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CBD Health Opinion

Ask A Doctor – Pain & CBD

Written by Dr. Leah Zachar

When it comes to dealing with pain, whether chronic or other, there are myriads of options out there. But if you want to use CBD to manage your pain, there are a few things you need to know…

Definition of pain

Pain is a symptom of an underlying problem.

The International Association for the Study of Pain defines it as “an unpleasant sensory and/or emotional experience associated with actual or potential tissue damage.

For example, a broken leg can cause pain. When the leg heals, the pain resolves. A gum infection can cause pain. When the infection is treated, the pain resolves.

In chronic pain however, even when the cause of the pain is addressed, the pain may continue.

For example, herniated discs that compress the spinal nerves cause pain. After a few months, surgery is often performed to alleviate the pressure on the spinal column, but often, the pain remains.


Because pain that has been present for three months or longer creates changes in the nerve receptor located in the spine. This receptor transfers the pain sensation from the nerve that carries the pain from the source to the spine, to the next nerve, which carries the pain sensation to the brain. The term for this is neuropathic pain.

What are the different types of pain?

  1. Nocioceptive pain –   In this type of pain there is tissue discomfort that is reported to the brain. Examples of nocioceptive pain: muscle strain, swelling, broken bone, irritable bowel syndrome, inflammatory bowel disease, fibromyalgia, and migraine.
  2. Neuropathic pain – In this type of pain there is damage to the nervous system, meaning the spinal nerves themselves. Examples of neuropathic pain: sciatica, multiple sclerosis, diabetic neuropathy
  3. Psychogenic pain – In this type of pain, there is a psychological disturbance. Examples of psychogenic pain are anxiety, post-traumatic stress disorder (PTSD), & depression. Psychogenic pain is as real as the other two. Just because the cause of the pain cannot be “seen” on an X-ray or MRI, does not make it any less legitimate.

What are the types of pain that CBD can control? 

  • Nocioceptive pain
  • Neuropathic pain
  • Psychogenic pain

What is neuropathic pain?

Neuropathic pain is caused by a problem in the somatosensory system. The somatosensory system includes the sensory nerve and the pathway the nerve takes to reach the brain.

Heat, touch, & movement, are all sensations that activate the sensory nerves.

Neuro means nerves, and pathic means disease. Pain from the limbs, organs, & back all travel through the nerves in the spine – a kin to the “wires” that carry electricity from the generator in the house to the light bulb. Long standing pain from anywhere in the body has a neuropathic component.

As the sensory nerve travels to the brain, it stops at the spinal cord and transfers the information to another sensory nerve, which then continues on to the brain.

In neuropathic pain there is a “double-whammy”. There is a “pain” sensation created at the source, but in addition, there is a malfunction at the “terminal”, located in the spine, where one nerve transfers the pain sensation to the next nerve.

CBD is an excellent treatment for neuropathic pain because it works in the spine where it blocks the pain at the exact spot where one nerve transfers the pain sensation to the next nerve. 

How does CBD control pain?

CBD binds to the TRPV1 receptors in the spine. CBD, like capsaicin, causes desensitization of the TRPV1 receptors, with a subsequent “paradoxical analgesic effect”. As a result, CBD blocks the pain from transmission to the brain where the pain is “felt”.

CBD also binds to α3glycine receptors which are in the spine. As a result, just as seen with TRPVI, the CBD blocks the pain transmission.

In addition, CBD has anti-inflammatory properties. The cause of the pain may be swelling, such as in a sports injury or in arthritis. By reducing inflammation, the pain resolves.

CBD is exceptional in addressing psychogenic pain. It blocks the breakdown of anandamide, the “bliss” hormone, resulting in an increased sensation of wellness, with consequent alleviation of anxiety & PTSD.

There is no “one size fits all” when it comes to treating pain

Pain is not perceived in the same two people in the same way, because each person has his own coping (or not coping) mechanism.

There are numerous factors that must be considered in how each patient perceives pain. Some of them are the context of the pain, presence of opioid-induced hypersensitivity, emotional component, prior experience with pain, expectations for future pain, repeated exposures to painful stimuli, past exposure to trauma, and finally, one’s “acceptance” of pain.

As per your request, we are moving the weekly In-house doctor session from Thursday at 1 pm EST, to Thursday at 3 pm EST (That’s UK’s 20:00, NYC’s 15:00 and LA’s 12:00)

If you want to read more from Dr Zachar, check out: ‘Ask A Doctor – CBD Safety, Side Effects & Correct Dosing

[maxbutton id=”10″] [Image credit: Pixabay]

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About the author

Dr. Leah Zachar

Dr. Leah Zachar, M.D. is a physician who worked for nearly thirty years in Internal Medicine.
She currently is a scientific adviser to CBD Testers. Dr. Zachar believes that there is much that medical cannabis, and cannabidiol in particular can offer to traditional medicine.