Posted on

Cbd oil for neck injury

Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey

Corresponding Author: Mark T. Langhans, MD, PhD, Hospital for Special Surgery, Spine Service, 535 East 71st Street, New York, NY 10021. Phone: (212) 606-1000; Email: [email protected]

This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS

Abstract

Background

Cannabidiol (CBD) is a cannabis derivative that has been popularized as a medicinal product with analgesic and anti-inflammatory effects. Given the anecdotal observations that several patients have reported use of CBD for spine-related pain, this study was designed to characterize CBD consumption patterns and perceived effects in patients with spine-related complaints.

Methods

The study design was a cross-sectional survey. Over a 4-week period, an anonymous paper survey was administered to all patients presenting for evaluation by 1 of 9 spine surgeons at a single institution. Surveys were given upon registration for the office visit and collected by the office manager or nurse before evaluation by the surgeon. Patients were included regardless of surgical status (ie, preoperative, postoperative, or nonoperative) or region of pathology (lumbar, thoracic, or cervical). The survey consisted of multiple-choice questions on patient patterns of CBD use.

Results

Out of 300 surveys, 214 (71%) were completed. CBD use for spine-related pain was reported by 54 (25.2%) patients. CBD was initially used for potential relief of back pain (66.7%), neck pain (37.0%), leg pain (35.2%), and/or arm pain (9.3%). Users also sought improvements in insomnia (25.9%) and mood (18.5%). Oil was the most popular formulation (64.8%). CBD was most often consumed 2–5 times (40.7%) or 6–10 times (31.5%) per week. The most common source of initial recommendation for CBD was friends or family (75.9%). Reported benefits were pain relief (46.3%), improved sleep (33.3%), and reduced anxiety (20.4%); however, 24.1% of patients reported no benefit from CBD use. The most reported side effect was fatigue (7.4%). Most users (63.0%) would recommend CBD to a friend for pain relief.

Conclusion

CBD is already used by many patients, and further high-quality research on this supplement is essential.

Level of Evidence

Clinical Relevance

CBD is a commonly used by spine patients as an off label treatment.

INTRODUCTION

The endocannabinoid system is a recently characterized endogenous neurotransmitter network in humans.1 The most powerful exogenous mediators include delta-9-tetrohydrocannabidiol (THC) and its partner cannabidiol (CBD), both derivatives of the Cannabis sativa or marijuana plant. While the exact mechanisms of the endocannabinoid system are still under investigation, THC is considered an agonist at the CB1 and CB2 receptors, while CBD is an antagonist. Therefore, CBD is not believed to produce the psychoactive effects associated with the use of marijuana as a recreational drug.2 This distinction led to recent changes in regulation of hemp products, placing CBD in an uncertain position with the law.3

Except for a single Food and Drug Administration (FDA)-approved drug used to treat rare forms of childhood epilepsy,4 the marketing and sale of CBD has outpaced the science behind its efficacy. Given that the endocannabinoid system is involved in a variety of pathologies ranging from neurodegenerative disorders to diabetes,1,5,6 CBD has been marketed as a cure for almost every imaginable ailment. As a result, the availability of CBD has skyrocketed, transforming it from a Schedule I controlled substance into a ubiquitous supplement, available at a wide variety of physical and online stores. Many spine surgeons face questions about the potential of the drug to reduce spine-related complaints, such as mechanical or neuropathic pain.7

While some of this popularity may be related to marketing, there is certainly evidence behind CBD as a potential mitigator of inflammatory and neurogenic pain. Multiple rat models have shown decreases in early phase inflammatory markers, neuropathic pain signaling, and pain behaviors after the oral or transdermal administration of CBD.8–11 The purpose of our study was to characterize CBD consumption patterns and beliefs of patients with spine-related complaints through an anonymous cross-sectional survey.

MATERIALS AND METHODS

Study Population

This study was approved by the Institutional Review Board. A cross-sectional paper survey was administered to all patients presenting for evaluation by 1 of 9 spine surgeons at a single center in New York, New York during the month of October 2019. The survey was given to all adult patients (age ≥18 years) upon check-in for their office visit, regardless of surgical status (ie, preoperative, postoperative, or nonoperative) or region of pathology (lumbar, thoracic, or cervical). Given the continued stigma regarding the use of marijuana-related products for therapeutic purposes, the survey was administered anonymously. Exclusion criteria included non-English speakers or inability to understand or answer survey questions secondary to a medical condition (eg, dementia, history of traumatic brain injury). Surveys were completed in the waiting area or in the examination room and collected upon completion by the office staff or the nurse rooming the patient always before evaluation by the surgeon.

The survey was prefaced by an information sheet that explained the background and purpose of the study, assured that no protected health information would be collected, and that patients’ choice to participate would not impact their care in any manner. The survey was designed by the investigators, consisting of 22 multiple-choice questions, with options for free-text answers for 10 items. When applicable, patients were permitted to select more than 1 response (Appendix 1).

Demographics

Patients were asked to self-report age, height, weight, gender, state of residence, and identify an ethnicity (American Indian or Alaska Native, Black or African America, Asian, Native Hawaiian or Other Pacific Islander, White, or Other [free text]). The site of previous surgery, if applicable, was also queried (cervical, lumbar/thoracic, or not applicable).

Reasons for CBD Consumption

Participants were asked if CBD was used for pain control for one of several spine-related areas (back, neck, leg, arm, or none). Patients who responded affirmatively were asked to identify the initial reason for trying CBD and the form in which CBD was consumed. The survey also questioned participants regarding how they first heard about CBD and how they purchased CBD. CBD consumers were asked if they would “recommend CBD for pain control to a friend” (yes or no).

Timing and Effects of CBD Consumption

Questions on the timing, frequency, and effects of CBD consumption were asked. Specifically, CBD users were asked about the timing (before surgery, after surgery, before and after surgery, or not applicable) and the frequency of CBD use (0–1, 2–5, 6–10, 11–20, 21–30, or >30 times/week). Subjects that reported CBD use were asked about the beneficial and adverse side effects they experienced after CBD consumption.

Statistical Analysis

Descriptive analytics, including means, standard deviations, and proportions were used to report the data. Demographics and surgical history were compared between CBD users and non-CBD users. Categorical variables were analyzed using χ 2 tests (Fischer’s exact when appropriate); continuous variables were analyzed for normality using Shapiro Wilk’s tests and then compared using student’s t test or Mann-Whitney U tests as appropriate. All analyses were conducted using SPSS version 25.0 (IBM, Armonk, NY).

RESULTS

Out of 300 distributed surveys, 214 (71%) were completed. Average age of the patient sample was 58.0 ± 14.5 years, with an average body mass index (BMI) of 27.6 ± 5.5 kg/m 2 , and most participants identified as white (86%, 185/214) and male (58%, 123/214). Approximately a quarter of the sample (26%, 46/214) had never had surgery, 47% (100/214) had a history of lumbar or thoracic surgery, 22% (47/214) cervical surgery, and 5% (11/214) had both cervical and lumbar or thoracic surgery. CBD was used by 25% of patients (54/214). Age, BMI, gender, ethnicity, and surgical history were similar between CBD and non-CBD users (P > 0.05; Table 1 ).

See also  Cbd oil near me for sleep

Table 1

Comparison of cannabidiol users to nonusers.

CBD+ (N = 54) CBD− (N = 160) P
Age, mean ± SD, y 56.2 ± 14.7 58.6 ± 14.4 0.308
BMI, mean ± SD, kg/m 2 26.5 ± 4.2 28 ± 5.8 0.102
Gender, n (%) a 0.073
Male 25 (46.3) 98 (61.3)
Female 26 (48.1) 57 (35.6)
Ethnicity, n (%) a 0.35
White 48 (88.9) 137 (85.6)
Black 0 (0.0) 5 (3.1)
Asian 1 (1.9) 7 (4.4)
American Indian 0 (0.0) 2 (1.3)
Other 0 (0.0) 4 (2.5)
State of residence, n (%) a 0.621
New York 35 (64.8) 101 (63.1)
New Jersey 9 (16.7) 36 (22.5)
Connecticut 2 (3.7) 9 (5.6)
Other 5 (9.3) 10 (6.3)
Surgical history, n (%) a 0.117
Lumbar or thoracic 27 (50.0) 73 (45.6)
Cervical 14 (25.9) 33 (20.6)
Both 0 (0.0) 11 (6.9)
Never had spine surgery 13 (24.1) 33 (20.6)

Abbreviations: BMI, body mass index; CBD, cannabidiol; SD, standard deviation.

Among participants who reported CBD use, consumption patterns were analyzed ( Table 2 ). Most (67%, 36/54) patients reported using CBD for back pain, with 37% (20/54) using for neck pain. Approximately a quarter of patients also used CBD for potential improvements in sleep (26%, 14/54). Out of the CBD users with a history of spine surgery, 29% (11/38) used CBD before their surgery, 18% (7/38) before and after, and 53% (20/38) after surgery. Oil or tincture was the most common formulation (65%, 35/54), with topical creams (37%, 20/54) and edible methods (33%, 18/54) being the next most common. Approximately a third of patients (35%, 19/54) used more than 1 form. Most patients used CBD either 2–5 (41%, 22/54) or 6–10 (32%, 17/54) times per week.

Table 2

Patterns of cannabidiol use.

Usage n (%), N = 54
Reason for using CBD
Back pain 36 (66.7)
Neck pain 20 (37.0)
Arm pain 5 (9.3)
Leg pain 19 (35.2)
Insomnia 14 (25.9)
Mood 10 (18.5)
Timing of CBD use
After surgery 20 (37.0)
Before surgery 11 (20.4)
Before and after 7 (13.0)
Never had surgery 16 (29.6)
Method of consumption
Oil 35 (64.8)
Topical cream 20 (37.0)
Vaporized 2 (3.7)
Edible (eg, pills, candy) 18 (33.3)
Average number of times used per week
0–1 4 (7.4)
2–5 22 (40.7)
6–10 17 (31.5)
11–20 6 (11.1)
21+ 2 (3.7)
Not specified 3 (5.6)
Initial recommendation for CBD
Friend 41 (75.9)
Doctor 12 (22.2)
Advertisement 5 (9.3)
Other 2 (3.7)
Method of obtaining CBD
Friend 5 (9.3)
Online 14 (25.9)
Physical store 15 (27.8)
Prescription 11 (20.4)
Other 6 (11.1)
Not specified 3 (5.6)
Benefits experienced from CBD
Pain relief 25 (46.3)
Anxiety relief 11 (20.4)
Improved sleep 18 (33.3)
None 13 (24.1)
Adverse side effects 0 (0.0)
Agitation 1 (1.9)
Diarrhea 2 (3.7)
Fatigue 4 (7.4)
Nausea 2 (3.7)
None 46 (85.2)

Abbreviation: CBD, cannabidiol.

Nearly half of patients who used CBD experienced pain relief (46%, 25/54), a third noted improvements in sleep (33%, 18/54), a fifth reported reduced anxiety (20%, 11/54), and approximately a quarter noted no beneficial effects (24%, 13/54). Adverse effects were reported by 15% (9/54) of CBD users, consisting of agitation (n = 1 patient), diarrhea (n = 2), fatigue (n = 4), and nausea (n = 2). Most patients received the initial recommendation for CBD from a friend (76%, 41/54). Only 22% (12/54) of patients reported the initial recommendation for CBD came from a physician. Out of all CBD users, 63% (34/54) answered that they would “recommend CBD for pain control to a friend.”

DISCUSSION

In this cross-sectional, anonymous survey of 214 patients presenting for evaluation by a spine surgeon, it was found that a quarter of patients had used CBD at some point for relief of spine-related pain. This study took place in a state where recreational marijuana is illegal, and the survey participants were majority white (86%) and middle aged. Out of the patients who took CBD, three-quarters first heard about CBD from a friend, consistent with the spread of the product in popular culture. Many survey participants also heard about CBD from a physician, showing that the perceived effects of CBD are espoused by members of the medical community. While the anonymous methodology limited the ability to capture many patient-level factors, there were no demographic variables associated with CBD use. These findings provide quantitative support behind the perceived adoption of CBD by many patients with spine-related complaints.

The incidence of CBD use in this study appears consistent with similar trends in orthopaedic patient populations, as patients’ willingness to try cannabis-based medicines has followed changes in public perceptions about the substance.12,13 This study shows that patients hear about CBD from trusted sources (friends, family, and their physician). The prevalence of CBD use can only be expected to increase, especially considering that most of the CBD users (63%) in our study would recommend it to a friend. These trends have wide-reaching implications for spine surgeons. While the compound is generally well tolerated with relatively benign side effects, CBD has been associated with elevated liver enzymes and interactions with the cytochrome P450 family (responsible for metabolism of the drug), potential concerns for unaware patients.2 Furthermore, the unregulated status of CBD has led to concerns about the actual ingredients in the supplements, with several reports revealing widespread mislabeling.2,4 Though self-reported marijuana use has not been shown to affect short-term outcomes after surgeries such as lumbar fusion or knee replacement, this may not apply to CBD given its unregulated status.14,15 Surgeons must be aware of the prevalence of CBD use, potential side effects, medication interactions, and in many cases, uncertain ingredients.

This study found that the predominant reasons for initially using CBD were for potential relief of back and neck pain. Given that axial back and neck pain are 2 symptoms often refractory to various forms of conservative and surgical treatments,16,17 it would be expected that patients with these symptoms would be eager to try a novel therapy for relief. The etiology of chronic back and neck pain is multifactorial, consisting of inflammatory, neuropathic, and psychogenic components.16,17 The CB1 receptor is found in regions of the peripheral and central nervous system where pain signaling is intricately controlled, including the peripheral and central terminal of primary afferent neurons, and the CB2 receptor has been shown to modulate inflammatory signaling.18 From a pathophysiologic standpoint, there are several animal studies providing evidence for the ability of CBD to mitigate both the inflammatory and neuropathic components of musculoskeletal pain. Several studies have shown promising initial results in orthopaedic applications. One study showed decreased afferent nerve-fiber firing from a rat knee joint after topical CBD administration.8 Similarly, another study compared pain behaviors and knee joint inflammation after topical application of CBD in a rat osteoarthritis model, finding a dose-dependent response to topical CBD.9 In addition to topical application, oral CBD use has also been found to be efficacious in animal studies.10 While data in spine patients are scarce, a noncontrolled observational study of 11 patients with failed back surgery syndrome found that an oral CBD/THC combination drug provided improvements in several pain-related patient-reported outcomes, even after the failure of multiple other pharmacologic modalities.19

See also  2022 best thc cbd vape oil for back pain

Regarding the benefits of CBD use, slightly fewer than half of survey participants reported pain relief. Other benefits included improved sleep and anxiety relief, effects that may be particularly useful in the acute postoperative period, an association corroborated by past studies.20–22 Regarding the effect of CBD on pain, there are no published investigational trials on the effects of CBD alone on musculoskeletal pain, but there is low-quality evidence supporting the efficacy of THC-predominant compounds in reducing pain.14,23–27 A recent systematic review on this subject found many low-quality observational or noncontrolled studies but only 5 randomized controlled trials, only 1 of which showed a low risk of bias.25 The trials consisted of heterogeneous patient populations, orally administered, THC-based compounds, and follow-up periods ranging from 300 minutes to 14 weeks. Two of these studies demonstrated improved pain responses versus placebo, 1 showed an equivalent response to placebo, and 2 trials with active comparators (ketoprofen and dihydrocodeine crossover) showed decreased pain improvement with medical cannabis. The authors concluded that the current body of literature on medical cannabis provides preliminary evidence that cannabinoids are effective for musculoskeletal pain and that larger studies are needed to make definitive conclusions.25 Whether these beneficial effects of THC-predominant compounds translate to CBD products remains unknown.

There are numerous limitations of the current study. Most significantly, reported effects of CBD are not objective and subject to confirmation bias and the placebo effect. Given that the study is purposefully not designed to determine whether CBD is an effective treatment for spine-related complaints, conclusions about the effectiveness of CBD cannot be drawn from this investigation. Rather, this study should provide impetus for researchers to design randomized trials on the potential benefits of CBD in spinal pathologies. Second, the survey is subject to selection bias in that patients could decline participation in the survey, which could impact both the estimate of CBD use and its reported effects. Third, the survey used in the study was designed specifically for this investigation and has not been validated in other populations. Fourth, while we believe the anonymous design of the survey was useful given the stigma attached to the use of cannabis-derived compounds, this did impact our ability to make associations between patient or surgery-related factors with CBD use. Fifth, given that CBD continues to be unregulated by the FDA, the method of consumption (tinctures, edibles, or topical) and actual content of the supplements was certainly variable, making it difficult to draw generalizable conclusions about their effects. Unless the content of the CBD product is verified by a regulatory agency (eg, by the FDA or in a controlled experimental setting), this will continue to present a problem when studying the effects of CBD. Future trials will need to consider the contents and route of administration of CBD compounds, as clinical outcomes may differ based on dosage and route.9,10,25 Lastly, the findings reported in this study may be unique to this specific geographic and demographic sample, as use patterns are likely different in states or countries in which recreational marijuana is legal.12,13

CONCLUSIONS

This is the first study, to our knowledge, to examine the consumption patterns and perceived effects of CBD in patients with spinal pathology. This investigation demonstrates that CBD is a prevalent alternative therapy used by many patients with spine-related symptoms. As the popularity of the supplement is only expected to increase over time, spine surgeons must educate themselves on the evidence behind the use of CBD, understand its legal status, and be aware of the potential for mislabeling of ingredients. Surgical candidates should be specifically questioned on the use of CBD. While CBD use may be generally safe, the potential risks inherent to perioperative use of this unregulated compound (eg, possible medication interactions or unknown ingredients) must be explicitly discussed with the patient. While its risk profile remains unknown, the findings in this study provide preliminary evidence for CBD as a perceived therapeutic modality in spinal pathologies, a strong impetus to create well-designed, randomized trials to test the effectiveness of CBD.

Footnotes

Disclosures and COI: None of the authors have any conflict of interest or relevant financial disclosures.

Cbd oil for neck injury

Even in years not plagued by global pandemics, working from home, and endless video conferencing, our necks take the brunt of abuse from hunching over computers, makeshift workstations, and too many hours sitting in non-ergonomic chairs. The result? Tech Neck: stiffness, pain and discomfort radiating from the back of the head down the neck and into the shoulders. The sensation may be dull, achy, stabbing, throbbing, or may even manifest as a headache, blurry vision, or limitation of mobility. Of course, neck pain also may be an indication of injury, age-related osteoarthritis, or other potentially serious underlying medical issues. All of these should be evaluated promptly by your healthcare professional. But if you are experiencing neck pain that you suspect most likely may be due to poor posture, prolonged sitting, or way too much connectivity, you may be a victim of Tech Neck, and there’s a lot you can do to help ease the pain. Before you reach for Over-the-Counter (OTC) pain medications, non-steroidal anti-inflammatories (NSAIDs), or even physician-prescribed analgesics, anti-inflammatories or muscle relaxants, you may want to consider other options to help relieve the pain and stiffness of Tech Neck.

Add CBD Tinctures and Topicals to Your “To Do” List

Cannabidiol (CBD) continues to garner attention as an effective natural means of reducing pain and inflammation, and for good reason. While more studies are needed and many are currently underway, research and experiential evidence suggests that CBD may possess analgesic, anti-inflammatory, anxiolytic, and neuroprotective properties that may aid in resolving nagging neck pain and more. CBD derived from the hemp plant contains little or no THC, so is non psychoactive and a good choice for those who need to stay focused and functional or seek a restorative, restful sleep to survive or even impress at the next morning’s video conference.

But how does CBD work?

CBD (cannabidiol) is one of at least 100 chemical compounds unique to the cannabis sativa or hemp plant. These compounds are referred to as cannabinoids. THC (tetrahydrocannabinol) is the cannabinoid most commonly associated with marijuana. However, unlike THC, CBD is non psychoactive and has been shown to offer a myriad of wellness benefits without the “high” effect of THC. An ever-increasing number of health studies and growing experiential evidence show that CBD may be helpful in promoting calm, addressing muscle tension and soreness, and supporting the musculoskeletal, gastrointestinal, nervous, and immune systems, among other useful applications. Adding to these benefits, CBD is considered to be non habit-forming and well tolerated, making it a desirable supplement choice.

See also  Cbd oil for anxiety negative reviews

The Endocannabinoid System

Cannabinoids are naturally effective in our bodies because, throughout our evolutionary development, we have been hardwired to gain the benefits of the cannabis sativa plant through the endocannabinoid system (ECS), a complex signaling network within the mammalian body that functions as a lock and key mechanism when cannabinoids are present or introduced into the bloodstream. These receptors exist throughout the body — nervous, musculoskeletal, digestive, immune, endocrine, circulatory, respiratory, and other systems — and are the reason why cannabinoids can have such diverse and profound effects. All mammals, including humans and companion animals, have an ECS, and the body produces “endo” (internal) cannabinoids (naturally occurring substances such as anandamide) that operate to keep the body’s systems in balance. However, when an external force such as injury, illness, or stress (think 2020 here) is introduced, our body’s own endocannabinoids may be depleted, resulting in an interruption to homeostasis that can manifest as anxiety, pain, inflammation, sleep disturbance, compromised immune function, and more. CBD and related “phyto” (plant) cannabinoids are natural compounds that can supplement the body’s own cannabinoids and lock into our cannabinoid receptors to address the imbalance and restore homeostasis.

Why Trove?

Trove CBD topicals and tinctures are THC free and formulated with organically-grown USA hemp. Trove tinctures under the tongue or added to your favorite beverage provide systemic pain relief and help to calm the stress, relieve tension, and improve mental focus. Powerful Trove topical balms target specific areas of neck and shoulder pain and stiffness, release tension and muscle knots, and offer welcome and nearly immediate relief.

[SHOP TROVE]

Triple Tested, Trusted and Transparent.

All Trove CBD products are triple-tested for quality, purity, consistency and concentration. QR codes on each product package link directly to the Trove website and to the Certificate of Analysis (CoA) for that specific product batch. Want more information on how to read, understand, and interpret a CoA? Click here to read our previous blog post.

Other Tools and Tips to Tackle Tech Neck

Change your workstation. Create a more ergonomically friendly work environment by changing the position of your desk, chair, or keyboard. Even if you are relegated to WFH from the dining room table, you can prop up your laptop to create your own “standing desk”. When you resume your sitting position, use back supports and make sure you change frequently the viewing position of your screen. Utilize a warm or cool neck compress periodically as you sit or stand at your workstation.

Movers and Shakers. Every now and then, remember to stand if you’re sitting, get up and stretch, move your head and neck, shake out your arms, roll your wrists, and wiggle your fingers. When you’re sitting, remember to pull your shoulders up, around and down again in both directions. Reach both hands around and give your shoulders and neck a mini massage now and then. Remember that taking a break from your monitor does not mean you pick up your phone and start scrolling on social media! And don’t neglect the break for your eyes. Take your eyes off your monitor, your mobile phone, the mounds of paper layered with all that small print, and shift your focus. Use lubricating eye drops, keep fresh air circulating, and drink plenty of water!

Take a break from neck pain

Trove CBD Balm 750 provides fast, targeted, temporary relief from neck and shoulder strains, tight muscle knots, and minor upper and lower back discomfort including general muscle soreness.

  • Infused with THC-free hemp and other natural hydrating and therapeutic ingredients
  • 750 mg CBD per 1.7 oz jar

Trove CBD Oil 750 taken under the tongue or on food or beverage helps provide systemic relief from pain and inflammation, addressing soreness and tension and supporting improved calm and mental focus.

  • Infused with THC-free hemp in organic MCT coconut oil in choice of natural or with essential oil of lemon or peppermint to enhance therapeutic benefits and deliver exceptional flavor
  • 25 mg CBD per 1 mL dropper (750 mg CBD per 30 mL bottle)

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

Understanding CBD (Cannabidiol) for Back Pain

Cannabidiol, commonly referred to as CBD, is a new and relatively understudied treatment for pain, including back pain. Studies suggest it may help relieve inflammation, which is often a factor in chronic back pain. 1

CBD is available in many forms; topical creams and gels have shown promising results for inflammation and neuropathy, which may make them a good option for back and neck pain. 2

CBD requires more research in order to prove and explain its effectiveness as well as to better understand potential side effects (especially long-term) and potential drug interactions.

What Is CBD?

CBD oil is derived from a plant called cannabis sativa. The plant has over 100 chemical compounds, called cannabinoids, that have a range of effects, including anti-inflammatory and analgesic (pain relieving) qualities.

The cannabis sativa plant has two main varieties that are grown for specific purposes:

  • THC content. THC is the compound associated with the “high” feeling of marijuana use.
  • Industrial (non-drug) uses. This form of the plant contains trace amounts of THC (less than .03%) and can be used to make paper, clothing, and some building material. This variation of the cannabis plant is called hemp.

While CBD is present in both varieties, many of the CBD products available to consumers are from the hemp plant. CBD does not come with the high or psychogenic effects of marijuana.

Ways CBD Treats Back Pain

Research indicates that CBD may reduce back pain by:

  • Reducing inflammation 3
  • Combating anxiety, often associated with long-lasting or chronic back pain 4
  • Helping with sleep and improving overall state of relaxation 5

Some studies suggest that CBD can have an effect on how an individual perceives pain, but more robust research is needed. CBD is generally considered a full-body treatment, which means that it does not target back pain specifically—except in the case of topical products—but contributes to an overall feeling of relaxation and pain relief.

Advocates of CBD believe it can be used to treat a range of conditions in addition to back pain, such as anxiety-related disorders. 5

Potential Risks and Side Effects of CBD

Cannabidiol, even in high amounts, is generally safe. Side effects from CBD may include:

  • Drowsiness
  • Dizziness
  • Dry mouth
  • Low blood pressure

More severe side effects, while rare, include:

  • Mental confusion
  • Nausea
  • Vomiting
  • Diarrhea

As with other natural products, there is potential for adverse reactions when taken with other medications, especially those that come with grapefruit warnings, such as certain blood thinners. These warnings indicate that certain medications should not be taken with products containing grapefruit.

CBD use prior to surgery

Before having surgery, all cannabis use, including CBD and marijuana, should be disclosed to the surgeon or anesthesiologist. A recent study suggests that cannabis use may have an effect on medications used to sedate patients. 6