One of the most common reasons people use CBD is to help treat various medical conditions and, more specifically, to treat different types of pain from those conditions. But how does CBD actually work to reduce pain, you ask? Well, it all starts with the body’s endocannabinoid system.

The endocannabinoid system

The endocannabinoid system is a biochemical communication system in our bodies that helps regulate everything from nerve function and muscle coordination to immunity and blood circulation. It’s made up of two types of cannabinoid receptors, CB1 and CB2, which both promote neural sensitivity and efficacy. CB1 receptors are found in the brain and central nervous system and influence our emotions, mood, appetite, coordination, movement, and pain. CB2 receptors are found primarily in the immune system, but also in peripheral organs and tissues of the muscular and cardiovascular systems.

While our body naturally produces endocannabinoid compounds that react with the CB1 and CB2 receptors and help keep the body balanced, when we experience injury, disease or other deficiency of endocannabinoids, the compounds found in CBD, called phytocannabinoids, can help pick up the slack. But instead of interacting directly with CB1 and CB2 receptors like THC compounds, CBD compounds simply help to stimulate the receptors and get the body to recognize and use more of its natural cannabinoids and neurotransmitters. (Hence, no “high”.)

So, what does this mean for pain?

CBD’s effect on pain depends on the type of pain: nociceptive, neuropathic or central pain.

1. Nociceptive pain comes from physical injury and damaged tissue and is influenced by the immune system (e.g. chronic pain and inflammation, inflammation from injury, arthritis, IBS, etc.).

2. Neuropathic pain can come from physical injury but is linked to damaged nerves rather than tissue and, therefore, is influenced by the central nervous system (e.g. multiple sclerosis, Parkinson’s disease, HIV, shingles).

3. Central pain, on the other hand, is a more generalized category, describing the pain that comes from dysfunction in the nervous system where the cause may be unknown (e.g. fibromyalgia).

How CBD affects nociceptic pain

CBD most readily affects nociceptive pain by recruiting CB2 receptors in the immune system. It blocks the inflammatory signals, or mediators, sent to the brain in order to stop the onset of inflammation after damage, and also switches macrophage repair cells from instigating inflammation to reducing it. CBD further mitigates nociceptive pain by diminishing the pain signals sent to the brain through neurotransmitters and CB1 receptors. Effectively, it amplifies the activity of inhibitory receptors for those neurotransmitters, making fewer pain signals reach the brain so the body doesn’t feel as much of it. A few studies on mice and rats have found very favorable results in CBD’s effect on chronic pain and inflammation.

How CBD affects neuropathic pain

Because neuropathic pain comes from the nervous system and isn’t necessarily localized to an easily targetable area, it’s more difficult to treat. Where CBD has been found to be helpful is in limiting the expression of certain pain and inflammatory mediators (see: CB2 receptors!) that spike when treating neuropathic conditions (e.g. multiple sclerosis, Parkinson’s disease, HIV, shingles), coupled with its increased activation of serotonin receptors (CB1!). Higher serotonin levels naturally make us feel better, happier and less acutely aware of or affected by pain.

How CBD affects central pain

Lastly, we have central pain. As the blanket category encompassing many varied types of pain, central pain, and CBD’s impact on it, is the least studied at this point. A 2018 study, however, did find significant positive effects of using cannabis products in patients with fibromyalgia.

Conditions CBD can help with

Separately, studies have also found supporting results in CBD’s effectiveness in treating drug addiction as well as reducing the likelihood of potential addiction to opioids when using them to treat pain.

The CBD wave is still new, and the data and scientific research around its effects are in early stages. But already there is much evidence pointing to its highly positive impact on inflammatory pain, with increasing data supporting its beneficial effects on neuropathic and central pain, and all data pointing to CBD having no adverse effects. The most common conditions finding notable impacts thus far are:

  • Anxiety and depression
  • Cancer and chemotherapy pain treatment
  • Chronic pain and inflammation
  • Epilepsy
  • Fibromyalgia
  • Intestinal or bowel disease
  • Multiple sclerosis

To see more studies’ findings on specific conditions, see this list.

As more and more studies come out, we will continue to update our resources and bring you the best information available.

Anthony Tribunella

Having experienced the benefits of CBD first hand when it was starting to gain popularity, Anthony decided to spend his working life championing it to the public and his peers in the wider CBD community. As a CBD innovator himself, Anthony likes to remain at the leading edge of scientific and product development to ensure that the potential of CBD has every chance of being fully realized.

See all posts by Anthony Tribunella

Research Papers