Understanding CBD: Does it Work for Muscle and Joint Pain?

Nowadays, you can’t go anywhere without seeing or hearing something about cannabidiol (CBD). There are so many options—creams, tinctures, salves, lozenges, gummies, you name it—and so many potent claims for its benefits, including muscle and joint pain relief.  

But with all the hysteria and hundreds of products on the market, is CBD really worth the hype? (TLDR: There’s a lot of promise, but not enough research to know for sure yet.)  

If you are considering using CBD for pain relief, here are some basics to help you make an informed decision and understand the science behind the sensation.
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What is cannabidiol (CBD)?

CBD is a plant-based chemical found in the Cannabis family of plants, the medicinal use of which goes back thousands of years. It is a specific type of chemical called a cannabinoid, which, when taken into your body, can alter how you function and feel.  

So far, scientists have identified at least 144 cannabinoids in cannabis plants (Urits, 2020). The most famous ones are CBD and tetrahydrocannabinol (THC), the latter of which is well-known for its ability to get you “high.”  

In recent years CBD has gained fame as a popular natural remedy for a range of problems including pain, anxiety, nausea, and seizures.
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How does CBD work?

The jury is still out on the exact way CBD works. Scientists believe it may help common problems by interacting with a system in your body called the endocannabinoid system (ECS).  

The ECS is a communication system between your cells that researchers believe helps with homeostasis (the balance of your body’s internal environment). If you’ve been sidelined by an injury or an infection, for example, the ECS is believed to help ease your pain, lower inflammation, reduce stress, and more.

Your body naturally produces chemicals called endocannabinoids which turn on the ECS when needed. Cannabinoids like CBD and THC can mimic endocannabinoids and impact the way your brain and body behave (Batalla, 2020).
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CBD vs THC: What’s the difference?  

Since CBD and THC are both cannabinoids, you may be wondering how they differ. Here are a few key ways:

High vs. no high: THC and CBD alter your ECS differently. Much is still unknown, but in a nutshell, THC seems to activate the ECS with much more impact, causing a wide range of sensations from mood-altering feelings of being high to negative effects such as paranoia and anxiety. CBD, on the other hand, does not provoke the same strong sensations of euphoria or intoxication, but seems to activate the ECS enough to help with pain, nausea, and other problems.  

Hemp vs. marijuana: CBD and THC also differ in their sources and the laws that regulate them. For CBD to be sold legally (federally), it must come from a plant that has less than 0.3% THC—that plant is called hemp. Any cannabis plant with more than 0.3% of THC is generally referred to as marijuana, weed, pot, and more and more commonly, cannabis.  

(There’s a bit of controversy and confusion over cannabis names and botany—so don’t be alarmed if you’re stupefied, even without alteration of your ECS system! Things can get even blurrier because the legal limits of THC in cannabis products can differ from state to state. To find out the regulations in your area, your best bet is to check with your state’s website.)

Prescription needed? Since CBD products contain low levels of THC, the government does not regulate CBD the same way it does marijuana. This means you don’t need a prescription to use hemp-based CBD products for medical purposes. Typically, any product that contains at least 0.3% THC or more—like medical marijuana—requires a prescription.
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Can CBD help relieve pain?

While there is a lot of anecdotal evidence, sufficient research is still lacking to answer this question definitively. Early research shows promising signs, however, particularly for certain types of pain.

One study, for example, found that CBD can reduce the need for opioids in people suffering from chronic pain (Capano, 2019).

Other data suggests CBD can help nerve pain—the burning, tingling, stinging, and itching sensations from damaged nerves from conditions like diabetes or shingles (Urtis, 2020).

Additional studies shows that CBD can ease muscular symptoms and discomfort of multiple sclerosis (Whiting, 2015; Koppel 2014).

But not every study shows CBD helps. For example, a 2021 study evaluating the effects of CBD oil on exercise-induced muscle damage in men found that applying 150 mg of CBD oil right after, 24 hours, and 48 hours after a workout had zero effect on muscle soreness and inflammation (Cochrane-Snyman, 2021).

Whether or not CBD can relieve pain from osteoarthritis is also up for debate. Data from a review article published in 2016 found that CBD gel applied to the skin of rats eased joint swelling and improved pain (Hammell, 2016). On the other hand, a recent study evaluating the effects of CBD in people who have hip and knee osteoarthritis showed no major benefit in using CBD for pain versus not using it (Deckey, 2021). Researchers across the board, though (including the authors of the former paper), agree that more human studies are needed to know for sure.  

Studies also indicate that CBD may be most effective for pain when taken in combination with THC. Indeed, several countries have approved drugs that contain a combination of THC and CBD for specific pain types.
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CBD might help, but consider it carefully

Depending on the type of pain you have, CBD may be helpful. But there’s a lot to consider and a lot still to uncover when it comes to CBD and pain relief, explains Jim Fiechtl, MD, a sports medicine physician at Vori.

“I generally have an open mind about most  treatment options as long as they don’t cause harm,” Dr. Fiechtl says. “There is a lot about pain we don’t fully understand, and there is a lot about CBD that we don’t fully understand. It may help you, but then again it may not.”

If you are considering taking CBD products, it is also important to note that they can interact with certain prescription medications. And, since CBD products are not regulated, be aware of the variation on the shelves.  

“Since CBD products are not FDA regulated,” Dr Fiechtl says, “I would recommend using a product that has been third party, independently evaluated for its components and from a company that can provide a certificate of analysis—proof of what’s in the bottle.”

Like any other product you put on or in your body, you need the right information to make a smart decision. If you are considering taking CBD for pain relief, we recommend talking with a medical provider or the care team at Vori to determine if CBD may be right for you.