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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Best CBD Oil for Nerve Pain Reviewed in 2022
Neuropathy involves not only pain but also other pesky symptoms such as anxiety, nausea, and vomiting, as shown in studies on painful peripheral neuropathies. If nerve pain plagues every day of your life, things like muscle spasms, joint inflammation, and stiffness can become unbearable.
People who used up their conventional treatment options, but to no avail, have recently started switching to natural resources, such as CBD oil, for their nerve pain. According to recent studies, CBD may ease neuropathy and help individuals manage their symptoms in a safe and effective way.
These findings are promising for people with neuropathy, even though it’s too early to make definite statements. In this article, we’ll present the data from the current research on this subject on top of our industry overview, where we give our recommendations on the best CBD oil for neuropathy.
Best CBD Oils for Neuropathy
The quality of CBD oil is paramount for your results with neuropathy. Unfortunately, no two CBD oils are made the same; in fact, there’s a large degree of difference in quality between brands. There are many great companies committed to quality, but there’s an equal number of fly-by-night brands preying on uneducated customers.
Having been in the business for 7 years, we’ve tried a plethora of CBD oils from dozens of different brands. This year was even more demanding in terms of the tested products considering the continuously rising popularity of CBD.
We’ve selected the top 5 CBD oils for neuropathy from over 40 companies that offer CBD oil in three different types: full-spectrum, broad-spectrum, and isolate. Our ranking is based on the quality criteria such as hemp sourcing, extraction methods, third-party testing, and customer service.
1. Royal CBD (Best CBD Oil for Neuropathy)
Get 15% off all Royal CBD products. Use code “CFAH” at checkout.
|Potency||250 mg –2500 mg|
|Available Flavors||Natural, Berry, Mint, Vanilla|
|CBD per serving||8.3 mg – 83.3 mg|
Why Royal CBD is the Best CBD Oil for Neuropathy
Royal CBD was launched in 2018 in California by a group of cannabis aficionados with a vision to elevate the quality standards and customer service on the market after collecting their own experiences from the customer’s side. This premium brand offers full-spectrum CBD oil sourced from organic hemp and extracted with supercritical CO2. This method of extraction allows even high-potency oils to maintain the plant’s original chemical profile due to lower temperatures.
Royal CBD oil comes in four different strengths, including 250 mg, 500 mg, 1000 mg, and 2500 mg. For potencies between 250 mg and 1000 mg, you can choose between three flavored options, such as Mint, Berry, or Vanilla. The strongest version (2500 mg) is only available in the natural flavor, as adding flavorings would negatively impact the potency of CBD.
Speaking of high-potency oils, the 2500 mg bottle is my favorite product from Royal CBD. The hemp aftertaste is surprisingly mild because the oil has been infused into food-grade coconut-derived MCT oil. This adds another benefit because MCT oil also enhances the absorption of CBD.
If you experience nerve pain — whether regularly or from time to time (like me) — this potency will probably be your go-to choice. It has a deeply relaxing effect and can reduce inflammation for quite a long time after ingestion. I take it under the tongue, wishing the extract around my mouth to increase the surface area for absorption and minimize the amount of oil that passes through the gut.
- Sourced from non-GMO, Colorado-grown hemp
- Extracted with supercritical CO2
- Contains full-spectrum CBD
- Available in 4 strengths and 3 flavored options
- Up to 2500 mg of CBD per bottle
- Lab-tested for potency and purity
- 30-day money-back guarantee
- Slightly more expensive than the competition
- No vape products available
2. Gold Bee (Best Organic)
|Potency||300 mg – 2400 mg|
|Available Flavors||Natural, Honey-Kiwi|
|CBD per serving||8.3 mg – 33.3 mg|
About Gold Bee
Our second-best CBD oil for neuropathy comes from Nevada, but Gold Bee is a true maverick among other brands due to the unique honey flavor of its full-spectrum CBD oil, which the company produces from locally grown, non-GMO hemp.
The quality of ingredients — just as the honey flavor — are award-winning in my opinion. This CBD oil has a very natural flavor, with an actual honey aftertaste, which makes this product particularly enjoyable to use. There’s no tart, earthy taste that you can feel with the majority of CBD oils.
When it comes to easing nerve pain, I noticed similar results to what I got with Royal CBD, but due to the lack of high-potency oils in its lineup, Gold Bee is the runner-up in this compilation.
- Made from US-grown organic hemp
- Contains the full spectrum of cannabinoids and terpenes
- Up to 33 mg CBD/mL
- Good potency range for new users
- Lab-tested for CBD content and purity
- No high-potency oils
- Honey is the only flavored option
3. CBDPure (Top Transparency)
|Potency||100 – 1000 mg|
|CBD per serving||3.3 mg – 33.3 mg|
CBDPure is one of the most reputable US brands that specialize in making low-potency CBD oil, although the company has lately expanded their line up with a 1000 mg strength. This is a nice nod towards users who want to save more money on their CBD oil but their dosage doesn’t exceed 30 mg CBD daily.
CBD pure is also one of the most transparent companies on the market. The guys at CBDPure explain every step of how their oils are made, and surprisingly for low-potency extracts, these products provide decent results when it comes to pain relief. The only reason CBDPure scores third place on this list is because of the higher prices. Some users may find these oils less affordable than other premium brands in the long run.
Want to try if CBDPure products will work for you? The brand has a 90-day money-back policy. You can return the product for a full refund within 90 days if you’re unsatisfied with the results.
- Sourced from Colorado-grown organic hemp
- Extracted with CO2
- 4 strengths to choose from
- Lab-tested for potency and purity
- 90-day return policy
- No high-potency oils
- Only two forms of CBD available
- Priced higher than competitors
4. Hemp Bombs (Best CBD Isolate)
|Potency||125 – 4000 mg|
|Available Flavors||Natural, Acai Berry, Orange Creamsicle, Peppermint, Watermelon|
|CBD per Serving||4 – 133 mg/mL|
About Hemp Bombs
When it comes to the best isolate-based CBD oil for nerve pain, Hemp Bombs offers the widest selection of products. The company has covered the entire potency range for CBD oils, offering up to 4000 mg of total CBD.
This oil is a good alternative for people with neuropathy who, for some reason, want to abstain from taking any THC in their product while getting a decent dose of CBD per serving. Full-spectrum products contain up to 0.3% THC; while this isn’t enough to get the user high, CBD isolate is completely free of THC. This trait is particularly important for CBD users who are regularly tested for drugs at work.
Because CBD isolate is made from 99% pure CBD, it has no aroma and flavor, which makes it more versatile thankful-spectrum extracts.
On the other hand, you won’t get the synergy from other cannabinoids and terpenes with CBD isolate, so this company may not have the best products if you want to benefit from whole-plant extracts in your supplementation.
- Made from organic hemp
- Extracted with CO2
- Third-party tested for potency and purity
- Up to 4000 mg of total CBD
- 5 potency options to choose from
- Flavored with synthetic ingredients
- No synergy from other cannabinoids and terpenes
- Most people don’t need so much CBD oil in their routine.
5. CBDistillery (Most Affordable)
|Potency||250 mg – 5000 mg|
|Potency||8.33 – 166 mg/mL|
CBDistillery is one of the most reputable companies in the American market. The company has been selling premium CBD oils for over 5 years, becoming one of the largest brands in the USA. Started by a group of Colorado natives with a mission to produce high-quality CBD products affordable for everyone, CBDistillery offers two types of hemp extracts: full-spectrum and broad-spectrum (pure oil). Similar to the full-spectrum CBD, broad-spectrum extracts contain CBD along with other non-intoxicating cannabinoids, but without any traces of THC. The THC is removed from the product after initial extraction.
The CBDistillery CBD oil comes in a wide range of concentrations, from 250 mg to a massive 5000 mg of CBD per bottle. The strongest version provides 166 mg of CBD per milliliter, which usually lasts for months.
As for the results, I was satisfied when it came to pain and irritation. I also noticed that my stomach was calmer than before taking this oil. However, there’s a reason why I’ve placed CBDistillery at the very bottom of this compilation. Unlike competitor brands, this one doesn’t use organic hemp plants.
So, CBDistillery may not sell the best CBD oils out there, but considering the price, these are hands down the best CBD oils for neuropathy in their range.
- Available as full-spectrum or broad-spectrum CBD
- 5 strengths to choose from
- Up to 166.6 mg of CBD per mL
- Third-party tested for CBD content and purity
- Very affordable
- Sourced from non-organic hemp
- No flavored oils
What Causes Neuropathic Pain?
Neurons within the body carry signals to the brain, including pain signals. While this sensation is anything but pleasant, it has one important purpose — to prevent injuries. Once you place your foot on a hot surface, the painful sensation will warn your brain against the danger.
That’s how the process is supposed to work in healthy people. But with patients suffering from neuropathic pain, that nervous signaling system falls out of whack. In simple words, your brain receives pain signals, and you feel the pain, but there’s no obvious cause of that feeling. And because of this, it’s difficult to find an immediate remedy.
What’s the matter with those wayward nerves? Most of the time, it’s the result of damage from a disease or physical injury, including:
- Physical injuries: this is a very common cause of neuropathic pain, in which nerves get crushed, compressed, or severed.
- Shingles: this condition is another cause of neuropathy, one that can transform into a painful disease called postherpetic neuralgia. This type of nerve pain can be particularly severe and immediate.
- Cancer and other tumors: As they grow, tumors can constrict the surrounding nerves. Cancer cells can also grow out of the nerves on their own. Sometimes, chemotherapy or radiation can damage nerve cells too, resulting in neuropathic pain.
- HIV: this autoimmune viral condition can lead to painful nerve damage. Nerve pain actually affects around one-third of HIV patients, and nerve within the hands and feed is one of the first symptoms that occur. Antiretroviral treatments can also lead to nerve damage that triggers pain.
- Diabetes: if you have diabetes, you have a higher risk of suffering from nerve injury. At some point, consistently high levels of glucose accompanied by hypertension can damage the nerves.
These are just a few conditions that can cause nerve damage and lead to neuropathic pain. Others include vitamin deficiencies, hormone balances, constant exposure to stress, and more. In some rare cases, nerve pain can just occur without a reasonable explanation.
Experts on Neuropathic Pain and Its Prevalence
Nerve pain derives from the central or peripheral nervous system. These networks are made of the brain and spinal cord. The spinal cord runs down from the brain and through the center of the spine. The nerves stretching from the spinal cord and traveling throughout the limbs and head are the peripheral nervous system. All these structures work together, constantly exchanging signals about your body.
Dr. Suraj Muley, an esteemed neurologist and director of the neuromuscular division at Barrow Neurological Institute in Phoenix, there are several common points for patients with neuropathy. They usually include electric-like, shooting pain with an ice-cold sensation, sensitivity to touch, and feelings of numbness.
The nerves are important players for any kind of pain, as well as other types of sensations. According to Dr. Ryan Jacobs, a neuromuscular neurologist, pain messages are sent by the nerves. This often happens as a result of inflammation or injury that causes damage to body tissues such as skin, bones, or muscles. However, nerve pain refers to damage caused by an injury to the nerves on their own. He also added that in some cases, it can be damage to one significant nerve or a few minor ones that can contribute to a widespread nerve injury.
How Can You Determine the Cause of Neuropathic Pain?
Doctors first conduct an interview with their patients, asking about the symptoms, history of medical conditions, and running a short examination. A physician may check for such things as sensory loss using a pinprick on different parts of the body. If the patient doesn’t feel the impulse from the pinprick or other things, that could indicate neuropathy, as said by Dr. Eva Feldman, a professor of neurology at the University of Michigan.
Aside from the interview and initial examination, your doctor may recommend conducting additional testing, such as bloodwork, to gain a bigger picture of what’s the reason behind the neuropathic pain in your case. You may be asked to run a test called hemoglobin A1C to check your average blood sugar levels and exclude the possibility of diabetes. The doctor may also check if you have sufficient vitamin B12 levels; deficiencies in this vitamin can lead to nerve damage and numbness.
Treatment Options for Nerve Pain
Treating neuropathy is tricky due to its specific nature and the exact cause of the problem. When nerve pain is triggered by a condition such as HIV, diabetes, or cancer, tackling the underlying disease is undoubtedly the priority. However, this treatment won’t necessarily help with your neuropathic pain. Nerve pain may require a dedicated treatment, one that is different from the treatment for the disease that’s causing it.
Doctors typically use prescription painkillers depending on the type and severity of neuropathic pain. However, people can build a tolerance to the active ingredients in these medications, let alone the risk of addiction and several dangerous side effects, including lethal overdose.
Experts believe that 40 million Americans struggle with nerve pain. The impact of neuropathy on modern society is enormous, and for many of us, the potential side effects of pharmaceutical medications outweigh their benefits. It’s totally understandable that people have started to look for natural alternatives such as CBD oil.
Using CBD is an option for treating many types of pain. Studies have already highlighted a few mechanisms responsible for the versatility of CBD in mitigating pain signals. But can it help with neuropathic pain?
Why Some People Are Choosing CBD Oil for Neuropathy
Some forms of neuropathy can be easily treated and sometimes cured. If neuropathy is incurable, the treatment should aim at preventing further damage to the nerve and controlling symptoms.
CBD has been shown to have some therapeutic qualities that might assist patients with neuropathic pain and other symptoms linked to neuropathy such as suppression of the nerves like Carpal Tunnel Syndrome.
CBD vs Anxiety, Chronic Pain, and Vomiting
According to the American Chronic Pain Association, neuropathic pain is the type of chronic pain that occurs in the nerves in the peripheral nervous system due to injury or damage.
Anxiety, nausea, pain, and vomiting are telltale neuropathic symptoms, as noted by a study on painful peripheral neuropathies that was published in Current Neuropharmacology.
Research has shown that CBD may be useful in easing different types of chronic pain. Neuropathic pain falls into this category, but unlike other chronic pain conditions, neuropathy is particularly difficult to treat, according to the author of a paper on neuronal mechanisms of neuropathic pain.
On top of acting as a neuroprotectant, CBD also has some other therapeutic properties, including antiemetic and anxiolytic effects.
CBD vs Inflammation and Muscle Spasms
Neuropathy often results from chronic inflammation, such as in diabetes, which is the number one cause of neuropathic pain in the United States.
Neuropathy can also derive from autoimmune diseases, such as arthritis or lupus. Autoimmune diseases are linked to a higher risk of hypertension and cardiovascular problems.
CBD can inhibit inflammatory and neuropathic pain caused by autoimmune diseases. In a 2016 animal study published in the European Journal of Pain, topical application of CBD helped reduce pain and inflammation triggered by arthritis.
CBD’s remarkable anti-inflammatory effects were also demonstrated in vivo in a 2018 study published in the Journal of pharmacology and Experimental Therapeutics.
Moreover, CBD may help relieve muscle spasms, which is a common feature of nerve damage, often marked by uncontrolled and painful muscle twitches.
Sativex, a combined oral spray consisting of THC and CBD in a 1:1 ratio demonstrated high efficacy in helping with pain management in patients with neuropathic pain caused by nerve damage, peripheral neuropathic pain, rheumatoid arthritis, advanced pain, and spasticity from multiple sclerosis. The results were published in Neuropsychiatric Disease and Treatment.
Similar results were observed in a review of similar studies published in The Cochrane Database of Systematic Reviews in 2018.
The above review examined hundreds of studies on using cannabinoid-based medicines on neuropathic pain in adults. While not all of them turned out positive, there was significant evidence that cannabinoids could reduce nerve pain and other symptoms of this condition.
How Could CBD Oil Help With Neuropathy?
The endocannabinoid system (ECS) is essential for understanding how CBD works to relieve neuropathy. The health benefits of CBD and other cannabinoids result from their interaction with the body’s ECS, which is the major regulatory network in all mammals.
The ECS controls a wide range of biological processes, including immune response, sleep, mood, appetite, metabolism, memory, and pain sensation.
This system consists of two types of cannabinoid receptors — CB1 and CB2 — which are found in specific parts of the body.
CB1 receptors are mostly found in the brain and central nervous system, but there are some concentrations of these receptors in reproductive organs, lungs, liver, retina, and urinary tracts.
CB1 receptors are involved in-memory processing, pain sensation, mood, sleep, and motor regulation. Their activation is linked to neuroprotective responses, suggesting that the cannabinoids acting on CB1 receptors could help in the prevention and treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis.
When it comes to CB2 receptors, these are primarily located on the surface of the immune system cells and their associated structures. The activation of CB2 receptors is said to produce an anti-inflammatory response, minimizing damage to nerves and reducing pain.
The above qualities have been found to be potentially helpful for treating autoimmune conditions, such as Crohn’s disease, arthritis, inflammatory bowel syndrome, and chronic inflammatory demyelinating polyneuropathy (CIDP).
CBD doesn’t bind to any of the cannabinoid receptors; it does, however, act indirectly on them, causing similar actions as the substances that typically stimulate the receptor.
CBD also has more than 65 molecular targets. It can interact with other receptors in the body, such as the 5-HT1A serotonin receptor. Serotonin is a neurotransmitter that controls feelings of well-being and emotional stability. It can also modulate nausea, anxiety, and pain.
Pros & Cons of Using CBD Oil for Neuropathy
- Can help with symptoms such as inflammation, anxiety, pain, nausea, vomiting, and muscle spasms
- Has been recognized as safe by major health agencies including the WHO
- Can be purchased without a prescription (locally and online)
- Not approved as an official treatment by the FDA
- Can interact with 70-80% of prescribed medications
- Side effects include dry mouth, drowsiness, fatigue, and changes in appetite
- Products sold online and in local stores are mostly unregulated
CBD vs Other Alternative Treatments for Nerve Pain
Alternative treatments for patients with neuropathy include the use of capsaicin, primrose oil, and amino acids.
Capsaicin is an analgesic compound found in hot peppers. A study examining the use of an 8% capsaicin dermal patch found that almost 71% of participants with cancer-related neuropathic pain experienced 90% relief.
Primrose oil may help ease neuropathic pain in people with diabetes, as stated by Mayo Clinic in an article regarding peripheral neuropathy diagnosis and treatment.
According to the same clinic, amino acids, such as acetyl-L-carnitine, may help people after chemotherapy as well as patients with diabetes.
Is there a way to combine the benefits of the above compounds with the analgesic effects of CBD?
Some CBD products come in the form of salves infused with capsaicin. In these CBD products, the capsaicin supports CBD’s natural pain-killing benefits to help with problematic spots on the body.
As for hemp oil, which is often added to CBD topicals, it’s an excellent source of essential fatty acids and amino acids. You can also look for topicals infused with primrose oil for enhanced anti-inflammatory effects.
How to Use CBD Oil for Neuropathy?
Figuring out how to use CBD oil for neuropathy can help you maximize your results. Sometimes, cream or gel maybe is your best option if you want to completely avoid ingesting the oil.
However, if you want to approach the problem from two different angles, we recommend that you use full-spectrum CBD drops as your primary means of CBD oil.
CBD oil should be applied under the tongue for approximately 60 seconds before swallowing. This method of administration ensures that the CBD absorbs into the bloodstream through sublingual capillaries, avoiding the first-pass effect in the liver.
Alternatively, you can take capsules or edibles if you have problems holding the oil in your tongue, but CBD taken orally takes more time to kick in. Capsules and edibles are a great option if you want to ease nerve pain in social settings, or when you need longer-lasting relief at the cost of delayed onset.
If you need something to help with localized pain, then a topical such as warming salve could provide some relief. Usually, people who take CBD for neuropathy combine the oil (or edibles) with topical products.
CBD Dosage for Neuropathic Pain
Everybody will react to CBD differently because we’re not made the same. You need to ask yourself a few questions.
How much pain am I in?
Is it chronic pain or does it just happen randomly throughout the day?
Do you want to take CBD oil to function better or take the nerve pain away entirely?
Other important considerations for CBD dosage include your weight, age, metabolism, overall health, and prior experience with CBD oil.
Customers usually take CBD oil as well as use a topical about 1–3 times a day. In order to find the right dose and strength for yourself, you’ll need to go through some trial and error, starting at the lower end of the recommended serving size, and slowly making your way up to the point where you experience a significant difference in your symptoms.
Safety and Side Effects of CBD Oil
CBD has a well-established safety profile. It can be taken under the tongue in doses of 300 mg – 1500 mg daily for up to several weeks. Dosage recommendations for prescribed cannabidiol (Epidiolex) range from 10 to 20 mg per kg regularly.
Some rumored side effects of CBD oil include dry mouth, dizziness, changes in appetite, and sedation resulting from a temporary drop in blood pressure. Signs of diarrhea have also been reported in some patients, but this is a very rare adverse reaction.
Final Thoughts on Using CBD Oil for Neuropathy
CBD has demonstrated the ability to reduce neuropathic pain in many studies. Not only that, but CBD can also help with other neuropathic symptoms, such as anxiety, nausea and vomiting, spasms, and inflammation.
As more studies are being conducted in this area, CBD may become the go-to treatment option for neuropathy in the future. However, CBD isn’t the only cannabinoid found in cannabis that can help alleviate neuropathy.
Full-spectrum CBD oil contains all phytonutrients naturally found in hemp, including terpenes, flavonoids, and trace cannabinoids. These compounds work together to amplify the health benefits of each cannabinoid, producing the “entourage effect.”
This is the best type of CBD for neuropathy. However, regardless of the product choice, make sure to check all marks on the quality checklist, including the source of hemp, extraction method, and third-party lab testing. If you don’t have the time to do your own research, you can use our recommendations from above.
Let us know in the comments if you use CBD oil for neuropathy — and how it works for you!
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
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