Neuropathic pain

People are using hemp-based cannabidiol (CBD) products to manage neuropathic pain. Non-intoxicating oils, capsules and e-liquids are believed to have a therapeutic effect, likely by regulating the endocannabinoid system (ECS). This complex network expresses cannabinoid receptors in both the central and peripheral nervous systems, and researchers have deduced that the ECS is implicated in pain perception regulation.

But experts have not clinically proven yet that CBD is effective for neuropathic conditions. So, are users really benefitting, or is it possible that they are simply enjoying a strong placebo effect? Let’s consider the available research.

What is neuropathic pain?

Neuropathic pain occurs when there is dysfunction in the sensory nervous system, which disrupts the connection between the system and the brain. This can happen due to injury or disease. In some cases, a severing of this connection causes numbness, in others it leads to intense, shooting pain.

Good treatments for neuropathic pain are few and far between, and can significantly affect quality of life. Researchers have found a link between peripheral nervous system irregularities and neuropathic pain, and injuries to the brain or spinal cord may also trigger it. Most of us are familiar with brief acute pain symptoms, from stubbing a toe or hurting an elbow. However, the difference is that this pain quickly eases, whereas for patients with neuropathy, symptoms are persistent.

Neuropathic pain is poorly understood relative to other conditions, and its full impact on the body is unclear. Some researchers have argued that the sharp pain symptoms may be caused by an uptick of neurotransmitters involved with pain signaling that cannot be managed by nerves. Experts have also found that strokes can cause a level of brain damage that makes it more difficult to neutralize pain. A dysfunctional spinal cord may also cause a flood of pain signals to the brain.

CBD and other cannabinoids may have therapeutic properties

ECS research is still in its early phases, with the system and the key compounds that work within it discovered only in the 1990s. This is exciting for many areas of medical science, including neuropathic pain, and there are indications that cannabinoids from hemp and cannabis could act as therapeutic agents. The Journal of Experimental Medicine featured a study in 2012 showing that cannabinoids modulate inflammation, while reducing neuropathic pain via alpha-3 glycine receptors.

Interestingly, there is one example of a cannabis medicine already being used to treat multiple sclerosis – a type of neuropathic pain – in a few countries, including France, Poland and the United Kingdom. Sativex, created by GW Pharmaceuticals, is an oral cannabis spray with an equal mix of CBD and delta-9-tetrahydrocannabinol (THC). This does make Sativex psychoactive, but less so than the recreational marijuana strains found at legal dispensaries.

However, the development of a CBD medication would be preferable, as CBD is completely non-intoxicating. Neuropathic pain patients are often prescribed opioids which have concerning side effects. Those taking opioids looking for an alternative ideally want something totally safe than a product that may induce other health issues.

Tests have shown that CBD may produce pain-relieving effects by regulating CB1 receptors and TRPV-1 receptors – the latter is not part of the ECS, although both are classed as g-protein coupled receptors. An important function of CBD is to boost anandamide, an endocannabinoid that binds with CB1 and CB2 receptors. Agonists of CB2 receptors deliver anti-inflammatory effects that are also vital for easing pain. CBD’s effects on these receptors are indirect, but important all the same. CB2 receptor regulation also provides an immunomodulatory effect that may help to manage autoimmune diseases.

How to manage neuropathic pain with CBD

Due to the sharp, shooting nature of neuropathic pain, the best type of CBD product is one that administers cannabinoids rapidly. Products that work by inhalation or sublingual absorptions are, therefore, the best candidates. Smokers and vapers should look at CBD joints and Koi CBD e-liquids. Those who do neither may favor CBD tincture oils, a distinctly healthier choice. If these products aren’t strong enough, then consider a concentrated CBD product – perhaps wax or crystals.

Full-spectrum CBD products might work better than CBD-isolate products, as the additional cannabinoids, flavonoids and terpenes increase the anti-inflammatory and analgesic value of an extract. Meanwhile, those with persistent but not overbearing symptoms may get most relief from edibles and capsules, or by incorporating any of these with a cream. There are lots of CBD products out there, and trying it for yourself is the only way of knowing what works.