CBD for Aches and Pains: How Does It Work?

At this point, you’re no stranger to the buzz about cannabidiol (CBD), one of over a hundred compounds produced by the plant cannabis sativa. Like its well-known sibling, THC, CBD is a phytocannabinoid. Like THC, CBD has action at numerous locations in the brain and body. However, unlike THC, CBD won’t get you high. Although CBD can act on the same brain targets as THC, it does so in opposite ways. CBD even has its own unique set of brain targets. 

In fact, because there are so many potentially therapeutically relevant CBD targets, there is an increase in pre-clinical (i.e. using lab rodents, but not humans) and clinical research into CBD’s medicinal effects. When incorporating CBD into your routine, it’s important to understand how CBD affects your brain and the body to fight inflammation and soothe aches and pains. And since stress, pollution, and other environmental factors will trigger your body’s inflammation response it’s entirely possible your body is fending off chronic inflammation and you might not even realize it. 

1. Everyone’s optimal dose varies.

At different doses, CBD can act on over 65 targets in the brain and body. But it’s important to understand that not every one of these targets is affected at a given dose. Instead, as CBD levels in one’s body rise, so do the number of affected targets. Studies show that once you find the optimal dose, increasing that dose can sometimes make CBD less effective. Identifying one’s “Goldilocks Zone” may require a bit of experimentation, and it’s important to remember that more is not always better.

"Identifying one’s Goldilocks Zone may require a bit of experimentation, and it’s important to remember that more is not always better."

2. The role of the ECS and common need states.

Cannabis helped reveal that we have an endocannabinoid system (ECS) and that it has an integral role in our brain and body wellness. It is comprised of two receptor types: CB1 and CB2 receptors, and the two chemicals that act upon them, anandamide and 2-AG. These receptors and endocannabinoids are found in various densities and have different strengths in ‘strategic’ locations throughout the body that promote cannabis’s role in regulating pain and inflammation, mood, and brain function. 

Pain is the manifestation of several brain regions working together to change mood and behavior so that the injured area can heal. However, in some cases, pain persists after the area has healed, suggesting that pain is complex, doesn’t necessarily reflect injury, nor can all types of pain be treated with a single approach.   

There are three potential sites by which pain treatment can be targeted: 

  1. Pain can be reduced at the site of injury by reducing inflammation. Inflammation triggers pain signals from the site of injury to the brain, informing it that damage has occurred. It’s meant to trigger discomfort so that you’ll stay off the injured area and allow for healing. So, reducing inflammation reduces pain.

  2. Pain signals can be dampened when they enter the spinal cord before reaching the brain. If the spinal cord serves as a highway for pain signals to travel to the brain, then the pain signals can be limited at the on-ramp. 

  3. Activation of pain networks in the brain can also be reduced. The ECS is found at each stage of this pain pathway, and therefore, can block pain at the site of injury by reducing inflammation, it can dampen the strength of pain signals in the spinal cord, and it can improve mood which helps relieve pain. 

3. CBD can help manage the body’s anti-inflammatory response.

Multiple mechanisms contribute to CBD’s anti-inflammatory effects. CBD can act as a weak activator of the endocannabinoid type II (CB2) receptors, which have an anti-inflammatory effect. CBD’s ability to increase anandamide levels is another way by which CBD can enhance CB2 action, and thereby, reduce inflammation. 

For certain types of inflammation, such as inflammation in the lungs, CBD’s anti-inflammatory properties are mediated through adenosine receptors. This myriad of targets that have been identified in vitro and in pre-clinical studies suggest that CBD can take multiple approaches to reduce inflammation. 

So, what’s the role of inflammation in pain? Inflammation can trigger the sensation of pain by activating a subset of nerve cells that carry pain signals to the brain. By dampening inflammation, pain is reduced. However, pain is more than merely an injury activating certain nerve cells going to the brain — it is a complex response that’s processed at multiple levels in the body, including the site of injury, the spinal cord, and across several brain regions. Therefore, pain can be affected by numerous factors including mood — if mood is improved, pain is reduced.

Additional reading:  Millar, S. A., et al. (2018). A systematic review on the pharmacokinetics of cannabidiol in humans. Frontiers in Pharmacology9.

Josh Kaplan, Ph.D., is an Assistant Professor of Behavioral Neuroscience at Western Washington University where he runs a laboratory studying the developmental consequences and therapeutic benefits of cannabis. He is a passionate communicator of cannabis science and has contributed to numerous publications including Leafly and HighTimes, from which he was named in the Top 100 Most Influential People in Cannabis in 2018.

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