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How much cbd oil for acute pain

What Dosage of CBD Should You Take?

Kendra Cherry, MS, is an author and educational consultant focused on helping students learn about psychology.

Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH).

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CBD is available in a number of different formulations including creams, tablets, oils, and gummies. These can vary in terms of their ingredients as well as dosages, and there is not a great deal of research available on what dose might be beneficial or safe to treat certain conditions.

Cannabidiol (CBD) is the second most abundant cannabinoid found in marijuana. Unlike tetrahydrocannabinol (THC), CBD does not have psychoactive effects. Interest in the use of CBD for health purposes has grown tremendously in the last few years.

CBD is believed to have a range of positive physical and mental health effects. Because of this, it has become increasingly popular as a way to alleviate everything from anxiety to sleep disorders.

In order to determine if CBD is right for you, it is important to consider its potential benefits, side effects, and available research on safe dosages.

Possible Benefits

CBD is just one of hundreds of different compounds found in the cannabis plant. While cannabis has been used in holistic medicine for many years, only recently have researchers begun to explore some of the medicinal purposes for CBD and other cannabinoids.

While further research is still needed, there is some evidence that CBD may have some beneficial mental health effects. These include:

  • Alleviating depression: Some research also indicates that CBD may be useful as a treatment for depression. Studies suggest that the cannabinoid might have an influence on how the brain responds to serotonin, a neurotransmitter that plays a key role in mood. People with depression sometimes have a low level of serotonin, so CBD may help the brain use available serotonin more effectively.
  • Improving sleep: While the reasons are not entirely understood and require further research, CBD also appears to have potential as a treatment for sleep problems. For example, one study found that people who took CBD also reported improvements in the quality of their sleep.
  • Reducing anxiety: Anxiety is one of the most common types of mental health conditions, affecting almost 20% of American adults each year. Research suggests that CBD may help alleviate acute symptoms of a number of anxiety-related conditions including generalized anxiety disorder, obsessive-compulsive disorder, and social anxiety disorder.

In addition to the mental health benefits, CBD may also have therapeutic benefits for a range of other conditions. The World Health Organization suggests that CBD may have beneficial effects in the treatment of:

  • Alzheimer’s disease
  • Arthritis
  • Cardiovascular disease
  • Diabetes
  • Infection
  • Inflammation
  • Multiple sclerosis
  • Nausea
  • Pain
  • Psychosis

It is important to remember that these benefits have not yet been conclusively proven. More research is needed to determine the role that CBD might play in the treatment of different disorders and health conditions.

Research

There have been a number of studies that suggest that CBD may have a number of different physical and mental health uses. However, more research is still needed to better understand the substance’s potential applications and possible long-term side effects.

A 2019 comprehensive review published in The Lancet Psychiatry looked at previously published studies. The review ultimately concluded that there was little evidence to support the use of CBD for mental health purposes and suggested that more research is needed in order to substantiate its use to treat symptoms of conditions such as anxiety, depression, and insomnia.

It is important to remember that this doesn’t mean that CBD isn’t effective. Many of the studies that were included in the review were small, had few participants, and were not randomized controlled trials.

This suggests that more research involving more participants and well-designed studies is needed in order to better understand if, how, and why CBD works.

While its effectiveness is still up for debate, one 2017 review found that it was a relatively safe option.   While it is important to remember that there is still a great deal we don’t yet know about CBD and its effects, it is something that you might opt to try to see if you experience any benefits.

How Much Should You Take?

The dosages used in research studies vary and there is no consensus on how much should be used for specific conditions. If you do decide to try CBD, it is also important to note that there is no universally agreed upon dose. Research also suggests that people may respond differently to various dosages, so the amount that is right for your needs might vary.

CBD Dosages

Some dosages that have been used in research studies for different conditions include:

  • Anxiety: 300 to 600 mg
  • Bowel disease: 10 mg per day
  • Cancer-related pain: 50 to 600 mg per day
  • Parkinson’s disease: 75 to 300 mg per day
  • Poor sleep: 25 mg per day
  • Psychosis: 600 mg per day

One 2020 review of studies found that participants showed improvements in anxiety levels after single doses of CBD ranging from 300 to 600 mg.   Such results indicate that the CBD may hold promise as a treatment to alleviate symptoms of acute anxiety.

It is important to remember that you should always talk to your doctor before using CBD if you have symptoms of a serious mental or physical health condition. CBD could potentially worsen symptoms or interact with other medications you are taking.

Looking at the dosage information for the CBD product that has been FDA approved can also be helpful. For Epidiolex, an FDA-approved cannabis-derived medication used to treat seizures in people with certain types of epilepsy, the starting dosage is 5 milligrams per kilogram of body weight. This dose can later be increased to 5 mg per kilogram of body weight twice a day.

Other CBD products are not FDA regulated and do not have officially recommended dosages. This can make it difficult to determine how much you might need, but there are some things you can consider that might help.

  • Assess your sensitivity to CBD: Your individual ability to tolerate CBD can also play a role in determining how much you need. If you are very sensitive to the effects of CBD, you should take a small dose. Some people may find that they are not as affected by the substance, so they may need to take a larger dose to notice any beneficial effects.
  • Consider individual factors: When you are trying to decide how much CBD to take, there are a number of factors you should consider. These include the formulation and concentration of the capsule, oil drops, or gummies you are taking, the symptoms you are treating, and your age, sex, weight, and overall health. Generally, people with heavier bodies need to take a little more to achieve the same effects. Men may need a larger dose, while older people may need less.
  • Consider the symptoms you’re treating: The symptoms you are trying to alleviate can also play a role in the CBD dosage you need to take to see results. In one study, participants who took 25mg of CBD each day had improved sleep quality, although the results were not consistent.   However, you might find that you need a lower or higher dose if you are treating another type of condition.
  • Try a dosage calculator: Researchers note that while the variety of dosing strategies and formulations make it difficult to determine efficacy, there are a number of online “dose-calculators” available online (such as mydosage.com) that are designed to help people choose the correct dose.   The accuracy of such calculators is difficult to assess, but it may be a good place to start.

Before you try CBD, discuss your plan with your doctor. They may be able to recommend a dose and help you better understand any potential risks, complications, side effects, or interactions you might experience.

Start With a Low Dose

Unless your doctor recommends a specific dose, start by taking 10 to 20 mg a day. Take this for a week to ensure that it is well-tolerated and that you don’t experience any unwanted effects or an allergic reaction.

If this dose does not have the desired effect, try increasing in increments of 5mg each week until the desired amount is reached.

In studies, amounts vary from as low as 20 milligrams per day to up to 1,500 milligrams (mg) per day. The World Health Organization reports that dosages in clinical research studies typically range between 100 and 800 milligrams per day.  

Is It Possible to Take Too Much?

So what is the maximum amount of CBD you should take? Researchers have found that 600 mg per day appears to be safe, but one study suggested that doses of up to 1,500 mg a day are safe and tolerated well.

However, it’s important to remember that research is still in its infancy and experts do not yet fully understand the potential long-term impacts of CBD usage. For that reason, you should always discuss your CBD use with your doctor.

Starting at a lower dose and working your way up to the amount you need may be the best ways to avoid taking too much.

How to Take CBD

The amount of CBD found in a product may depend on different factors, including the formulation and method of administration. CBD products are available in a number of different forms including oils, capsules, tablets, nasal sprays, and gummies.

One of the most popular ways to take CBD is as an oil. Such products are made by combining CBD with some type of carrier oil, such as coconut oil. Some more recently developed products include dietary supplements, foods, beverages, lotions, salves, and cosmetics.

The type of CBD product you choose may depend on what you are trying to treat. If you are looking for general mood improvements, a dietary supplement might be a good option.

If you are targeting specific symptoms of a condition, taking an oil, capsule, or gummy might be a better way to obtain a higher, more concentrated dose.

Topical applications may produce localized effects, but they are unlike to have any mental health benefits.

What Kind Should You Take?

It’s also important to remember that many products don’t contain just CBD on its own. There are three types of CBD available:

  • Isolate contains CBD and only CBD.
  • Broad-spectrum contains CBD and other cannabinoids, but not THC.
  • Full-spectrum contains CBD, THC, and other cannabinoids.

It may be helpful to take a broad-spectrum product since research suggests that CBD’s effects may be most beneficial when taken in conjunction with other cannabinoids, a phenomenon known as the entourage effect. CBD may also help mitigate some of the effects of THC.

Side Effects

While CBD is generally well-tolerated, this does not mean that you won’t experience any side effects.

Some of the most common side effects that people experience when taking CBD include:

  • Appetite changes
  • Diarrhea
  • Nausea
  • Dizziness
  • Stomach upset
  • Weight changes

Some recent research has generated concerns over the safety and potential long term effects of CBD. One study involved giving mice an equivalent of the maximum dose of the CBD medication Epidiolex, which is used to treat certain forms of epilepsy. The results indicated an increased risk for liver damage as well as concerns over its interaction with other medications.  

Safety

It is also important to remember that CBD products are not regulated by the U.S. Food and Drug Administration (FDA). Some manufacturers make unproven claims about the uses and efficacy of their products. There is also concern about the quality and safety of the products themselves.

One report by the Centers for Disease Control and Prevention (CDC) indicated that a number of people experienced negative unwanted side effects due to CBD products that contained synthetic CBD, although the products were not labeled as containing such ingredients.

Mislabeling appears to be a fairly common problem with CBD products. In one study, 70% of the CBD products that were sold online contained significantly more of the psychoactive ingredient THC than the label indicated.

Federal law prohibits the sale of products that contain more than 0.3% THC. States laws also vary, so you should always check with your state before buying CBD products online.

A Word From Verywell

If you do decide to take CBD to alleviate an acute or chronic condition, remember that the amount that you take will depend on a variety of factors. Finding the right dosage often takes some experimentation and adjustments. Starting with a low dose and then gradually increasing the amount you take until you achieve the desired effects is the best approach.

CBD Dosage: What’s the Right Dose of CBD for Pain Relief?

Take a look at the label on any over-the-counter pain reliever and you can easily figure out how much you’re supposed to take for your symptoms. Finding the right dose of cannabidiol (CBD) for pain relief, however, isn’t that simple.

Enthusiasts rave about CBD’s potential to ease pain, reduce inflammation, relieve anxiety and promote sleep. However, there’s no conclusive research about just how much CBD a person needs to take in order to experience benefits.

There are very few human studies on CBD, and those that have been done include doses that are all over the map: In some studies, patients used 5 mg of CBD; in others, they took as much as 600 mg. To further add to the confusion, CBD comes in a number of forms — oils and tinctures, creams and lotions, pills, vaping, and edibles — and each one has differences in terms of bioavailability (the percent of active ingredient that gets into your bloodstream).

“There are no standard doses for patients,” says Rachna Patel, DO, a physician who does consultations about medical marijuana and CBD and sells her own line of CBD products. “Ultimately, it’s trial and error, but you have to go about it in a methodical way.”

Here are some tips to guide you on how to find the right CBD dosage for your pain relief and other symptoms.

1. Work with an expert

Many factors, such as your body mass index (BMI), specific health condition(s) you have, medications you take, your health history, and the form of CBD you plan to use can influence how much CBD you may need to treat your symptoms. Although CBD is different than medical marijuana — which contains CBD as well as THC, an intoxicating ingredient — a doctor who’s well-versed in cannabis (marijuana) is probably the best person to help you help you sort it out.

“I wouldn’t recommend starting CBD without the supervision of a physician,” says Dr. Patel, author of The CBD Solution. “Many times people purchase a CBD product, try a dose that that doesn’t work for them, switch products and spin their wheels. Or, worse, they develop side effects.”

Ask your rheumatologist or primary care provider to recommend an expert, or find an expert near you by searching the directory of members of the Society of Cannabis Clinicians or the database maintained by your state’s medical marijuana program (if it has one).

2. Do some math

Let’s say you and your doctor settle on a dose of 30 mg of CBD per day. Now what? The answer depends on which form of CBD you take.

Figuring out how much CBD is in capsules or gummies is simple — just read the supplement facts section on the label. (If it says 10 mg of CBD per capsule, you’d take three capsules to get your 30 mg of CBD a day.)

Oils and tinctures can be trickier because the packaging often states the amount of CBD in the entire bottle, not in a dropper. This calculator can help you figure out how many drops you need based on the strength of the product.

When it comes to CBD in topical form (creams, lotions, and salves), you’ll probably see the total amount of CBD in the container listed on the label. You’ll then have to divide that total by the number of millimeters in the package to determine how much is in each milliliter. For example, if you have a 50 ml jar of salve that contains 200 mg of CBD, there’s 4 mg per ml. You should then use a metric measuring spoon to scoop out 7.5 ml to get a 30 mg dose of CBD.

3. Expect some trial and error

No two patients respond to CBD in the same way. You and your doctor will probably need to adjust the dose either up or down until you hit the right balance of benefits without side effects. “A lot of it depends on your biochemistry and the way your liver breaks down these chemicals. There’s a wide variety of factors that come into play,” says Dr. Patel.

It can take a little while to get it right, so be patient. Many people do not see a difference in symptoms after one or two doses of CBD. It can take up to eight weeks of regular use to feel an impact, says Bridget Seritt, co-founder of the Canna-Patient Resource Connection, a Colorado-based organization that is working to protect patient rights and end stigma against those who choose cannabis as medicine.

4. If you have side effects, stop or lower the dose

CBD won’t get you high the way that cannabis with THC can, but it may still cause side effects. “The most common side effects are fatigue and lethargy, and in rare cases diarrhea,” says Dr. Patel, who notes that CBD that’s taken topically less commonly causes side effects. Topical CBD is best used to address pain in a single joint, rather than widespread pain, she adds.

No matter which form of CBD you use, pay attention to how you feel. If you notice any negative side effects, stop or lower the dose and consult your doctor.

How To Use CBD To Help Manage Pain

Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.

Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Table of Contents

  • CBD for Pain Relief
  • CBD for Chronic Pain
  • CBD for Arthritis and Joint Pain
  • CBD for Neuropathic Pain

Without the intoxicating properties of its cousin delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD) can provide the human body with a handful of health benefits. Cannabinoids like CBD interact with receptors in the endocannabinoid system, which plays a role in signaling bodily functions, from emotional responses to motor control to energy balance [1] Mouslech Z, Valla V. Endocannabinoid system: An overview of its potential in current medical practice. Neuro Endocrinol Lett. 2009;30(2):153-179. .

Over the last two decades, scientists have tested CBD’s efficacy as an analgesic, or painkiller, specifically—and with promising results. While research is ongoing, here’s what we know so far about how we can use CBD oil for pain relief.

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CBD for Pain Relief

For now, no CBD-based medications are approved as painkillers in the U.S. Epidiolex, which is used for rare forms of epilepsy, is the only CBD treatment approved by the Food and Drug Administration (FDA).

Meanwhile, several countries have approved CBD to treat certain conditions. For instance, the U.K. approved it for multiple sclerosis, and Canada approved it for cancer pain. Ongoing research suggests CBD oil for pain can aid medical conditions, including arthritis and fibromyalgia, at varying doses. Some pain may not be treatable by CBD alone, but it can help when paired with THC or Western medication applications.

Interestingly, 60% of U.S. adults who use CBD products do so for its potential pain-relieving effects, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.

What’s more, 60% of U.S. adults have tried CBD and believe it has medicinal benefits.

CBD for Chronic Pain

Chronic pain is defined as any pain lasting longer than several months. Studies have found CBD, often alongside THC, to be an effective pain reliever for various chronic conditions.

In clinical trials, Sativex, a spray with equal parts CBD and THC, proved significantly successful as an analgesic for cancer-related pain [2] Russo EB. Cannabinoids in the management of difficult to treat pain. Ther Clin Risk Manag. 2008;4(1):245-259. . The spray, also used for multiple sclerosis-related pain, is approved in Canada to treat cancer pain and is currently undergoing trials for approval and use in the U.S.

A 2019 study found Sativex to be an “effective and well-tolerated add-on treatment” for patients with severe chronic pain stemming from various ailments. The study identified three types of pain: nociceptive (affecting body tissue), neuropathic (affecting nerves) and mixed pain. Sativex helped treat all three kinds but proved especially effective against neuropathic pain.

An earlier study also found CBD to be effective in chronic pain relief for conditions like multiple sclerosis and spinal cord injury, although across a much smaller sample size [4] Wade DT, Robson P, House H, Makela P, Aram J. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clin Rehabil. 2003;17(1):21-29. .

CBD for Arthritis and Joint Pain

Arthritis is a broad term that encompasses hundreds of joint-related conditions and pains. Common symptoms include swelling, pain and stiffness in the joints and may progress over time.

Already a proven analgesic for other conditions, CBD shows promise as an anti-inflammatory substance in both animal and preclinical trials, which bodes well for arthritis treatment [5] Nichols JM, Kaplan BLF. Immune Responses Regulated by Cannabidiol. Cannabis Cannabinoid Res. 2020;5(1):12-31. [6] Mlost J, Bryk M, Starowicz K. Cannabidiol for Pain Treatment: Focus on Pharmacology and Mechanism of Action. Int J Mol Sci. 2020;21(22):8870. [7] Kosgodage US, Mould R, Henley AB, et al. Cannabidiol (CBD) Is a Novel Inhibitor for Exosome and Microvesicle (EMV) Release in Cancer. Front Pharmacol. 2018;9:889. [8] Lowin T, Tingting R, Zurmahr J, Classen T, Schneider M, Pongratz G. Cannabidiol (CBD): a killer for inflammatory rheumatoid arthritis synovial fibroblasts. Cell Death Dis. 2020;11(8):714. . However, clinical research dedicated to CBD administration for arthritis is less robust and ongoing.

The first controlled trial conducted in 2006 focused on patients with rheumatoid arthritis, an autoimmune disease that causes inflammation in the joints and other affected areas [9] Blake DR, Robson P, Ho M, Jubb RW, McCabe CS. Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology (Oxford). 2006;45(1):50-52. . Researchers found that, compared to a placebo, Sativex significantly improved participants’ pain during movement, pain at rest and quality of sleep. Any adverse reactions to the treatment were mild or moderate, and there were no complications with withdrawal.

In 2018 researchers tested the efficacy of topical CBD gel on participants with osteoarthritis-related knee pain over the course of 12 weeks [10] Hunter D, Oldfield G, Tich N, Messenheimer J, Sebree T. Synthetic transdermal cannabidiol for the treatment of knee pain due to osteoarthritis. Osteoarthritis and Cartilage. 2018;26:S26. . Participants used either 250 milligrams or 500 milligrams, split into two applications, daily. Overall, participants’ weekly pain levels didn’t improve much with CBD compared to placebo. However, when researchers evaluated the average weekly worst pain scores and Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical function scores, participants who applied 250 milligrams of CBD daily experienced significant improvement over placebo participants.

Meanwhile, a small 2019 trial suggests a mix of CBD and THC may prove beneficial for people with fibromyalgia, a type of arthritis that results in whole-body pain and fatigue [11] van de Donk T, Niesters M, Kowal MA, Olofsen E, Dahan A, van Velzen M. An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain. 2019;160(4):860-869. . The study found that, via a single inhalation, a CBD-THC solution performed better than a placebo and either substance on its own.

CBD for Neuropathic Pain

Various conditions and injuries that damage nerves or the nervous system can result in neuropathic pain. This kind of pain manifests as tingling, numbness, muscle weakness and a sharp, shooting, burning or stabbing pain.

Multiple sclerosis (MS) is a common cause of neuropathic pain. The disease wears down myelin, a mixture of proteins and phospholipids that coats nerve cells. Sativex is already approved as an MS treatment around the world due to its success in clinical trials. As a spray, Sativex is absorbed in the mouth. Studies support a median dose of eight sprays a day for patients with MS, which provides about 20 milligrams of CBD and 21.6 milligrams of THC [12] Sativex Oromucosal Spray – Summary of Product Characteristics (SmPC). Datapharm. Accessed 7/9/2021. . However, doses vary between patients, and each person needs to find their optimal dose.

A 2020 study also tested topically administered CBD oil as a treatment for patients with peripheral neuropathy, or damage to the peripheral nervous system, which sends information throughout your body from the central nervous system [13] 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. . When compared to placebo, the topical CBD significantly reduced patients’ intense pain and sharp pain, as well as cold and itchy sensations.