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|Dr. Amanda Anderson, DPT|
Doctor of Physical Therapy
Pain Management Expert
The use of CBD and hemp oil for pain and Inflammation has shown a lot of potential. But, do they actually work, and if so, which one is better? More importantly, are there any risks of long term use?
In this article, we’ll address the top CBD/hemp questions I am often asked.
In particular, the use of CBD and hemp oil products to relieve and manage chronic pain and inflammation. I will also share additional ways that can play a big role in pain management and inflammation, including natural anti-inflammatory supplements, diet and lifestyle options.
CBD, Hemp & Chronic Pain
Chronic pain is definitely a huge public health issue. As a doctor of physical therapy, I see the effect chronic pain has on the quality of life of my patients every day. And, despite the many advancement we have made in the area of pain management, pain can still have a devastating negative impact on people’s lives.
In fact, according to a poll taken by ABC News, 19% of adults in the United States are living with chronic pain. That’s over 62 millions Americans!
Interestingly enough, 12% of this group has used some form of cannabis to relieve their symptoms.1
Recent research is being conducted on cannabis use, specifically on CBD/hemp oil to evaluate how these natural alternatives can help with pain and inflammation in the human body. So, what have we learned so far?
Do CBD & Hemp Oil Work for Pain & Inflammation?
The endocannabinoid system (ECS) is a complex web of receptors and enzymes throughout our body that affect pain, appetite, memory, mood, and immune function.
This system plays a key role in maintaining homeostasis in the body. In other words, in an event of an imbalance, the endocannabinoid system releases natural cannabinoids to restore the balance.
So, the first thing you should know, is that we make our own natural cannabinoids. Also called, endocannabinoids, these neurotransmitters send messages throughout our bodies via receptors located in the brain, muscles, fat, and GI system. The most common receptors are called cannabinoid receptor type 1 (CB1) and cannabinoid receptor type 2 (CB2).
Now, to the CBD and hemp supplement part.
We can also ingest cannabinoids from plants. In particular, cannabis plants and hemp, but also, black pepper, cloves, hops, ginseng, black truffles, and even dark chocolate.
These plant-based cannabinoids (phytocannabinoids) are similar in shape to the endocannabinoids that we naturally produce. So when a person ingests plant-based cannabinoids, they can bind to the CB1 and CB2 receptors and trigger the release of neurotransmitters.
So essentially, these neurotransmitters are used to communicate vital information to different organs.The result of this “information” has shown to regulate several imbalances in the body and help to relieve pain, reduce inflammation, calm anxiety, and other potential benefits.
What is the Difference Between Hemp Oil and CBD?
It is important to note that hemp oil, hemp extract and CBD are not the same and have different benefits and uses. In particular:
- Hemp seed oil.
The oil that comes only from the seeds of the Cannabis sativa plant. While hemp seed oil has many health benefits, (it has an excellent nutritional profile, for example), it does not contain CBD. Thus, the use of pure hemp oil for pain do not appear to be effective.
- Pure CBD oil.
Most CBD oil on the market are made from the stalks, leaves, and flowers of hemp, which unlike the seeds, have a higher concentration of CBD.
- Full-spectrum hemp extract.
“Full-spectrum” means that all the naturally occuring phytocannabinoids, including CBD, terpene, antioxidants, and other compounds are retained within the oil. This makes their synergistic effect stronger than pure CBD oil and can provide users additional benefits.
So, in order to address pain and inflammation, full-spectrum hemp extract seem to offer the most potential.
Important: CBD Content in Full-spectrum Hemp Extract
A common issue with many hemp oil and hemp extracts supplements, is that they do not have enough CBD in them. Thus, they may not be effective for pain and inflammation.
So you have to make sure the full-spectrum hemp extract has enough CBD in it. The CBD amount should always be mentioned on the product page.
Dr. Group Hemp Extract is a great example, which is also certified organic from US grown hemp and has no added fillers or binders. As you can see in the image above, half of 121 mg hemp extract is CBD (65 mg), with a total of 73 mg cannabinoids.
Can Hemp or CBD Oil Get You High?
While CBD is extracted from a cannabis plant, it doesn’t mean that it will create “high” or a state of euphoria as marijuana. This is because the cannabinoid that is responsible for the “high” is THC and not CBD.
So what is the difference between THC and CBD?
- THC works by decreasing nausea and pain and increasing appetite and feelings of relaxation. This includes the “high” commonly associated with marijuana use.
- CBD does not produce the psychotropic effects that THC does. Instead, it produces a more calming effect that can reduce anxiety.
So, while both THC and CBD have significant anti-inflammatory and pain relieving properties, only THC gets you high.1
In fact, hemp must contain less than 0.3% THC to get a “food-strain” legal status. If made properly, the doses of THC in hemp are so minimal that there isn’t any chance of you getting high. Sorry!
With that said, research has shown that some commercial brands of hemp have THC concentrations of 1250% higher than the legal limit!
So, it is imperative that your hemp or CBD oil comes from a trusted source.
A CBD or hemp supplement should test and share the levels of CBD and THC. If these are not mentioned, move to the next product.
How do you use hemp for pain & inflammation?
For systemic pain and inflammation, the easiest and most effective way is to take hemp extract orally using a tincture.
For best results, hold the hemp extract in your mouth below the tongue for at least one minute before you swallow.
This method can help to increase the amount you absorb through your submucosal tissue in the mouth. Thus, bypass some of the processing that typically occurs in your digestive tract.
Is it better to ingest CBD/Hemp or to apply topically?
While there is some research that indicate that cream-based CBD can reduce pain and inflammatory markers in rats, it is unknown at this time what method works “better” for humans.4
Additionally, there isn’t a lot of research or information on best dosages or methods of application at this point. For example, absorption through the skin. Or, joint vs. muscle pain. So, until we have more data on what works best, you may need to do some testing as you find the best method, dosage, and brand for you.
As mentioned, an oral full spectrum hemp extract that includes CBD, is probably the best option to start. Especially since CBD cream (or CBD oil) only contain a portion of the phytocannabinoids that are in the full spectrum hemp extract.
Other Natural Methods for Reducing Inflammation
In addition to using hemp or CBD oil, there are several other natural compounds that can help with pain and inflammation.
Phycocyanin (Blue majik)
Blue majik is a natural extract of Spirulina (Arthrospira platensis) that contains phycocyanin, the blue colored protein that gives spirulina its Bluish color. Research has shown that phycocyanin has natural anti-inflammatory cox-2 inhibitor properties, that can be very helpful to reduce pain and inflammation.
While the taste is not for everyone, you can take it in capsules or add it to a drink or beverage of your choice, as a nutrient-dense supplementation option.
Liquid turmeric (curcumin)
Turmeric is an ancient natural spice that helps to reduce inflammation throughout the body and calm an irritated gastrointestinal system.
Liquid turmeric extract works much better than just the spice and offers an easy natural anti-inflammatory support. Simply add to your favorite tea or drink to get an additional benefit from your nighttime calming ritual.
Diet for Pain and Inflammation
There are many foods that contain anti-inflammatory properties that can help with pain and inflammation. On the flip side, some foods may cause inflammation in the body.
Foods to eat may include:
- Wild small fatty fish.
Wild fatty fish such as wild alaskan salmon are high in omega 3 fatty acids which are shown to help reduce inflammation.6
(Smaller fish have less amounts of mercury).
- Foods that regulate the ECS.
Especially, black truffle, black pepper, cloves, cinnamon, oregano, basil, lavender, and rosemary. Similarly, vegetables like cauliflower, broccoli, and cabbage, contain indole-3-carbinol which is converted into diindolylmethane (DIM) in your gut. DIM binds to the CB2 receptors to activate the ECS.
- Probiotic supplement.
Probiotics can help not only for your digestive system but also for the functioning of your endocannabinoid system. Lactobacillus acidophilus, for example, a well-known probiotic strain, can help to modulate the ECS in your gut.
What foods should you avoid?
It is best to limit processed foods and refined sugars which are known to increase inflammation. Additionally, certain foods (including healthy options) contain high histamine, which may also increase inflammation. So, you may want to limit these as a part of your anti-inflammatory diet.
Histamine-rich foods include:
- Fermented alcoholic beverages, like wine, champagne, and beer
- Fermented foods like sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha
- Foods high in vinegar like pickles, mayonnaise, olives
- Cured meats like bacon, salami, pepperoni, deli meats, hot dogs
- Soured foods like sour cream, sour milk, buttermilk
- Dried and citrus fruits
- Aged cheese
- Vegetables like avocados, eggplant, spinach, tomatoes
- Any smoked fish and certain fish species like mackerel, mahi-mahi, tuna, anchovies, sardines
- Any processed foods (preservatives contain high amounts of histamines).
In general, foods that are high in vitamin C (ascorbic acid), quercetin, vitamin B6, omega-3 fatty acids, and riboflavin can help reduce the amount of histamine your body makes.
Lifestyle Considerations for Pain and Inflammation
Obesity is related to many chronic conditions, like diabetes, high blood pressure, and heart disease that result in system-wide inflammation. Even more, the data suggests that there is a link between obesity and chronic pain.
In fact, adipose (fat) tissue doesn’t only function as a way to store energy; it also helps regulate inflammation in the body. It seems that too much adipose tissue, however, can cause the body to produce many of the chemicals that promote the presence of inflammation. For this reason, weight control is imperative for managing pain.5
In addition to the diet, get your body moving is also key. And the simple little things we do every day can add up and help relieve pain and control inflammation.
Try and park your car further away from the grocery store, take the stairs instead of the elevator, or take a walk during your work break. Some other great ways to get moving include cycling, swimming, yoga, pilates, or jogging.
Most importantly, pick something you enjoy that agrees with your body, so you’re more likely to stick to your routine!
Stress is a major cause of inflammation. When our bodies are in a chronic state of stress, hormone imbalance can occur leading to more inflammatory chemicals in our bodies.
To reduce stress, it’s important to focus on getting at least 10 minutes of stress reduction into your day every day. This can include meditation, a brisk walk, or yoga. Just like movement, this doesn’t have to consume your entire day. All you need is a couple of minutes each day to allow yourself to re-center and de-stress.
No one should be defined by their pain or let pain control their life.
While more research is required to determine the dosages and long-term effects of CBD and hemp oil use, we have enough data that indicate they may offer natural and sustainable options for pain control.
I hope you find this information helpful in your journey to better health and wellness.
3 Interesting Facts About Cannabis
Did you know?
- Cannabis has been a mainstay treatment for all types of ailments for centuries all over the world. The cannabis plant originated about 12,000 years ago in central Asia, but the first written record of cannabis wasn’t until 5,000 years ago.
- Cannabis use has spread across the world, becoming a popular remedy in the United States. It is used to treat pain, gastrointestinal issues, mental illness, nausea, headaches, insomnia, asthma, epilepsy, menstrual cramps, among others.
- Since the discovery of the endocannabinoid system (ECS), a renewed interest in cannabis has emerged, especially in the realm of pain and inflammation.
- Cannabinoids in the management of difficult to treat pain.[pubmed]
- Cannabinoids and Pain: New Insights From Old Molecules.[pubmed]
- Omega-3 Supplementation Lowers Inflammation and Anxiety in Medical Students: A Randomized Controlled Trial.[pubmed]
- Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis.[pubmed]
- Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach.[pubmed]
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- CBD vs. Hemp Oil for Pain and Inflammation: Which is Best? - May 27, 2020