CBD als alternatives Schmerzmittel: Was es wirklich kann

CBD as an alternative pain reliever: What it can really do

Written by: Anne Ullrich

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Time to read 9 min

Recurrent or chronic pain is part of daily life for millions of people today. Even if conventional therapies and preparations often work well, the side effects are often severe, and the quality of life of those affected is significantly restricted.

For this reason, interest in alternative pain therapy options has increased significantly in recent years. Products from the hemp plant (Cannabis sativa), such as medicinal cannabis and cannabidiol (CBD), are considered particularly promising.

But do cannabis medications really deliver on the promises of numerous testimonials? When is the use of medical cannabis recommended, and when is CBD the better choice? And what does research actually say about the effects of CBD?

The Most Important Things at a Glance

CBD shows promising results in many scientific studies for the treatment of various types of pain. Nevertheless, further research is still needed to substantiate the evidence.

Compared to conventional pain relievers, CBD has significantly fewer side effects and is not addictive. However, both effects and side effects always vary from person to person.

Medical cannabis also carries more side effects than CBD. Here, it is important to carefully adjust treatments and dosages to achieve optimal effectiveness.

How does CBD work for pain?

CBD exerts its pain-relieving effect through various mechanisms in the body, primarily through the endocannabinoid system (ECS) and other pain-regulating systems. Detailed information on how CBD works for pain can be found in our article CBD Oil for Pain.

Basically, CBD indirectly interacts with the endocannabinoid system, which plays an important role in pain regulation. It also acts on other receptors involved in pain perception. This variety of possible mechanisms of action has led to extensive research into the effects of CBD on pain.

Sounds interesting?

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Sounds interesting?

Try CBD oil now.

Discover CBD oils now

Study Situation: What do we really know?

Scientific interest in CBD as a treatment option for pain has risen sharply in recent years. But how reliable are the results?

Chronic Pain

Chronic pain affects about 20% of adults worldwide and often significantly reduces the quality of life of those affected. A systematic review and meta-analysis by Mondello et al. (2023) examined 20 randomized controlled trials on the efficacy of CBD for chronic pain.

The results were mixed: while some studies showed significant improvements, others could not demonstrate clear benefits. The authors concluded that the evidence for the pain-relieving effect of CBD is in the "low to moderate" range and that "further well-designed clinical studies" are needed. (1)

The most important criticism: most studies work with too few participants, and the studies are usually too short to obtain reliable results.

Neuropathic Pain

Neuropathic pain, i.e., nerve pain, is considered particularly difficult to treat. It often responds little or not at all to conventional pain relievers. According to a study by Xu et al. (2020), the use of topical CBD could help. The study participants reported a significant reduction in their pain when the CBD product was applied topically to the skin. (2)

However, critics note that many studies on CBD for neuropathic pain are conducted with combination preparations (e.g., CBD and THC). This makes it difficult to isolate the specific effects of CBD. It remains unclear to date whether CBD alone is as effective as in combination with THC.

Inflammatory Pain

For inflammatory pain, such as that typically found in osteoarthritis or back pain, CBD is particularly promising. A clinical study (3) already showed in 2017 that CBD reduced both inflammation and neuropathic pain in osteoarthritis in an animal model. The results also indicate that CBD may not only act symptomatically but also slow the progression of the disease.

However, here's the caveat: the transferability of animal studies is limited, and more research in clinical studies on humans is urgently needed to make more reliable statements.

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Critical Review: How well does CBD really help with pain?

Certainly: The research results are very promising and a great hope for all those suffering from pain. But how reliable are the results really?

Strengths of current research

Weaknesses and limitations

Several animal studies consistently show the pain-relieving and anti-inflammatory effects of CBD

Many studies have methodological shortcomings (e.g. small sample sizes or short observation periods)

Initial clinical studies in humans indicate positive effects on various types of pain

A large proportion of studies are still conducted on animal models; the results are not automatically transferable to humans

The use of CBD carries very few risks and side effects

Long-term studies on efficacy and safety with continuous consumption are still lacking


Many clinical studies investigate THC and CBD together instead of pure CBD

A review by Villanueva et al. from 2022 (4) concludes that CBD shows promising analgesic and anti-inflammatory properties in the treatment of chronic pain. However, according to the authors, higher quality clinical trials with larger sample sizes and longer observation periods are needed to fully evaluate efficacy and safety.

More important than thought: The placebo effect

An important aspect in the discussion about CBD is and remains the placebo effect. CBD has received enormous media attention in recent years. The expectation that CBD works very well against pain can actually influence its effectiveness.

A 2018 study (5) showed that the placebo effect can be very strong in pain treatments in general – up to 30% of reported pain relief could be attributed to it, according to the authors. (5) Even if this makes it difficult to assess the actual, pharmacological effect of CBD, it shows one thing: CBD can have a positive effect and significantly improve the quality of life of those affected.

Our tips for dosage and application

The optimal dosage of CBD can vary greatly and depends on various factors, including:

  • Type and intensity of pain

  • Body weight and other individual characteristics of the pain patient

  • Sensitivity to cannabinoids

  • Type of CBD product (oil, spray, topical application, etc.)

In most clinical studies, dosages between 15 mg and 300 mg of CBD per day were investigated, with higher dosages often showing better results.

We generally recommend that you consume CBD mindfully: start with a low dose (5-10 mg CBD twice daily) and observe the effect on your body and your symptoms. Slowly increase until the desired effect occurs. This way you minimize the risk of possible side effects and find your individually optimal dosage.

Application

CBD is available in various forms. The choice of administration method depends on your personal preferences. However, the effectiveness of pain treatment varies depending on the administration method.

For localized pain, topical applications may be useful, while for chronic or systemic pain, CBD oils or sprays are usually more suitable. Consult your treating physician to find the optimal application for you.


Advantages

Disadvantages

CBD oil

Faster effect through sublingual application (15-45 minutes), flexible dosage

Taste can be an acquired taste, not as discreet and suitable for everyday use as sprays

Topical application

Direct application to painful areas, no systemic side effects

Only works locally, possibly not sufficient for deeper or extensive pain

Spray

Simple and discreet application even on the go

Dosage can be less precise

Painkillers in comparison: Where does CBD stand?

Particularly interesting in connection with CBD is its potential as an alternative or supplement to conventional painkillers such as non-steroidal anti-inflammatory drugs (e.g. ibuprofen) and opioids.

But CBD can also be the better choice compared to medical cannabis, because it is not addictive and does not have psychoactive effects. This makes it much easier to integrate into everyday life and reduces the risk of stigmatization. However, unlike medicinal hemp, cannabidiol is currently not available on prescription and is instead sold as an over-the-counter food supplement. CBD products are therefore considered food and are not covered by health insurance.

Pro CBD

Contra CBD

Fewer side effects (e.g. for cardiovascular diseases)

Clinical evidence still low

CBD is not addictive

Effect can vary individually

Multiple mechanisms of action, therefore possibly broader efficacy for various types of pain

Product quality can vary

Discreet, everyday consumption

CBD is not available on prescription, health insurance does not cover costs

Overall, CBD can therefore at least be a valuable addition to pain management - especially for patients who suffer from the side effects of conventional painkillers and are looking for a remedy that can be easily integrated into their everyday life. It is important that you consume CBD mindfully, slowly increase the dose (and adjust it if side effects occur) and only take high-quality products.

Stay realistic: What can CBD do and what can't it do?

What CBD can do:

  • Moderate pain relief: For many patients, CBD can lead to a noticeable, though often moderate, reduction in pain.

  • Better tolerability: Compared to many conventional painkillers, CBD causes fewer side effects.

  • Positive accompanying effects: In addition to pain relief, CBD can have positive effects on sleep, stress perception and mood, thus indirectly improving the quality of life of those affected.

What CBD probably cannot do:

  • Complete pain relief: CBD is not a magic bullet that makes all pain disappear.

  • Immediate effect: For most people, the full effect of CBD only becomes apparent after regular use over several weeks.

  • Consistent effect for everyone: The individual response to CBD can vary greatly - what works well for one person may not have the same effect for another.

We recommend viewing the use of CBD as part of a holistic approach to pain management. Measures such as physiotherapy, psychological support, relaxation techniques, and conventional painkillers when needed, work in conjunction with CBD to improve patients' quality of life.

CBD for Pain: What You Should Consider

If you want to try CBD for pain relief, you should keep the following in mind:

Gradual Increase in Dosage

  • Start with a low dose (5-10 mg CBD per day) and increase it slowly until you achieve the desired effect.

  • Keep a pain diary to monitor the effects precisely.

  • Positive effects often only appear after regular use over several weeks. Be patient!

Quality and Control

Unfortunately, there are many disreputable providers on the market. Therefore, when purchasing, make sure to choose only high-quality products from reputable providers in Germany or the EU. We source all our hemp from Europe, and product quality is continuously monitored in the laboratory. This also ensures that our products remain below the approved THC content of less than 0.3% and are not psychoactive.

We generally recommend consuming full-spectrum oils, as they are more natural and contain other beneficial cannabinoids and terpenes (keyword "entourage effect").

Especially if you are already taking other medications or suffer from health problems, you should definitely talk to your doctor before using CBD to minimize risks and side effects.

Our Conclusion: CBD for Pain – Promising, but Not a Panacea

One thing is certain: CBD can do a lot, and research has recognized this. However, further research is still needed to confirm the results and determine in detail how and in what dosage CBD works best against pain. Especially for neuropathic pain and inflammation, the evidence certainly points to the positive effect of CBD.

Even if it's "just" the placebo effect: CBD has positive health effects and can help significantly improve the quality of life for pain patients. It is important to ensure particularly high product quality, consume mindfully, and, if necessary, consult with your doctor.

Our customers' opinions:

Sources and Studies

(1) Mondello E, Quattrone D, Cardia L, et al. Cannabinoids and Pain: A Systematic Review and Meta-analysis of Controlled Clinical Trials. Drugs. 2023;83(4):389-412.


(2) Xu DH, Cullen BD, Tang M, Fang Y. The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities. Curr Pharm Biotechnol. 2020;21(5):390-402.


(3) Philpott HT, O'Brien M, McDougall JJ. Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. Pain. 2017;158(12):2442-2451.


(4) Villanueva, M. R. B., Joshaghani, N., Villa, N., Badla, O., Goit, R., Saddik, S. E., Dawood, S. N., Rabih, A. M., Niaj, A., Raman, A., Uprety, M., Calero, M., & Khan, S. (2022). Efficacy, Safety, and Regulation of Cannabidiol on Chronic Pain: A Systematic Review. Cureus, 14(7), e26913.


(5) Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018;3(3)


(6) Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis Cannabinoid Res. 2017;2(1):139-154.