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
CBD Oil For Sciatica: An Osteopath’s Guide
Whilst CBD oil is a hot topic these days with a myriad of brands and countless types of products from bath bombs to gummies, not many people actually know what it is, what is a good product and how to use it to benefit themselves.
The vast majority of CBD products on the market are just that – CBD in a carrier oil. CBD is one cannabinoid of many in the cannabis plant. CBD has useful properties in its own right but is merely one player in a team of cannabinoids, terpenes and flavonoids.
Sadly, most people buy a CBD extract with precious little else in it and whilst it may help some people it is often ineffective or only partially successful on its own.
What you really want to look for is not CBD oil but a full spectrum plant extract that contains all the other clever parts of the plant in the right balance. Unfortunately, unscrupulous sellers of CBD often label their product as full spectrum when it clearly is not.
A true, high-quality CBD oil is dark in colour and has a complex earthy, spicy smell and taste. One customer described it to me as smelling like a walk down a country lane. I think that is a pretty good description.
The name CBD oil is actually a misnomer as what we are really looking at is a cannabis extract. Our Life edition oil is actually a raw CBD product and is as close to nature as one can get with all the right, legally acceptable, the balance of cannabinoids, terpenes and flavonoids.
This means that with all CBD One’s products you get the vital entourage effect – the synergy of all the compounds in cannabis that make it potent and effective. This is far from the case for many low-grade CBD oils sold in the UK right now.
Disclaimer: This article may contain occasional references of CBD “for” a specific topic, for example, “CBD Oil for Sciatica”.
It is important for us to clarify that CBD is a food supplement that, while very useful for many people, is not sold “for” any specific purpose other than general health and wellbeing.
Any references of CBD for a specific subject are simply so we can clarify this to anyone searching for these terms.
Can CBD Oil Help With Sciatica?
People regularly ask will “CBD help me with…” and then you can add just about any illness or pain known to humanity!
Unfortunately, the answer to this question is simple but disappointing: “We don’t know if it will help.”
One thing we do know is that CBD oil is remarkably safe to take so if you are taking CBD oil for sciatica the one thing we can say with confidence is that it will do no harm.
Now if you compare that to an over the counter anti-inflammatory we see a very different story.
For every thousand users of these drugs, three have heart attacks, one of which will be fatal. They are potent drugs but they come with a potentially serious price for your health.
Given the choice between something that is natural and causes no harm and may be of benefit compared to a drug that comes with risks and merely suppresses the healing response of your body, I know what I would try first.
What Is Sciatica?
Osteopaths see a lot of sciatic type problems. We also have a lot of patients who attend our clinics telling us they have sciatica when it is quite obvious they do not.
Sciatica is a dumping ground diagnosis that often comes from a lack of knowledge of anatomy and/or a failure to examine a patient effectively. If you go to the doctor and tell them you have pain down the back of your leg there is a good chance you will be told you have sciatica regardless of any other symptoms.
There are also a thousand doctors in the pub and I can assure you they will tell you that your problem is sciatica if you mention pain anywhere near your hip or leg.
So what is sciatica?
The word simply refers to pain from the sciatic nerve. This nerve is the longest nerve in your body so simply referring to sciatic nerve pain doesn’t help us establish what or where the problem is.
Let us take a look at the anatomy of this nerve.
More often than not the nerve is formed from the union of five branches of nerves that come from the lumbar spine. Each of these branches exits your spine through a foramina. This is a gap in your spine to allow nerves out to supply your body and allow it to function and move. The gap is formed of two vertebrae, one on top and one below and between them, they effectively form a bony tunnel for the nerve to exit your spinal cord.
The sciatic nerve has the vital role of supplying the skin, muscles and joints of your thigh, leg and foot.
Where Does The Sciatic Nerve Get Injured?
The sciatic nerve can be injured by a variety of problems that irritate it, inflame it or compress it.
Common injuries can be caused by a facet joint injury in the spine. This causes swelling and inflammation around the joint and since this is close to the sciatic nerve the swelling can impinge upon the sciatic nerve OR the inflamed joint releases chemicals that heal you but can also, during the healing process, irritate the nerve causing you to get the pain down your leg.
Damage to the foramina that causes it to become narrowed can compress one of the branches of the sciatic nerve. This is often from arthritic changes but can also be because of a trauma.
Disc problems can also cause sciatic pain because whether it is a slight tear of the disc or a full-blown prolapse there are chemicals released as part of the injury that irritates the nerve and the disc can also bulge and compress the nerve.
One area that is often neglected is where the nerve passes through your hip muscles to get to your leg. In about 50% of the population, the sciatic nerve passes through the piriformis muscle and if this becomes injured or contracted from postural strain and muscle imbalances, often from things like prolonged sitting, then you will get sciatic pain. This is called piriformis syndrome.
So you can see from this list, which is far from the full list, that to just dump sciatica upon somebody without investigating WHY they have the problem can lead to a pain that does not get fixed.
A common problem I see with most treatments of sciatica is that everybody stares at the site of the injury. Let’s say for the sake of argument that the injury is being caused by a disc problem in the lumbar spine.
The one question rarely asked is ‘why?’ Why has this injury happened at this place? In my experience, it is often because this area is being overloaded because another area is not working properly so the key is to hunt out the areas that are not working correctly.
I often find the area of the spine above the lower back is very stiff, especially between the shoulder blades and the hip muscles are also closed up and tight. Between the two lies the very mobile and relatively vulnerable lower back which then gets overworked because it is making up for the imbalances everywhere else. Lo and behold you get a disc injury that causes the sciatic pain but the cause is most definitely other areas not working.
If people investigated this before they embarked on major surgery they may find they can begin to change their problem without the need for a surgeon’s knife which, no matter how well-intentioned or skilfully applied, is not addressing the underlying reasons for the lower back injury.
How Does CBD Work?
Your body has a widespread system called the endocannabinoid system (ECS) which is a series of receptors in your central and peripheral nervous system. It is also in many of your organs and tissues, including your skin.
When you take CBD the cannabinoids in it effectively talk to the ECS and help it function well. The ECS is involved in homeostasis, or the ability of your body to maintain its balance regardless of the circumstances you are in. The ECS is a great balancer of your body.
CBD is also well known for having interesting anti-inflammatory effects. Because inflammation may be involved in sciatic pain CBD may have a role to play in helping. Most importantly do not forget that inflammation is a healing response and we do not want to suppress this healing or there is a possibility of ending up with a long term problem.
However, CBD is generally considered very safe and gentle acting and certainly does not come with the many serious side effects of taking too many opiate-based painkillers or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen or Naproxen so it is highly unlikely to stop your body healing.
So if there is an inflamed injury there may be some sense in taking CBD. However, if there is a serious structural problem CBD will not fix this so make sure you speak with your doctor or health professional.
Warning signs that there may be a more serious problem are when your bowel or bladder does not seem to be working normally or you have a change of sensation in the area we call the saddle area ie. the area you would use to sit on a bicycle seat.
How To Use CBD Oil For Sciatica
You have three main choices when using CBD: oral products, a topical CBD cream or even our new CBD patches.
The oral option then subdivides into a CBD oil or a water-soluble CBD.
I would suggest that a great starting point is to look at an oral product. The oils are taken up to three times a day and up to three drops at a time. Drop them under your tongue and let them stay there for a few minutes before swallowing.
Our water-soluble products can be added to any hot or cold drink and most people, most of the time, take just one dose a day. Of course, this is a very personal choice and you may safely take more if you wish.
When it comes to CBD dosage the key on how to get the right dose for you is to listen to your body. When you see changes you can maintain the dose or increase or lower it depending on your progress. Some people find they can take CBD every other day but others find they have to take it much more regularly. This is a very personal choice and relies on you observing what is happening.
The best place to start is with a middle strength CBD product such as Signature Blend No2 or Absorb Pure or Ultra. This allows you to increase or lower your dose. If you start with a lower strength product and nothing changes the temptation is to think CBD did not work for you when it may simply have required something with a little more strength to begin with.
Some people use a topical cream to apply to the area of pain. I suspect with a sciatic problem this will do little good because the injury is often quite deep inside and there is little chance the CBD will get anywhere near the site of the injury.
How Soon After Taking CBD Should The Pain Subside?
Do not despair if you do not see instant relief from your problem. Whilst many see rapid improvements it can take from a few days to a few weeks to really get the optimum from CBD whatever you may be taking it for.
I have seen people get almost instant relief and others report that they felt nothing then after 8 weeks, everything improved all of a sudden.
I have also seen some people get no relief at all. There is no substance on planet earth that fixes everyone all the time but the key with CBD is that it comes with little risk, therefore, is a safe option for possibly great gains. It certainly does not come with the risk of heart disease or internal gut bleeding that the NSAID group of drugs comes with.
Will Taking The Oil Versus The Absorb Range Impact How Fast It Works?
We find that the oils tend to have a more calming effect whilst our Absorb products tend to have a more energising effect. I suspect this is because the water-soluble Absorbs get into your system faster.
Because they both have these slightly different initial effects many people get one of each and take the Absorb first thing in the morning for an energising hit then take the oils later in the day for their more calming properties.
Do I Have To Keep Taking CBD Oil For Sciatica?
The answer one of my osteopathic tutors would give to this question is succinct and to the point, “You don’t have to do anything!” I take CBD oil regularly because it is good for me.
With chronic problems, more action is often required to make a permanent fix than just taking CBD. So with sciatica, I would suggest you add a few other important changes to make more permanent improvements.
Many back problems are caused by a chronic lack of movement and I refer to these as ‘too much sitting syndrome’ so please look at how you use your body. We are built to move and if there is one posture more unhealthy and guaranteed to cause more trouble than any other it is prolonged sitting.
Take up pilates and/or yoga with a trained tutor who can tailor the exercises to help you safely and make sure you practice a little every day. If you have an injury do not just turn up at a class at your local gym without getting guidance from a tutor first. With the greatest will in the world, a generic class at your local gym may be perfectly fine for most of us most of the time but if you have pain you need skilled support and advice on a one to one basis first.
People often worry about the cost of such one to one lessons but my answer back is what is the cost to you of your pain?
A skilled osteopath is also a useful option where they can look at the cause of your problem and find ways to fix it and also give you lifestyle advice to prevent further trouble.
Fasting can also help because this allows your body to direct its energy into healing and repair processes rather than digesting food. Do not underestimate the power of this simple act. We have evolved to be able to have periods of fasting and it is an incredibly healthful thing to do.
Which CBD Oil Is Best For Sciatica?
I would suggest going for a moderate to high am/pm bundle which gives you a potent combination of the best of our products. The Absorb will get to work fast and then later in the day and overnight you will benefit from the slower more calming effects of the oil.
If you have any questions about your problem and what may help, get in touch via our free health advice service.