Every individual on the planet has a central nervous system (CNS). The central nervous system consists of the brain and spinal cord. It is called the central nervous system because, much like a powerful computer, it functions as a central processing unit, gathering important information from all over the body. This system works hand in hand with our peripheral nervous system which essentially carries the nerve signals from the CNS to different parts of our body.
Unlike our CNS, which is protected by a number of factors such as the vertebral column, skull, and blood-brain barrier, the peripheral nervous system is left pretty exposed to a range of things – from toxins and bacteria to injury.
If damage occurs in the peripheral nervous system, then there is a high chance that peripheral neuropathy may occur. Neuropathy can manifest in both the upper and lower extremities, but patients and doctors most often report neuropathy of the feet.
- Anxiety, vomiting, nausea, and pain are typical neuropathic symptoms, as reiterated in a study on painful peripheral neuropathies, which was published in Current Neuropharmacology(1).
- CBD may possess some anti-anxiety and anti-emetic (anti-vomiting) characteristics, according to a report in the Journal of Psychopharmacology(2). Meanwhile, a study published in the Journal of Experimental Medicine demonstrated one mechanism by which CBD inhibits inflammatory and neuropathic pain(3).
- Muscle spasms can be symptoms of neuropathic damage, which often manifests in painful, uncontrolled muscle twitches(4). A study has demonstrated that medicine containing CBD and THC in a 1:1 ratio may help with pain management in people with spasticity, chronic neuropathic pain, severe pain due to nerve damage, and peripheral neuropathic pain(5).
- It is essential to conduct research into the safety and effectiveness of cannabis products and consult with a doctor experienced in cannabis use before consuming or using these products as treatment options or part of a health regimen.
How CBD Oil Works to Help with Neuropathy
To understand how CBD works to help with neuropathy, it is essential that one understands how the endocannabinoid system (ECS) works.
The therapeutic effects of cannabinoids, such as CBD, are realized by their interaction with the body’s ECS and its specialized cannabinoid receptors.
The ECS, integral to the body’s physiologies, is responsible for regulating a wide range of body functions, including pain sensation, immune response, anxiety, sleep, mood, appetite, metabolism, and memory.
CB1 and CB2 are the two main types of receptors found in specific parts of the human body. These receptors each have particular roles in the ECS.
CB1 receptors are mostly located in the brain and central nervous system. However, they are also found in the reproductive organs, gastrointestinal and urinary tracts, liver, lungs, and retina(24).
CB1 receptors play a role in motor regulation, memory processing, appetite, pain sensation, mood, and sleep(25).
The activation of CB1 receptors has also been related to neuroprotective responses. This activity suggests the cannabinoids with a higher affinity for CB1 receptors could help in the treatment and prevention of neurodegenerative conditions, such as Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis.
Meanwhile, CB2 receptors are primarily situated on cells in the immune system and its associated structures.
When CB2 receptors are triggered, they stimulate a response that fights inflammation, reducing pain, and minimizing damage to tissues.
These anti-inflammatory responses have been found to be potentially useful for treating inflammation-related conditions, such as chronic inflammatory demyelinating polyneuropathy (CIDP), Crohn’s disease, arthritis, and inflammatory bowel syndrome(26).
CBD acts indirectly against cannabinoid agonists, which are substances that bind to a receptor and cause the same action as the substances that typically attach to the receptor.
CBD also interacts with several other receptors in the body, such as the 5-HT1A receptor, which is linked to serotonin, a neurotransmitter found to be a contributor to feelings of well-being. It is through this interaction that these cannabinoids promote healing and balance(27).
The Pros and Cons of CBD Oil for Neuropathy
- Studies mentioned previously demonstrate CBD’s therapeutic benefits in helping alleviate neuropathic symptoms, such as inflammation, spasm, anxiety, pain, nausea, and vomiting.
- CBD has been well-received by several health agencies, like the World Health Organization (WHO), which states that CBD “is generally well-tolerated with a good safety profile.”(28). CBD oil may be safer than most over-the-counter and prescription drugs that may have many side effects.
- CBD is non-addictive, says Nora Volkow, director of the National Institute on Drug Abuse (NIDA) in a 2015 article (26). This characteristic makes CBD safe for daily intake(29).
- CBD oil may be purchased without a prescription in locations where they are legally available.
- Studies are too limited to determine whether or not CBD is an effective treatment for conditions other than the ones approved by the U.S. Food and Drug Administration (FDA).
- As with the use of any natural chemical compound, there are risks involved in using CBD. According to the Mayo Clinic, possible side effects include drowsiness, dry mouth, diarrhea, fatigue, and reduced appetite(30).
- CBD has been shown to interact with other drugs and alter how the body metabolizes certain medications, as a 2017 research revealed(31). Consult with a doctor experienced in cannabis use before starting a CBD regimen or combining it with current prescription medications.
- Dr. Doris Trauner, professor of neurosciences and pediatrics at the University of California San Diego School of Medicine and a physician at San Diego’s Rady Children’s Hospital, cautions that CBD products marketed online and in dispensaries are mostly unregulated(32).
- Marchettini P, Lacerenza M, Mauri E, Marangoni C. Painful peripheral neuropathies. Curr Neuropharmacol. 2006;4(3):175–181. doi:10.2174/157015906778019536.
- Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., … Hallak, J. E. C. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of Psychopharmacology, 25(1), 121–130. https://doi.org/10.1177/0269881110379283; Parker LA, Rock EM, Limebeer CL. Regulation of nausea and vomiting by cannabinoids. Br J Pharmacol. 2011;163(7):1411–1422. doi:10.1111/j.1476-5381.2010.01176.x.
- Xiong W, Cui T, Cheng K, et al. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. J Exp Med. 2012;209(6):1121–1134. doi:10.1084/jem.20120242.
- NINDS. (2018, Aug). Peripheral Neuropathy Fact Sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet.
- Perez J. Combined cannabinoid therapy via an oromucosal spray. Drugs Today (Barc) 2006;42:495–503.DOI: 10.1358/dot.2006.42.8.1021517.
- Cleveland Clinic. (2019, Dec 16). Neuropathy (Peripheral Neuropathy). Retrieved from https://my.clevelandclinic.org/health/diseases/14737-neuropathy.
- The American Chronic Pain Association. Neuropathic Pain. Retrieved from https://www.theacpa.org/conditions-treatments/conditions-a-z/neuropathic-pain/.
- Marchettini P et al. op. cit.
- Grinspoon, P. (2019, Aug 27). Cannabidiol (CBD) — what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476.
- Zhuo M. Neuronal mechanism for neuropathic pain. Mol Pain. 2007;3:14. Published 2007 Jun 6. doi:10.1186/1744-8069-3-14.
- Crippa et al. op. cit.
- Cleveland Clinic. op. cit.
- Mayo Clinic. (2019, May 22). Peripheral neuropathy. Retrieved from https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061.
- Wolf VL, Ryan MJ. Autoimmune Disease-Associated Hypertension. Curr Hypertens Rep. 2019;21(1):10. Published 2019 Feb 2. doi:10.1007/s11906-019-0914-2.
- Xiong W et al. op. cit.
- Grinspoon, P. op. cit.
- Hammell DC, Zhang LP, Ma F, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. Eur J Pain. 2016;20(6):936–948. doi:10.1002/ejp.818.
- Petrosino S et al. Anti-inflammatory Properties of Cannabidiol, a Nonpsychotropic Cannabinoid, in Experimental Allergic Contact Dermatitis. Journal of Pharmacology and Experimental Therapeutics June 2018, 365 (3) 652-663; DOI: https://doi.org/10.1124/jpet.117.244368.
- NINDS. op. cit.
- Malfitano AM, Proto MC, Bifulco M. Cannabinoids in the management of spasticity associated with multiple sclerosis. Neuropsychiatr Dis Treat. 2008;4(5):847–853. doi:10.2147/ndt.s3208.
- Perez J. op.cit.
- Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018;3(3):CD012182. Published 2018 Mar 7. doi:10.1002/14651858.CD012182.pub2.
- Reggio PH. Endocannabinoid binding to the cannabinoid receptors: what is known and what remains unknown. Curr Med Chem. 2010;17(14):1468–1486. doi:10.2174/092986710790980005.
- ECHO. (2017, April 18). Retrieved from https://echoconnection.org/look-endocannabinoid-systems-cb1-cb2-receptors/.
- Turcotte C, Blanchet MR, Laviolette M, Flamand N. The CB2 receptor and its role as a regulator of inflammation. Cell Mol Life Sci. 2016;73(23):4449–4470. doi:10.1007/s00018-016-2300-4.
- ECHO. (2017, March 29). Retrieved from https://echoconnection.org/differences-cbd-thc/.
- WHO. Expert Committee on Drug Dependence. (2017, Nov 6-10). Cannabidiol (CBD). Retrieved from https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf.
- Nora Volkow. NIDA. Researching Marijuana for Therapeutic Purposes: The Potential Promise of Cannabidiol (CBD). National Institute on Drug Abuse website. https://www.drugabuse.gov/about-nida/noras-blog/2015/07/researching-marijuana-therapeutic-purposes-potential-promise-cannabidiol-cbd. July 20, 2015. Accessed January 31, 2020.
- Bauer, B. (2018, Dec 20). What are the benefits of CBD — and is it safe to use? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700.
- Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis Cannabinoid Res. 2017;2(1):139–154. Published 2017 Jun 1.
- Peachman, RB. (2019, Feb 26). Can CBD Help Your Child? Retrieved from https://www.consumerreports.org/cbd/can-cbd-help-your-child/.
- Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708–1709. doi:10.1001/jama.2017.11909.
- Mayo Clinic. (2019, May 22). Peripheral neuropathy. Retrieved from https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/diagnosis-treatment/drc-20352067.
- Baranidharan G, Das S, Bhaskar A. A review of the high-concentration capsaicin patch and experience in its use in the management of neuropathic pain. Ther Adv Neurol Disord. 2013;6(5):287–297. doi:10.1177/1756285613496862.
- Mayo Clinic. op. cit.
- Huestis MA. Human cannabinoid pharmacokinetics. Chem Biodivers. 2007;4(8):1770–1804. doi:10.1002/cbdv.200790152.
- Lehmann C et al. Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes.Clin Hemorheol Microcirc. 2016;64(4):655-662. doi: 10.3233/CH-168021. DOI: 10.3233/CH-168021.
- Jordi Perez & Mª Victoria Ribera (2008) Managing neuropathic pain with Sativex®: a review of its pros and cons, Expert Opinion on Pharmacotherapy, 9:7, 1189-1195, DOI: 10.1517/146565188.8.131.529.
- NIH. (2013, June). A Study of Sativex® for Pain Relief in Patients With Advanced Malignancy. Retrieved from https://clinicaltrials.gov/ct2/show/NCT00530764.
- Ware M. (2020, Jan 23). Medical cannabis.https://www.britannica.com/science/medical-cannabis.
- E. Small and D. Marcus, “Hemp: A New Crop with New Uses for North America,” in Trends in New Crops and New Uses, ed. J. Janick and A. Whipkey (Alexandria, VA: American Society for Horticultural Science Press, 2002.
- Mogil, J. Animal models of pain: progress and challenges. Nat Rev Neurosci 10, 283–294 (2009). https://doi.org/10.1038/nrn2606.
- The Foundation for Peripheral Neuropathy. (2016). Peripheral Neuropathy Clinical Trials. Retrieved from https://www.foundationforpn.org/research/peripheral-neuropathy-clinical-trials/