From the Guidelines
CBD should not be considered a primary treatment for chronic pain due to limited and inconsistent evidence, and its use may be associated with adverse events such as dizziness, nausea, and sedation. When managing chronic pain, a holistic, multimodal approach that involves a comprehensive interdisciplinary team is recommended, focusing on achieving functional goals, decreasing pain severity, improving quality of life, and identifying and addressing any treatment-related adverse events or behaviors 1.
Chronic Pain Management
The goal of treatment is to restore function, and patient education on the neurophysiology of pain is crucial in helping patients manage their pain and understand the goals of pain management 1. Nonpharmacologic interventions, such as exercise, physical therapy, and behavioral therapy, should be considered first-line treatments for chronic pain.
Pharmacologic Interventions
For patients with insufficient response to nonpharmacologic interventions, pharmacologic options such as NSAIDs, duloxetine, and anticonvulsants may be considered, depending on the type and severity of pain 1. However, these medications should be used with caution, particularly in older adults and patients with comorbidities, and at the lowest effective dosage and shortest duration needed.
CBD and Chronic Pain
While some studies suggest that CBD may have potential benefits for managing pain, the evidence is limited and inconsistent, and its use is not recommended as a primary treatment for chronic pain 1. If considering CBD, patients should start with a low dose and gradually increase as needed, under the guidance of a healthcare provider, and be aware of potential interactions with other medications.
Key Considerations
- A comprehensive interdisciplinary team approach is recommended for managing chronic pain
- Nonpharmacologic interventions should be considered first-line treatments
- Pharmacologic options should be used with caution and at the lowest effective dosage and shortest duration needed
- CBD is not recommended as a primary treatment for chronic pain due to limited and inconsistent evidence.
From the FDA Drug Label
PRINCIPAL DISPLAY PANEL - 59 ML Bottle Box MDSCIENCE™CANNABIDIOLTHE SCIENCE OF HEALTHY CBD 250MG TOTAL CBDMUSCLE AND JOINTPAIN RELIEFCREAM 2FL OZ (59ML)
The role of Cannabidiol (CBD) in the management of Chronic (CRH) pain is not explicitly stated in the provided drug label. However, it mentions MUSCLE AND JOINT PAIN RELIEF, which may be related to chronic pain.
- The label does indicate that the product contains 250MG TOTAL CBD.
- It is intended for MUSCLE AND JOINT PAIN RELIEF. The FDA drug label does not answer the question about the role of CBD in managing Chronic (CRH) pain as it does not directly address CRH pain. 2
From the Research
Role of Cannabidiol (CBD) in Chronic Pain Management
- CBD has been proposed as an alternative to opioids for pain management, with studies suggesting it may have a comparable efficacy with a better safety profile 3.
- The exact mechanism of CBD in pain management is currently unknown, but it is believed to interact with the endocannabinoid system and other signaling systems involved in pain regulation 4, 5.
- Studies have shown that CBD can reduce pain in animal models of inflammatory and neuropathic pain, but clinical studies are limited and lack sufficient rigor to provide strong evidence for its analgesic activity 4, 6.
Efficacy of CBD in Chronic Pain Management
- A systematic review of 15 studies found that CBD may be useful in treating chronic pain, with pain reduction ranging from 42% to 66% in some studies 6.
- However, the evidence is not conclusive, and more studies with robust designs are needed to evaluate the effectiveness of CBD in treating chronic pain 6, 7.
- Some studies have reported significant improvements in quality of life indicators, such as sleep quality and pain intensity, in patients using CBD for chronic pain management 3.
Safety and Limitations of CBD Use
- CBD is generally considered to have a benign side effect profile, but its safety in patients with chronic illness remains untested 4, 5.
- The quality of CBD products is a major concern, with studies finding high variability in the content of CBD products 4.
- Pharmacists and healthcare professionals should exercise caution when recommending CBD for pain management, and patients should be advised to use CBD under clinical supervision 4, 7.