mitigation of legal and regulatory barriers surrounding purified CBD products in several countries and recent increased interest in CBD treatments. The results of this study contribute to address the myths and misinformation about CBD treatment and demand further investigation.However, these studies were often limited by small cohorts, and the varied disease states indicated that the beneficial effects of CBD are context dependent, which was illustrated in a study where treatment did not improve outcomes in patients suffering from Crohn’s disease (Naftali et al., 2014).Instead of binding directly, it influences these receptors to modulate pain signals and reduce inflammation.It can be helpful to classify pain to better understand what causes it and find the best way to treat it.In the Canadian medical cannabis program, CBD-rich cannabis oils contain approximately 0.5–1 mg of THC/mL and 20–25 mg of CBD/mL depending on the product manufacturer.The study has limitations that must be considered when interpreting these results.In addition, CBD can help limit the side effects of chemotherapy, reduce pain, and improve appetite and mood in cancer patients. CBD, or cannabidiol, is a natural compound of the cannabis plant that lacks psychoactive effects and is recognized for its therapeutic properties. It is crucial to be aware of the possible side effects of CBD and to consult a doctor before use, especially for people taking other medications or belonging to risk groups. These benefits have been supported by scientific studies, although the quality of the evidence still needs improvement. Although there is no specific law in Spain regulating the production or consumption of CBD, the situation is interpreted through international regulations. CBD has minimal psychoactive effects and therefore may be preferred in the older adult. More research would inform our understanding of CBD and its action and effects in the older adult population. Determine if other medications may become toxic when used concurrently with CBD. Effectiveness in pain management for older adults requires repeated evaluation. Screen initial hepatic function prior to initiating the dose, as CBD use may elevate transaminase and is potentially hepatotoxic. Phytocannabinoids can be extracted from the cannabis plant, and this active chemical, when combined with the receptor, affects the functioning of the body in many ways. Relevant information was summarized in Table 7 to show an overview of each study collected from the databases. New Castle Ottawa Tool is used to evaluate the eligibility of two observational studies in Table 5. We would like to thank our clinic personnel in the Center of Excellence clinics of Desert Clinic Pain Institute and Summit Institute for their help and efforts in completing this study. The majority of participants are residents of Riverside County, with a smaller amount from neighboring San Bernardino and San Diego Counties. Additionally, 36.4% were unable to work due to disability and 5.1% of the cohort reported to have served on active duty in the United States armed forces. A total of 253 participants started the survey and we received between 237 and 253 responses per question with the overall number of responses decreasing towards the end of the survey. No significant difference was found for either pain medication or opioid medication reduction between groups. Support for People Using CBD Oil for Health Some studies have reported improvements in sleep patterns among CBD users. By reducing pain levels and promoting relaxation, CBD can help individuals with chronic pain achieve better sleep. CBD may improve sleep quality by addressing factors that cause sleep disturbances, such as pain and anxiety. Some of the potential therapeutic actions of CBD include relief of chronic pain, sleep disorders, spasticity and Tourette syndrome, nausea and vomiting in chemotherapy, and weight gain in HIV patients, to name a few. Hence, more research and studies are being done to give patients with chronic pain an efficacious and safe alternative to the existing kinds of pain medication available on the market. However, a few studies are showing the benefits of CBD not only for chronic pain but also for sleep improvement and quality of life. We recommend consulting with your healthcare professional before using any products recommended on this site. As depicted by the studies reviewed herein, the use of CBD is context-specific, and it should not be used indiscriminately (see Table 1). The observed teratogenic effects of CBD exposure may be due to the compound itself and/or due to CBD working synergistically with other teratogenic compounds perhaps by enhancing permeability of xenobiotics through the human placental barrier thereby increasing fetal exposure (Feinshtein et al., 2013). Teratogenicity of CBD has been reported in mice where prenatal exposure leads to an increase in craniofacial malformations and eye defects (Fish et al., 2019). Similar delays in embryonic development have been reported in zebrafish embryos exposed to CBD albeit without the decrease in viability (Valim Brigante et al., 2018). It also increases nervous system adverse reactions, including psychiatric disorders, in 17% of participants . Some studies showed promising evidence to support the safety of CBD. Rabgay et al. concluded that there is no sufficient evidence to fully establish CBD’s efficacy on pain. In addition, different routes of administration showed other forms of pain relief. Over half (53%) of the participants reduced or completely stopped taking opioids within 8 weeks and 94% reported improved quality of life, including less pain and better sleep. One 2019 study tested the effects of full-spectrum CBD softgels in chronic pain sufferers that use opioids. A similar study that looked at the effects of blocking FAAH, the enzyme that breaks down anandamide, reported increased anandamide levels and reduction of inflammatory pain. Furthermore, patients in the program consistently reported reduced pain, improved quality of life, and better activity levels. A preliminary cohort study published in the journal PLoS One explored this issue by following chronic pain patients who were habitual opioid users. Yes, it’s highly recommended to consult a healthcare professional before starting CBD for pain management. CBD can also interact with certain medications, so it’s crucial to consult with a healthcare provider before starting CBD, especially if you’re taking other drugs. What are the potential side effects of using CBD for pain? It’s important to consult a healthcare professional before replacing any prescribed medications with CBD. The use of CBD for arthritic conditions is beginning to garner attention and may provide a therapeutic avenue with a favorable side effect profile. Cannabinoids offer an interesting future and relatively novel modality for pain reduction in musculoskeletal disease. Marketing efforts have largely contributed to the rising popularity of CBD, and it has been touted as a treatment for numerous ailments. Logistic regression to analyze the effect of variables for those who selected yes for the question “Did you reduce or discontinue the use of other pharmacologic treatment modalities? Count and percentage (%) of patients who indicated reducing drug intake and/or discontinuing drug use in each category. With the crisis of opioid use and dependence, medical providers and the government need to work hand in hand to urgently find alternatives to the treatment of chronic pain, whatever the reason may be . In an RCT done by Lichtman et al., nabiximols (THC+CBD) oromucosal spray was used as an adjunct treatment in 291 patients with advanced cancer and chronic pain on opioids . With more states opening their doors to the medical benefit of CBD, the issue of obtaining good quality CBD poses a risk for those who want to use it as an alternative to their current pain medications . Another study with 2224 patients by Maurer et al. revealed that the patients’ post-injury three and four-week use of cannabis after concussions resulted in a lower severity score but not faster recovery from concussion symptoms . However, the US Hemp Farming Act of 2018 legalized the cultivation and refinement of hemp and its constituents, thus beginning a trend of mass marketing for CBD products both legal and illegal (Hemp Production and the 2018 Farm Bill, 2019; Mead, 2019). For rituals and medicine dates back millennia, and it has made recent advances in treatment of varied conditions (Kalant, 2001; Whiting et al., 2015; Aviram and Samuelly-Leichtag, 2017; Ren et al., 2019). In this mini-review we will evaluate literature discussing CBD use in treating intractable pain and the potential hazards of its overuse and/or misuse (see Figure 1). The Future of CBD for Pain Relief Table 4 illustrates JBI as a quality assessment tool for case reports. A total of 12 studies were found eligible for this review. Two do not have full texts, and one is an animal study, hence excluded. Figure 1 is a PRISMA 2020 flow diagram showing how related studies included in the review were identified . A PRISMA flow diagram 2020 was used to show the study’s inclusion and exclusion of articles found in the databases used. The scientific community has been increasingly interested in CBD’s potential for pain management, leading to a growing body of research. A 2018 review published in the Journal of Pain Research found that CBD was effective in overall pain management without adverse side effects. Additionally, CBD’s potential in managing cancer pain, especially when traditional opioid therapies are inadequate, has been noted. CBD has shown promise in addressing various types of pain, from chronic conditions to acute injuries. Unlike its cousin THC, CBD doesn’t produce a “high” but has gained attention for its potential therapeutic properties, particularly in pain management. This vast range of doses for CBD products found in the literature depicts the need for establishing safe dosing parameters in the older adult populations. Hemp CBD products became available over the counter in 2018 when it became legal to sell CBD in the United States. Each microliter spray of Sativex® contains 2.7 mg THC and 2.5 mg CBD for adjunctive treatment of spasticity in patients with multiple sclerosis (Sativex® Product Monograph, 2019). Healthcare providers, however, may not be aware of legal, clinical and safety issues, making them unable to educate and guide older adults in the use of CBD to manage their pain. Eight percent of those over 65 years said they used CBD for pain (40%), anxiety (20%), insomnia (11%), and arthritis (8%) (Brenan et al., 2019). Patients’ global impression of change of pain intensity, physical function, and sleep after using CBD for their joint pain. We compared demographics by type of arthritis and found a significant difference in age (P2). Multivariate logistic regression models incorporating age, sex, arthritis subtype, dose, frequency, and length of CBD use were used to analyze the effect on other medication reduction or cessation. Descriptive statistics were performed to evaluate the demographics of the study population and questions without mutually exclusive answers. Incorporating CBD into pain management requires understanding different product types and usage methods. Consumers should check their local laws before purchasing or using CBD products. Recent years have seen a surge in CBD studies, with many focusing on its pain-relieving properties. CBD Oil: Highest Quality and Benefits of Use Drug interactions can occur, and it’s essential to consult a healthcare provider before starting any new treatment. This lack of oversight means that the quality and safety of CBD products can vary widely. The approval and use of Epidiolex highlight the potential of CBD in providing life-changing benefits for individuals with specific health conditions. Improved patient retention and more robust, harmonized data collection methods will improve future observational studies and allow for long-term assessment. The total treatment cost has significant impact on treatment continuation. Limitations are common in real-world data (RWD), especially in retrospective studies. The majority of RCTs investigated single-dose administration of CBD making it difficult to compare observed treatment outcomes with chronic dosing clinical settings. In summary, it is crucial to adjust the CBD dosage according to individual needs and the type of product used. The maximum recommended dosage of CBD in cream is 200 mg per 100 ml of cream, ensuring an adequate amount for localized pain relief. This dosage can be gradually increased as needed, especially to treat mild pain with a 5% concentration. The maximum recommended dose of CBD in cream is 200 mg per 100 ml of cream, ensuring an adequate amount for localized pain relief. Full effects may require regular use over days or weeks. CBD is not a miracle cure, but it can be a valuable part of a comprehensive pain management plan. CBD may act as a muscle relaxant, making it beneficial for conditions like multiple sclerosis or spinal cord injuries. Living with constant pain can lead to anxiety and depression. Reliability and Safety of Cannabidiol Labeled Products This study will fill the existing gap and update knowledge on CBD's role in chronic pain. Regulations of cannabis products remain a challenge for most countries. People have more access to a wide variety of CBD products like cannabis flowers, tinctures, concentrates, topical lotion/creams, and edibles which are self-administered and with little or no supervision by a physician . In contrast, opioid painkillers are notorious for their significant side effects and a high risk of addiction and withdrawal symptoms. But these side effects are relatively minor and have only been reported by studies using high oral doses of pure CBD. Boureau et al. compared ibuprofen and paracetamol in patients with arthritis of the knee or hip and found superior pain reduction with NSAID use. Patients with arthritic conditions were included in their chronic pain cohort, but they did not stratify by reason for chronic pain in their analysis (Gulbransen et al., 2020a, b). Subgroup analysis demonstrated that patients with osteoarthritis reported greater reductions in NRS score than RA and other autoimmune arthritis groups, which may suggest that the efficacy of CBD may be better in patients with osteoarthritis. In terms of pain improvement, participants reported a 44% reduction in pain and a 2.58-point difference in the NRS after using CBD. The current context of medical cannabis access, including social stigma, high cost, and lack of universal insurance coverage can increase the patient selection bias. The self-reported subjective assessment used may be biased by the patient’s positive expectation of treatment, which could lead to a possible placebo effect. Further studies can investigate the use of CBD to treat several symptoms simultaneously. In this study, with no control group, no causality effect can be drawn between CBD-rich treatment and symptom improvement. Regarding the effects of CBD on depression symptoms, further research is required to draw conclusions (Khalsa et al. 2020; Schier et al. 2014; Turna et al. 2017). Like prescription medicines, cannabis works by activating receptors in your brain. If you've got slow-healing wounds from diabetes or other conditions, CBD may help enhance your recovery. Thwarting the development of nerve damage in arthritic patients may help stop the condition from worsening. Lastly, a large proportion of patients did not know the type of CBD product (e.g., isolate, broad spectrum, full spectrum) they consumed, and therefore, the authors were unable to evaluate associations between patient-perceived effects of CBD and product type. Additionally, because the survey was distributed online through social media posting and patient representative groups, patients with arthritis who have limited connectivity to the internet are potentially underrepresented. Two recent studies found a prevalence of CBD use in patients with arthritis to be between 24 and 57% which is lower than our findings (Deckey et al., 2021, Nowell, 2019). Another possibility is that healthcare professionals may not be discussing CBD use with their patients. Research indicates that CBD can reduce chronic pain by impacting endocannabinoid receptor activity and decreasing inflammation.Regardless of the cause and disease pathogenesis, patients with arthritis are subject to chronic pain, joint degeneration, and articular neuropathy, for which there are few viable long-term treatment options without significant side effects.Therefore, formulation of the safety standard used for CBD could be a possibility soon if the growing evidence from more studies points to the efficiency and safety of CBD.Participants reported to be able to reduce overall pain and specifically opioid medication and would be more comfortable receiving CBD through prescription or purchase from their healthcare provider.Because of these limitations we cautiously describe our cohort as participants in a pain clinic environment and not as patients.The population studied were young healthy adults and not older adults, however, it did highlight the differences in impairment effects of THC/CBD and THC compared with CBD only.Ongoing pain that’s typically caused by a persistent or intermittent condition, such as arthritis, migraines, fibromyalgia, cancer, or diabetes.Using CBD products with higher THC levels can lead to legal issues.“The animal data are very promising for a number of conditions, but rigorous randomized clinical trials have yet to be done,” says Kevin Hill, MD, an addiction psychiatrist and a professor at Harvard Medical School in Boston. Consulting a healthcare professional before using CBD products is recommended, just in case there are underlying conditions or medications that would be a concern. Interest in CBD use for pain management has been bolstered by the challenges of managing pain in older adults with minimal potential for adverse effects, but healthcare providers who are asked for guidance by older patients may have limited education related to CBD. This study on CBD-rich products demonstrates the potential of RWE for the advancement of medical cannabis research and practice guidelines, especially in a world where CBD use is exponentially increasing but scientific data are limited. In summary, most participants expressed a positive attitude about CBD products as a treatment option, reported positive outcomes when used for multiple different conditions, and would prefer to obtain information about and prescription for CBD from their physicians. The studies also included sprays, capsules, and other medications. Because it’s not intoxicating, hemp-derived CBD is behind most commercially available CBD products. But scientific research is less clear on whether cannabis oil reliably provides these health boons. We also recommend using full-spectrum CBD products whenever possible. Finally, oral products are best used for their convenience, since they have relatively low absorption and therefore won’t be as effective as CBD oil. On top of that, studies of whole-plant cannabis, where CBD is the second-most abundant active ingredient after THC, have shown promising results. The study found that while THC alone did not outperform placebo for pain relief, the combination of THC and CBD resulted in statistically significant improvement. More than half of the patients saw a 30% or greater improvement in pain at all time points. The chronic pain category included all medical indications for which pain was the main symptom such as but not limited to fibromyalgia, spinal stenosis, and chronic low back pain.While hemp-derived CBD products are federally legal if they contain less than 0.3% THC, legal risks arise due to varying state laws.In a publication looking at the CBD concentration in a variety of products, one study shows inaccurate labeling of products in the majority of cases.3 The combination of variable familiarity and CBD concentration in available products puts patients in a difficult position when they are in search for a standardized CBD product to try as a therapeutic option.Chronic pain affects between 50 and 116 million American adults, a staggering number that surpasses those affected by heart disease, cancer, and diabetes combined (Committee on Advancing Pain Research Care and Education, 2011; Nahin, 2015; NIH, 2020).Table 4 illustrates JBI as a quality assessment tool for case reports.Therefore, there is fear on the patients’ part about CBD’s availability after research and the financial cost they would have.Currently, the only CBD product approved by the Food and Drug Administration is a prescription oil called Epidiolex.While research is ongoing, a compelling body of evidence highlights CBD’s potential as a safe and effective option for managing complex chronic conditions. The effects of long-term cannabinoid use are especially unclear in pregnant women, in whom potential teratogenic effects could have implications on future generations. The preclinical work being done to disentangle the mechanisms of CBD in providing analgesic support in chronic pain is flourishing, but much remains in the wake of chronic disease and enhancing our understanding of the mechanisms at play. Of these, 2 products had no CBD, and about half of the CBD products had less than 20% of the CBD content claimed. Reports indicate that the cannabinoid content in products purchased online were only accurate in 26 of the 84 products tested (Bonn-Miller et al., 2017). In states where cannabis has been approved for recreational and/or medical use, there are efforts to equip dispensary staff with scientific knowledge to make evidence-based recommendations, but these efforts are limited and often overshadowed by anecdotal understanding of CBD and other cannabinoids (Haug et al., 2016; Piermarini and Viswanath, 2019). These mechanisms make CBD a compelling option for chronic pain management, especially for individuals with arthritis, fibromyalgia, neuropathy, back pain, or inflammatory disorders. To choose quality CBD products, prioritize those that have undergone third-party lab testing and ensure proper labeling. Cannabidiol (CBD) is a non-psychoactive compound from the cannabis sativa plant, recognized for its potential health benefits. Whether it’s a soothing balm for sore muscles or a moisturizing cream for skin conditions, these products offer a practical and effective way to harness the benefits of CBD. These products are applied directly to the skin, targeting specific areas and skin conditions. Out of those, 715 were eligible for the study (at least 18 years old and initially treated exclusively with CBD-rich products).Many people turn to CBD as an alternative to traditional chronic pain medications, drawn by its non-intoxicating properties and the potential for fewer side effects.The maximum recommended dose of CBD in cream is 200 mg per 100 ml of cream, ensuring an adequate amount for localized pain relief.2) Educate patients about the use, risks, anticipated effects and adverse effects, and dosing of CBD for pain management (see Table 2).Symptoms evaluated include six physical- (pain, tiredness, nausea, drowsiness, lack of appetite, and shortness of breath), two emotional- (depression, anxiety), and one overall wellbeing-related symptoms.Although CBD and THC come from the same cannabis plant and have almost identical chemical structures, they attach differently to a CB1 receptor, eliciting different effects.The safety appraisals evaluated in the following paragraphs will be product variability, contraindications, and adverse effects.The majority reported knowing someone (family, friend, neighbor) who has used a CBD product (80.6%).The average daily CBD dosage authorized at our clinic (11.5 mg) is closer to other observational studies (Gulbransen et al. 2020) compared to what is seen in RCTs (up to 1000 mg for a single dose) (Larsen and Shahinas 2020). Public Health Hazards And Teratogenicity Of Cannabis Products Chronic pain affects between 50 and 116 million American adults, a staggering number that surpasses those affected by heart disease, cancer, and diabetes combined (Committee on Advancing Pain Research Care and Education, 2011; Nahin, 2015; NIH, 2020). As well, CBD use by pregnant women is rising and poses a major health-hazard for future generations. CBD purchased freely entails the risk of adulteration by potentially hazardous chemicals. No use, distribution or reproduction is permitted which does not comply with these terms. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Of the respondents, 176 (30%) patients with arthritis had not tried CBD, whereas 428 (70%) endorsed CBD use. Previous cross-sectional analyses have found at least one reported side effect in 29–59% of patients using CBD for different indications which is in concordance with our findings (41%) (Corroon & Phillips, 2018; Devitt, 2019; Moltke & Hindocha, 2021). Cannabidiol could have unwanted side effects and/or interactions with other medications. It is important to remember that CBD is not an FDA approved medication and should not be used as a replacement for established medical treatments. If severe symptoms are experienced, medical attention should be sought immediately. CBD may interact with other treatments, which could alter their effectiveness or increase the risk of side effects. It is crucial to get information from a healthcare provider before starting to use CBD. People taking other medications should talk to their doctor before using CBD, as it may interact with other treatments. In comparison to THC, CBD is a relatively new drug, and studies are limited to establishing its safety and efficacy. An incidental wound improvement was noticed starting at two weeks post-treatment . It also highlights the antinociceptive and anti-inflammatory effects of D8-THC, cannabidiol, derivative HU308, and the new racemic CB1 allosteric ligand . CBD is considered legal in Spain as long as its THC content does not exceed 0.2%.This effect is likely due in part to the effects of CBD as low birth weights in mice offspring have been reported in response to prenatal CBD exposure exclusively (Fish et al., 2019).Over half (53%) of the participants reduced or completely stopped taking opioids within 8 weeks and 94% reported improved quality of life, including less pain and better sleep.The heterogeneity of the patient population with a variety of diagnoses and the diversity of medical cannabis preparations also affects the external validity of the study.We conducted a systematic review to determine the efficacy and safety of cannabidiol (CBD) for chronic pain.Hemp is the fiber extracted from the stem of the cannabis plant and is useful in making rope, textiles, building material, paper, and packaging.Patient Global Impression of Change to evaluate perception of cannabidiol’s (CBD) effect on pain intensity, physical function, and sleep based on type of arthritisAre there clinical trials supporting the use of CBD for pain?The purpose of this study was to explore patient perceived effects of cannabidiol on symptoms of arthritis. Survey Administration CBD may be beneficial for chronic pain management. Can CBD help with chronic pain management? Yes, CBD oil has shown promise in providing pain relief for various conditions. Specifically, studies showed self-perceived improvement in ESAS-r emotional symptoms (anxiety and depression) scores following CBM treatment in oncology patients, while pain and wellbeing symptoms showed no improvement (Good et al. 2019; Pawasarat et al. 2020). This retrospective observational study suggests CBD-rich treatment has a beneficial impact on pain, anxiety, and depression symptoms as well as overall wellbeing only for patients with moderate to severe symptoms; however, no observed effect on mild symptoms. Within the limited results from randomized controlled trials, and lack of trust in product quality and known clinical guidelines and dosages, real-world evidence (RWE) from countries with robust regulatory frameworks may fill a critical need for patients and healthcare professionals. Yes, while current studies are promising, more comprehensive research is needed. Is more research needed on CBD and pain management? CBD has anti-inflammatory properties that can reduce inflammation contributing to pain. Numerical Rating Pain Scale point reduction and percent pain reduction were evaluated among arthritis groups with nonparametric Kruskal–Wallis tests. Psoriatic arthritis, Lupus arthritis, Lyme arthritis, and other autoimmune arthritis were combined into one diagnostic group for comparisons—Other Autoimmune Arthritis—because individual groups contained a small number of participants. These aforementioned groups are patient advocacy organizations that use online social media accounts, forums, and newsletters to help provide general medical information to patients as well as establish a social network for patients to connect to one another. Lastly, participants were asked questions about reductions and cessations of medications related to their CBD use. Furthermore, we adopted the PGIC to assess the perceived effect of CBD use on participants' sleep quality and physical function. Are there any side effects of using CBD long-term? Do not disregard or avoid professional medical advice due to content published within Cureus. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Although the business of medical marijuana and CBD dispensaries is old, most countries worldwide are still regulating it to make it legal. In addition, it was difficult to find studies that focused on CBD alone since THC is often mixed with it. The Examine Database covers Epilepsy, Mental Resilience, and 12 other conditions and goals. Like THC, CBD is a cannabinoid (a compound in cannabis). Give us a call to learn more about our other pain management services, whether you have a misaligned spine, aching knees, or activity-impacting joint pain. At Northeast Spine and Sports Medicine, we understand the popularity of CBD for pain management, but we also realize cannabidiol extracts may not be an ideal choice for you. During heroin withdrawal, CBD has been shown to decrease symptoms of anxiety and cravings, offering significant relief. By binding to the CB1 receptor in the brain, CBD can positively affect anxiety, pain and nausea. These properties make CBD a promising alternative for the management of pain and inflammation in various pathologies. It acts on the receptors of the endocannabinoid system, helping to regulate inflammation and thereby relieving pain. With rising concerns over the side effects and addictive nature of prescription painkillers, many individuals are seeking safer, more natural alternatives. Chronic pain affects millions of people around the world, often impacting their quality of life, mobility, and emotional well-being. The future of CBD looks bright, and its potential to revolutionize health and wellness is just beginning to unfold. Studies suggest cannabidiol (CBD) may reduce chronic and neuropathic pain, making it a promising option for conditions like nerve damage or persistent discomfort. Factors such as body weight, metabolism, and specific health conditions all play a role in determining an effective CBD oil dose. What Is CBD Oil? Uses, Benefits, Side Effects, and More In states with medical marijuana programs, patients may have access to a wider range of CBD products.Despite the promotion of CBD, the evidence on its effectiveness on conditions such as anxiety and pain is still not sufficient in quality.Patients with conditions like multiple sclerosis and diabetes-induced neuropathy may find relief with CBD use.The majority of RCTs investigated single-dose administration of CBD making it difficult to compare observed treatment outcomes with chronic dosing clinical settings.There is inconsistency in the labeling of over-the-counter CBD products that can result in safety issues and will require more federal quality control.This favorable safety profile has led to the recent mitigation of legal and regulatory barriers surrounding purified CBD products in several countries and recent increased interest in CBD treatments.A complete medical history, including primary and secondary diagnoses, was collected at baseline visit. Young patients (ages 12-25) with treatment-resistant anxiety experienced a 42.6% reduction in anxiety severity after 12 weeks of CBD treatment at doses up to 800mg daily. Clinical trials are exploring CBD’s role in alleviating anxiety and improving mood in patients facing serious health challenges. CBD has shown promise in alleviating these conditions, offering a natural alternative to traditional treatments. This CBD product has been a game-changer for patients suffering from rare and severe forms of epilepsy like Lennox-Gastaut and Dravet syndromes. It’s worth mentioning that the Food and Drug Administration (FDA) has not approved hemp and most CBD products for use as medicine or dietary supplements. Comparison of socioeconomic demographics and CBD utilization based on type of arthritis between group comparisons of participants by type of arthritis and patterns of CBD utilization Socioeconomic demographics of 604 survey participants with arthritis who use CBD and those who do not use CBD Most participants who completed the survey had tried CBD for symptomatic relief of arthritis (70%). In addition, signs of liver injury have been reported with high doses of the prescription form of CBD, known as Epidiolex. Although CBD is generally well tolerated, it can cause side effects such as dry mouth, low blood pressure, grogginess, and drowsiness. Although these effects are usually mild, it is important to be aware of them. It is always advisable to start with a low dose and increase it gradually to avoid side effects and maximize therapeutic benefits. This success story paves the way for further research and development of CBD-based treatments for other neurological disorders, offering hope to many patients and their families.When evidence of CBD’s pain relief is fully recognized, guidelines need to be applied to the health insurance business to lessen its financial burden on the patient.The aim of this survey was to learn about participants’ attitudes and views towards cannabis-based medicine (CBM) with a focus on perception of “CBD” and its potential role for pain management.Given the severity of the current opioid epidemic, finding alternative treatments for pain is vital to public health (Mattson et al., 2021).Can CBD interact with other pain medications?Conflicting information is available about the benefits of CBD tinctures and capsules for cancer treatment.Inclusion criteria included participants ≥18 years old and those with a prior diagnosis of arthritis as a cause of joint pain. CBD's medical value was a hot topic for debate before being recognized in the medical field. CBD and tetrahydrocannabinol (THC), both from Cannabis plants with almost identical chemical structures, attach to the CB receptor, eliciting different effects like the psychoactivity seen on THC but less or none in CBD. Inclusion criteria were applied, and quality assessments were done, resulting in 12 publications eligible for the review. Started by two journalists covering medical cannabis, Project CBD offers a wealth of information on the therapeutic uses of CBD, including a Beginner’s Guide on CBD dosage. Speak to a doctor before using CBD oil or other CBD products. Interestingly, over 70 percent of those in the study found that it helped symptoms in some way, while less than 2 percent responded that CBD made it worse. Interestingly, these teratogenic effects are similar though milder than those observed for alcohol, THC, and the synthetic cannabinoids HU-210 and CP55,940 countering the popular perception that CBD is an unequivocally safe alternative to THC and other cannabis constituents (Fish et al., 2019). We will summarize here conclusions from both animal and human studies on some possible effects of CBD prenatally, perinatally, and postnatally. While several studies have focused on THC during pregnancy, investigation focused on the effects of CBD usage by pregnant women before, during, and/or after pregnancy are rare. Some of the potential therapeutic actions of CBD include relief of chronic pain, sleep disorders, spasticity and Tourette syndrome, nausea and vomiting in chemotherapy, and weight gain in HIV patients, to name a few.Long-term effects of CBD use are still under investigation.Therefore, real-world evidence (RWE) provides valuable insights and supplemental information about the use, safety, and effectiveness of CBD-based treatments (Graham et al. 2020).Topical CBD products, such as creams and salves, are designed to relieve localized pain.Research suggests that CBD works by interacting with the body’s inflammation and pain-regulating systems.Finally, CBD’s effects are supported by its interaction with biological systems.Chronic pain affects millions of people around the world, often impacting their quality of life, mobility, and emotional well-being.Control of chronic joint pain remains a difficult feat, and patients commonly resort to surgical options such as total joint arthroplasty once nonoperative modalities have failed (Breivik et al., 2006; Geeske Peeters et al., 2017; Peter et al., 2015).Therefore, funding and implementing randomized CBD trials in the older adult population is necessary before CBD is deemed efficacious for pain treatment in the older adult (Fick et al., 2020). A majority described some positive effects of CBD products on their conditions and reduction of pain medication. While the familiarity with dosing was mixed and participants used a wide variety of products including products containing THC, they report that these products have helped them with many different pain-involving and neurological conditions. Taken together, participants report some perceived beneficial effects using CBM and CBD products including the reduction of pain medication. Simultaneously, the growing access to unregulated CBD products, which may be adulterated with potentially toxic compounds, requires regulation and education about CBD for its potential benefits and/or adverse effects in health and disease. An estimated 4% of pregnant women use cannabis, and in California, which recently legalized cannabis, about 20% in a cohort of 18- to 24-year-old pregnant women reported using cannabis products in retrospective studies (Young-Wolff et al., 2017). However, these studies were often limited by small cohorts, and the varied disease states indicated that the beneficial effects of CBD are context dependent, which was illustrated in a study where treatment did not improve outcomes in patients suffering from Crohn’s disease (Naftali et al., 2014). Since the early 2000s, clinical trials involving CBD for the treatment of chronic pain have shown effects ranging from placebo-equivalent to highly effective; many of these studies have been well-designed randomized, double-blinded, and placebo-controlled. Associated Data The average daily CBD dosage authorized at our clinic (11.5 mg) is closer to other observational studies (Gulbransen et al. 2020) compared to what is seen in RCTs (up to 1000 mg for a single dose) (Larsen and Shahinas 2020). The examination of treatment regimen has been seldom addressed in the literature and further development is required to inform guidelines for prescription and refinement of clinical practice. Our results are largely novel as research on the effect of CBD on pain control is very limited (Boyaji et al. 2020). A Mean ESAS-r scores for the pain symptom, b mean ESAS-r scores for the anxiety symptom, c mean ESAS-r scores for the depression symptom, and d mean ESAS-r scores for overall wellbeing. These properties make it a viable option for treating a variety of health conditions. This difference in chemical composition is crucial in determining the use and legality of these products. Therapeutically, THC is commonly used to relieve chronic pain and nausea, while CBD is known for its relaxing properties and ability to reduce seizures. Unfortunately, efforts to discuss the dangers of CBD use have been severely lacking and require immediate attention to prevent the irreparable harm to the masses from the tsunami of CBD products. We conducted a systematic review to determine the efficacy and safety of cannabidiol (CBD) for chronic pain. CBD Nerds doesn’t offer medical advice and the content accessed on this site is not intended for medical advice, diagnosis, or treatments, and has not been evaluated by the FDA. He’s also written third-party lab test reports of CBD products and knows the industry inside and out. This systematic review can benefit other researchers and even ordinary people eager to know the latest updates on CBD research on chronic pain. CBD for chronic pain as an adjunct medication has gained popularity since it is easier to access and has less physician guidance. Although CBD and THC come from the same cannabis plant and have almost identical chemical structures, they attach differently to a CB1 receptor, eliciting different effects. This systematic review aims to determine the status of the efficacy and safety of CBD on chronic pain. Clinical trials on CBD are also scarce because it is relatively new and obtaining a good quality product is still a problem. Both Desert Clinic Pain Institute and Summit Institute are complex pain management clinics who primarily serve Medicare and Medicaid populations. The survey information/link was posted openly in the form of posters, flyers, and business cards containing QR-codes at seven pain clinic locations in Southern California including the University of California, San Diego, Department of Anesthesia Division of Pain Management. Participants were recruited voluntarily (convenience sample, no incentive) from seven pain clinics in Southern California. Material and Methods are reported according to the checklist for reporting Results of Internet E-surveys (CHERRIES).25 Cannabidiol (CBD) has been of increasing interest to patients and is being used to self-medicate a variety of ailments. For the overall cohort, the majority of participants reported subjective improvements in their symptoms with CBD use. For this question, participants could “check all that apply.” On the basis of the distribution, many patients had pain in multiple joints. Inclusion criteria included participants ≥18 years old and those with a prior diagnosis of arthritis as a cause of joint pain. Additionally, participants were asked to rate their arthritis pain on a 0-to-10 Numerical Rating Scale (NRS) before and after taking CBD (Cook et al., 2013). Efficacy of CBD use for their pain and arthritis symptoms was assessed by a number of different outcome variables. The heterogeneity of the patient population with a variety of diagnoses and the diversity of medical cannabis preparations also affects the external validity of the study. Self-selection bias is increased by the significant patient interest in medical cannabis as these patients must be motivated to access the non-traditional medication system. Most patients treated with CBM present with multiple severe symptoms and the analyses presented here are limited to identify the treatment outcomes for such patients. However, users should remain vigilant about potential adverse reactions, especially when using high doses or combining CBD with other medications. One of the significant concerns with CBD products is the lack of FDA regulation for most over-the-counter CBD oil products. This success story paves the way for further research and development of CBD-based treatments for other neurological disorders, offering hope to many patients and their families. Currently available studies rely on rodent and in vitro models but suggest molecular pathways that may be used to enhance CBD use in the clinic, or offer alternative approaches for higher efficacy. Combination of the two often improved upon the deleterious and psychoactive effects of THC-only administration (Ueberall et al., 2019). With the exception of Epidiolex, a Schedule V preparation, which is a pharmaceutical CBD extract from the plant, cannabis-derived CBD still remains a Schedule I substance according to the United States (US) Drug Enforcement Administration (Drug Enforcement Administration, 2018). CBD is the major non-psychoactive constituent of cannabis and is also found in hemp, a subspecies of Cannabis sativa that does not produce psychoactive compounds in significant amounts (Pertwee, 2006; Hilderbrand, 2018). It revealed that CBD-rich treatments have a beneficial impact on patients with self-reported moderate or severe symptoms of pain, anxiety, or depression and overall wellbeing but not in patients with mild symptoms. Importantly, medical cannabis products are generally not covered by most insurers and patients rely on out-of-pocket payments. This study is a retrospective examination of patients who were prescribed CBD-rich products by physicians at a clinic dedicated to CBM treatments operating at four locations across Quebec, Canada. We were interested to know whether participants distinguish between medical marijuana and CBD with 63.5% answering “Yes, there is a difference”. When asked if using a CBD product was able to reduce the amount of pain medication in general, the majority agreed (37.1%) or strongly agreed (30.5%). When asked what type of products they have used, the most frequent responses were inhaled/smoked (62.9%), edibles (54.3%), and oral tinctures (52.3%). Notably, this FDA approved CBD-based prescription medication is the only CBD product where purity, dose, and composition is known and regulated. Food and Drug Administration (FDA) (2018) for treatment of seizures (VanDolah et al., 2019). Hemp is the fiber extracted from the stem of the cannabis plant and is useful in making rope, textiles, building material, paper, and packaging.