If you’re an active person who gets occasional aches and pains, you’ve probably relied on topical pain relief at some point. Maybe you’ve heard that CBD is good for pain, and CBD topicals are all the rage these days–but do they actually work?
The short answer is maybe–assuming that you choose the correct product. But with so many CBD products and topicals on the market, how do you know which works the best?
But first, why would you use a CBD topical in the first place?
When it comes to pain relief, you have some options. However, it all depends on the type of pain or injury, along with your own preferences–while some people don’t mind popping several pills every four hours, others may prefer local options like patches, lotions, or gels.
Most pain relievers have inherent tradeoffs, however: Ibuprofen and Tylenol just aren’t enough sometimes. Opiates are great for the short term, but hard to get and not so great in the long term thanks to dependence issues and dangerous side effects. Other topicals, which have strong odors and sometimes unpleasant sensations, aren’t even true pain relievers–they rely on the placebo effect.
CBD is different than other pain relievers and unique among topicals. Below are just a few reasons why a high-quality CBD topical might be the best choice for your pain:
- Shown to be effective for both acute and chronic pain
- Works locally, targeting discomfort at the source
- By not reaching the bloodstream, most drug interactions are avoided
- No risk of psychoactivity
- Utilizes different pain pathways than other pain relievers
- Can help relieve stress that’s stored in the body
- Formulas that penetrate the skin pair well with soft tissue work and aid recovery
What is CBD and how does it work?
CBD topicals are different from other topicals such as IcyHot or Aspercream, because they contain cannabidiol, otherwise known as CBD. In order to understand how these products work differently, let’s look at CBD closer.
The Endocannabinoid System
Your body has an extensive system for regulation and homeostasis called the endocannabinoid system (ECS). This system performs many functions, but one of its jobs is to respond to and regulate pain signals. It does so by using molecules naturally found in the body called endocannabinoids–”endo-” meaning originating within the body, and “cannabinoid”, referring to the cannabis plant that led to the system’s discovery.
The ECS can also utilize exogenous cannabinoids, or cannabinoids found outside the body, for pain relief and other functions. CBD, or cannabidiol, is a phytocannabinoid, a plant-based cannabinoid molecule found within the cannabis plant. Research has shown that CBD can be effective for pain relief, both by reducing pain signals from the brain as well as reducing inflammation.
How CBD works to relieve pain
CBD can be used for pain relief in multiple ways, such as smoking or vaping, oral consumption, or absorbed sublingually in the tissues of the mouth. However, all of these routes represent systemic administration, meaning it circulates in the bloodstream and reaches the entire body, sometimes unnecessarily. But CBD can also be used locally at the site of pain by use of a CBD topical.
Other topicals that don’t contain CBD don’t actually even relieve pain; they’re “counter-irritants,” actually designed to mask the pain with a different (usually cool, tingly) sensation. CBD topicals are different; they penetrate the painful tissues and nerves and act on actual pain signals rather than simply distracting from the pain.
Not all CBD topicals are the same
Since extracting raw CBD from cannabis is a fairly simple process, that means there are lots of lots of topical products claiming to contain CBD. But while they might actually contain CBD, there’s more to the process than adding CBD to a lotion and claiming that it relieves pain.
Because of the chemistry of CBD, it needs to be formulated in a certain way for it to do you any good for pain or anything else. When designing a topical product utilizing CBD, you need to ask the following questions: does it penetrate the top layers of the skin and into the affected tissue? If it does, does it stay in the tissues long enough to be effective? And most importantly, does it actually help relieve the pain?
Check the data: penetration, persistence, and power
These days, more and more people are embracing the power of data, especially when it comes to products you’re putting in your body. Likewise, the best products recognize this and will often display science-backed claims either directly on their products or on the product’s website. If you want a CBD topical that’s effective at relieving pain, it’s worth doing a little digging (or at least checking the label). For an effective CBD topical, these are the targets it needs to hit.
It penetrates the skin
Other kinds of topicals, such as those that use the aforementioned counterirritants, have no need to absorb deep into the skin–they perform their action on the top layer of the epidermis (hence the name “topical”) or the outermost layer of skin. But for CBD topicals to work, they need to go deeper.
In fact, CBD pain lotions technically need to be transdermal, not just topical. As the name suggests, the “transdermal” route of administration penetrates through the epidermis and into the dermis, the deeper layers of skin. In the case where CBD is the active ingredient, it’s critical that CBD absorb deep into the painful muscles and joints.
Delivering medicine through the skin requires a special formulation. On their own, CBD molecules tend to clump together forming clumps too large to absorb through the epidermis. Most transdermal methods involve separating the CBD molecules into micro-vesicles, essentially creating a tiny bubble around each molecule of CBD. Sometimes combined with other ingredients that increase the permeability of the skin, the encapsulated CBD can absorb deeper into the skin and tissue.
While extracting CBD itself may be simple, formulating it to make it effective is not and requires special knowledge, skills, and equipment. If you want to make sure a product contains CBD that will penetrate the skin, look for one that’s been tested, such as via the Franz diffusion cell test, used to measure the effectiveness of transdermal medicines.
The CBD (and the pain relief) persists in the tissue
The next factor to check is whether the CBD topical is formulated to be retained in the skin. Once the modified CBD has absorbed through the layers of the skin and into the tissue, it needs to stick around for a while to be effective. Pain relief that’s delivered all at once and then quickly fades isn’t very efficient pain relief.
Again, it comes down to formulation. Much like time-release oral medications, transdermal products can be designed to release their active ingredients steadily over time, providing more even pain relief that lasts longer.
To ensure your CBD product actually persists and remains in the tissue where it can do its job, check for things such as “time-release,” “slow-release,” or similar on the product, or check the product’s website for skin retention or permeation tests or data.
It has the power to heal
Scientific claims on products are well and good, but they can also be misleading. For example, a claim might be perfectly valid, while not telling the whole story of the product; just because a certain molecule or ingredient has been “proven” to work in general, does not necessarily mean it will work within that specific product.
This brings us to arguably the most important claim of all–does the product itself (not just its individual ingredients) actually do what it says it can do? In terms of a CBD topical, it may penetrate the skin and it may be present in the skin a day later, but how much does it ultimately relieve the pain?
These days, as consumers, we recognize the power of social proof–all claims aside, what do the actual user experiences say about the product? That’s why there’s arguably no better measure for this kind of product than a simple survey of consumers–what do they have to say about how the product relieved pain, either overall or compared to other products?
Many people rely on reviews and testimonials to determine whether a product is worth the investment, and these are often a great source of information. However, the process isn’t always completely unbiased–some companies will offer products at a discounted rate in exchange for a positive review, for example.
An even better measure of a product’s efficacy are actual scientific trials, which are much less prone to bias.
For CBD topicals, a trial might have participants rate their initial pain before using the product, and then following up after a period of time to measure how much their perceived level of pain decreased. Other trials may compare the pain-relieving power of multiple CBD topicals to see which worked the best. While not everybody responds to pain relievers in exactly the same way, a product with proven pain-relieving power is probably a better bet than untested competitors.
The bottom line
CBD pain relievers are everywhere these days, but unless you do your due diligence, you might be throwing your money down a rathole. If you want real pain relief, be sure the product you choose crosses off the 3 P’s of CBD topicals–penetration, power, and persistence.
References
Bartosova, L., & Bajgar, J. (2012). Transdermal Drug Delivery In Vitro Using Diffusion Cells. Current Medicinal Chemistry, 19(27), 4671–4677. https://doi.org/10.2174/092986712803306358
Cannify. (n.d.). What is the difference between topical and transdermal? Retrieved July 1, 2021, from https://www.cannify.us/education/faq-cannabis-education/what-is-the-difference-between-topical-and-transdermal/
Counterirritant – an overview | ScienceDirect Topics. (n.d.). Science Direct. Retrieved July 1, 2021, from https://www.sciencedirect.com/topics/neuroscience/counterirritant
Guindon, J., & Hohmann, A. (2009). The Endocannabinoid System and Pain. CNS & Neurological Disorders – Drug Targets, 8(6), 403–421. https://doi.org/10.2174/187152709789824660Raypole, C. (2019, May 17). A Simple Guide to the Endocannabinoid System. Healthline. https://www.healthline.com/health/endocannabinoid-system
