The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities
Background: Peripheral neuropathy can significantly impact the quality of life for those who are affected, as therapies from the current treatment algorithm often fail to deliver adequate symptom relief. There has, however, been an increasing body of evidence for the use of cannabinoids in the treatment of chronic, noncancer pain. The efficacy of a topically delivered cannabidiol (CBD) oil in the management of neuropathic pain was examined in this four-week, randomized and placebocontrolled trial.
Methods: In total, 29 patients with symptomatic peripheral neuropathy were recruited and enrolled. 15 patients were randomized to the CBD group with the treatment product containing 250 mg CBD/3 fl. oz, and 14 patients were randomized to the placebo group. After four weeks, the placebo group was allowed to crossover into the treatment group. The Neuropathic Pain Scale (NPS) was administered biweekly to assess the mean change from baseline to the end of the treatment period.
Results: The study population included 62.1% males and 37.9% females with a mean age of 68 years. There was a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group when compared to the placebo group. No adverse events were reported in this study.
Conclusion: Our findings demonstrate that the transdermal application of CBD oil can achieve significant improvement in pain and other disturbing sensations in patients with peripheral neuropathy. The treatment product was well tolerated and may provide a more effective alternative compared to other current therapies in the treatment of peripheral neuropathy.
Keywords: CBD; cannabis sativa; diabetic neuropathy; hemp; nerve pain; review..
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The 5 Best CBD Topicals For Pain Relief (Plus 2 Highly Effective THC Balms)
But I don’t engage in physical activity solely because of my woefully wobbly midsection. My sanity depends on it. Truly. In the immortal words of Elle Woods: Endorphins make you happy!
In my early thirties I dabbled in SoulCycle, swimming at the 14th Street Y, and three disastrous attempts at SLT. These days it’s running loops in Central Park, Y7 yoga, and contact combat. And let me tell you, hitting a weekly fitness goal isn’t always easy—especially when you’re rapidly approaching your 40s with a few minor injuries under your belt.
I’m no spring chicken and the occasional bout of soreness is now a fact of life.
So recovery is a big deal. And personally, I’m all about CBD (a.k.a cannabidiol)—the non-psychoactive compound in cannabis. It’s been having a moment these past few years, making appearances in all sorts of wellness and beauty products—from CBD edibles, to capsules, to transdermal patches, and beyond. But make no mistake. It’s not the passing health trend that activated charcoal and golden milk used to be.
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“CBD is extremely anti-inflammatory and neuroprotective. A normal person may use it to prevent conditions such as arthritis or even topically to prevent acne breakouts,” Dr. Shivani Amin, a physician and cannabis expert who is a member of the AMMPA (American Medical Marijuana Physicians Association), says. “I think CBD shows great promise for the future. It all boils down to educating the public about the correct usage and understanding the plant better.”
I’ve long been a fan of edibles and tinctures, but for those who are skeptical of ingesting it, I’m also a big believer in topicals. From lotions and creams to balms and bath bombs, I have experimented with many different kinds—and I’ve come to rely on them for localized pain and reducing inflammation.
But as with any CBD product, there’s no skeleton key that unlocks relief for everyone—you have to find what works for your body. And you certainly have to experiment with different products, brands, and dosages—it’s the only way for you to see which ones really work.
Just know that topicals, unlike edibles, serve a different purpose: They’re primarily for targeted surface areas to address tension, spasms, and muscle pain because CBD applied to the skin doesn’t reach your bloodstream. Think of it as spot treating problematic areas. For instance, if your lower back is shot, apply your preferred product to that area only.
One thing to note, though: Only buy from established brands from licensed dispensaries—not random bodegas, sketchy websites, so-called health food stores, or even Amazon. Always ask for COAs (Certificates of Analysis) to ensure that the topical actually contains the cannabinoids it claims to have. And have an open mind about using CBD topicals incorporated with THC—because those two cannabinoids combined are more effective when addressing inflammation, which is the primary cause of soreness and pain.
“I have treated many patients with chronic conditions with full spectrum CBD and attained great results,” Dr. Amin says. “I also believe the public needs to understand that CBD works in conjunction with THC. Usually this requires at least 3–5% THC to work for serious forms of pain and more chronic medical conditions. I have patients come in with chronic and severe pain expecting to have their pain alleviated with just CBD. Although CBD works well for pain, in many situations patients with severe pain need to have some THC. [The cannabinoids] work synergistically to help ease severe pain.”
Here’s what I have found most effective over the years.
WILDFLOWER CBD COOL STICK (300MG; $60)
Wildflower was my inaugural topical. At the time, I had just started learning Krav Maga—a rather intense Israeli contact combat sport where there are no real rules. (Except to survive.) And my body was sore all the time those first few months. It didn’t help that I’ve got this existing and highly-bothersome back condition. I was also running a few times a week. But Wildflower’s CBD Cool Stick, which conveniently comes packaged as a roll-on, helped me tremendously. The trick is to apply the cooling stick before your workout or any other physically strenuous activity—not after. Why? Because in my experience, sweat reactivates the cooling components of the Wildflower’s formula. A six–mile run is infinitely more pleasant when you feel the the cream working even when you’ve got a ways to go. Also note that the brand also carries a Healing Stick (500mg) for $75. But it’s got arnica and I’m not exactly fond of the odor it emits through my clothes. However, if you do like arnica-scented everything, go for it.
POPULUM COLD THERAPY HEMP RUB (100MG; $45)
Unlike Wildflower, Populum comes in gel form. Also: It’s artic. Kind of like a more aggressive Vick’s Vaporub—so much so that you will definitely need to wash your hands after application. (The last thing you need is to accidentally rub your eyes with that stuff still on your digits.) But it’s effective—despite its relatively low dose of CBD. And a little goes a long way. Use it for minor aches and inconveniences—like when you find yourself stiff because you’ve been sitting on your far-from-ergonomic work chair most of the day. And if you find yourself really hurting, I recommend using a topical that contains both THC and CBD. (More on that below.)
LORD JONES + TAMARA MELLON HIGH-CBD FORMULA STILETTO CREAM (200MG; $70)
This is every woman’s dream come true. High heels are just not made the way they used to be—stilettos these days are narrower, higher, and pointier. Remember: Louboutin does not concern himself with the comfort of his designs. (He said so himself in the documentary and several other news outlets.) Gone are the days of the sensible heels our grandmothers wore. But alas, sky–high footwear is a necessary evil. So Lord Jones, the wildly–popular CBD company, collaborated with Tamara Mellon to help ease that discomfort. Just dab a little solution onto your feet and wait for your skin to absorb the formula before putting on your four–inch torture device.
BASKIN BODY WELLNESS CBD CREAM (400MG; $60)
Baskin has a lower–dose formula that clocks in at 150mg CBD that costs $20 less. But I say, Go big or go home. Invest in the higher dose if you want real relief all over: It’s meant to be used all over the body versus its cousin, which was specifically created for smaller targeted areas. Beyond that, you can always use the 400mg cream the way you see fit: Nobody is going to stop you if you want to use it only in specific pain points.
ONYX + ROSE BROAD SPECTRUM CBD BLISS BALM (500MG; $54)
This high–dose balm seems to be a crowd favorite, certainly in my household. The jar itself contains two ounces of product. It doesn’t seem like much—But because the consistency of the cream is particularly smooth and spreadable, it glides easily onto the skin and covers more real estate. In terms of relief, you can expect gradual relaxation of the muscles—especially if you’re prone to spasms or simply incredibly tight.
BASKIN GLOW (50MG THC + 500MG CBD; $80)
Now this is where we change course. Serious athletes and people suffering from chronic pain will benefit from this lotion. And yes, it’s in a jar but it rubs on like an incredibly light lotion—not at all like a heavy body butter. The main difference is that it contains both THC (tetrahydrocannabinol) in addition to CBD. And that’s a good thing. Both cannabinoids work synergistically together: THC will open up your receptors, enabling your body to absorb and metabolize more CBD. Beyond that, Glow is applied somewhat differently than the rest of the products on this list. Apply a minuscule amount to your pulse points, the insides of your elbows, and the backs of your knees—areas where the skin is at its thinnest. The reasoning: Because of its formula and consistency, your body will absorb the product so that it reaches your bloodstream—unlike many other topicals.
DIXIE SYNERGY RELIEF CBD AND THC BALM (50MG CBD + 50MG THC; $45)
I’m a huge fan of Dixie’s edibles, particularly its Birthday Cake White Chocolate and root beer elixir. But the cannabis company also does a damn fine job with its Synergy CBD and THC combo balm. It’s what I reach for whenever I’m too achy and cannabidiol alone just won’t cut it. It all boils down to the fact that the presence of THC opens up receptors in our bodies to allow for greater CBD absorption.
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:
- Dry mouth
- Low blood pressure
More severe side effects, while rare, include:
- Mental confusion
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