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Does Topical CBD Really Work for PAIN?

You’ve probably heard of CBD. It’s everywhere, from specialty clinics to even your local health store. People are using it for pain, anxiety, and even for sleep. But does it really work? More specifically, can topical forms of CBD such as creams and lotions, truly deliver on the promises of pain relief, neuropathy alleviation, and arthritis management? Let’s discuss what CBD is and find out what’s promising, what’s lacking, and what you need to know.

First, let’s clarify what CBD is. CBD stands for cannabidiol, which is a compound extracted from the cannabis plant. Now, it's crucial to note that this comes from hemp, not its close relative, marijuana. The defining difference between hemp and marijuana is their psychoactive ingredient: tetrahydrocannabinol, or THC for short. Hemp has 0.3% or less THC, meaning hemp-derived products like CBD oil or topical CBD don't contain enough THC to create the “high” traditionally associated with marijuana.

Many individuals turn to CBD as a remedy for a diverse set of health challenges. Foremost among these is pain management, which encompasses a wide variety of concerns, including arthritis, muscle discomfort, and neuropathic pain. In addition to physical ailments, CBD is increasingly recognized for its potential efficacy in addressing mental health conditions such as anxiety and depression. The compound is also being explored for its possible benefits in alleviating sleep disorders like insomnia and more severe neurological conditions like epilepsy.

It's worth noting that the use of cannabis-based remedies isn't a new phenomenon; it actually has deep historical roots. In fact, medicinal use of cannabis can be traced back thousands of years to ancient civilizations, including the Chinese, Egyptians, and Greeks. This extensive history underscores the notion that the fascination with cannabis and its derivatives, such as CBD, isn't a passing trend but a continuation of long-standing human exploration into its potential healing properties. But for the scope of this video, we're focusing on its role in pain management.

Let’s first discuss how CBD works for pain management. CBD engages with a specialized network within our bodies known as the endocannabinoid system, or ECS for short. This system plays a pivotal role in maintaining physiological equilibrium, including the regulation of pain and inflammation.

Within the ECS, there are two primary receptors—CB1 and CB2—that are the focal points for CBD interaction. CB1 receptors are chiefly located in the brain and are linked to emotional states and mood regulation. Conversely, CB2 receptors are predominantly found in the immune system and have a direct correlation with inflammation and the sensation of pain.

CBD's interaction with these receptors serves to mitigate inflammation and dampen our perception of pain. Beyond this, CBD also influences other biochemical agents in our body that participate in pain regulation.

So, what do scientific studies tell us about the effectiveness of CBD in managing pain? It's important to acknowledge that our current knowledge is based on limited data, particularly when it comes to gold-standard research methods like double-blinded, randomized, placebo-controlled trials. However, the preliminary evidence we do have is quite encouraging.

Animal studies indicate that topical CBD application has therapeutic potential for relief of arthritis pain related behaviors without side effects. Human studies have found similar results. For example, this study found that topical CBD treatment demonstrated significant improvements in thumb arthritis related pain and disability without adverse events.

Topical CBD has also been studied in athletes and individuals with musculoskeletal pain. One specific study revealed that topical CBD application led to notable improvements in pain levels and in pain-related impairments across various domains, including athletic performance, occupational tasks, and even family and household responsibilities. As for side effects, the most frequently reported issues were skin dryness and rashes, both of which were generally short-lived and resolved quickly.

Other studies like this one have studied topical CBD for the symptomatic relief of peripheral neuropathy. They found that topical CBD oil can achieve significant improvement in pain and symptoms in patients with peripheral neuropathy. They too report that the treatment product was well tolerated and offers an effective alternative to other current therapies.

On a more anecdotal note, a number of my own patients have shared positive feedback about their experiences with topical CBD for a variety of issues. These include conditions like tennis elbow, knee arthritis, plantar fasciitis, and even lower back pain. Interestingly, some patients have gone as far as to say that topical CBD has been more effective for them than over-the-counter options like ibuprofen and naproxen.

Ok so it seems like there may be some evidence that it works, but what about risks and side effects? Generally speaking, topical CBD is well-tolerated, though individual experiences can differ. It's also worth noting that there's little to no evidence to suggest that CBD is addictive or associated with withdrawal symptoms. However, it's important to be cautious about potential interactions with other medications you might be taking. If you're considering adding CBD to your treatment regimen, consult your healthcare provider first for potential drug interactions. ]

For those interested in trying it, there’s another issue of sourcing high quality CBD products. The current CBD market is somewhat like the 'Wild West,' largely due to the absence of stringent regulations. This lack of oversight means that the CBD and THC concentrations can vary widely between products, and some might even include harmful contaminants like heavy metals or pesticides. Therefore, it's crucial to opt for CBD products from trustworthy sources. One way to assure quality is by seeking products that have undergone third-party lab testing, which confirms the levels of CBD and THC and certifies the absence of harmful substances.

Cost is another pivotal factor to consider when weighing the pros and cons of using CBD for pain management. Although prices have come down in recent years, high-quality CBD products—especially those that have been third-party tested—can still represent a significant financial investment. It's worth mentioning that most health insurance plans do not currently cover CBD, making it an expense you'll have to cover yourself. When juxtaposed with other pain management options like over-the-counter medications or prescription drugs, CBD can often cost more on a per-dose basis. However, it's important to remember that non-pharmacological treatments like physical therapy or acupuncture might have similar or even higher costs over the long term, depending on your insurance coverage and how often you require treatment.

So, here's my take: Given its low-risk profile, CBD oil is certainly worth considering, particularly for managing pain. But I’m hesitant about recommending it widely to everyone until we have more conclusive data from randomized controlled trials. That said, if you're in search of an alternative to prescription medications—which can often come with a lengthy list of serious side effects—CBD may be a reasonable choice to consider.


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