In surveys of CBD users, pain management is always one of the top reasons given for using nonintoxicating cannabis products. So it makes sense that nearly all brands, especially those targeting athletes, now offer topical solutions meant to be applied directly to achy areas. Are these balms, salves, creams, lotions, roll-ons, patches, and sprays an intriguing advance in sports medicine? Or are they mostly an expensive but ineffective throwback to the Bengay locker-room aromas of decades ago?
The usual explanation for CBD topicals’ potential effectiveness is that, once the substances penetrate the outer layer of skin, they bind with cannabinoid receptors. These receptors can be thought of as locks on the surface of cells, causing cellular changes when they’re unlocked. In this metaphor, cannabinoids are the keys to the locks, and those keys can be either the body’s own endocannabinoids (which play a role in exercise euphoria) or an external source of cannabinoids, such as a CBD topical.
There’s at least a theoretical basis for believing in the power of CBD topicals
Anecdotally, CBD topicals seem to work best in managing flare-ups of the chronic low-grade problems most endurance athletes live with. Aggravated iliotibial band from running on slanted roads? Check. Shoulder strain from too much time riding an indoor trainer? Check. Torn ACL or ruptured Achilles? Not so check.
The placebo effect is likely behind some reports of CBD topicals’ efficacy. Given that they can cost twice as much as conventional topicals, it’s understandable that you’d be more inclined to believe they’ll work.
So if you think a topical solution will help with your throbbing Achilles tendon, it just might.
Phytochemicals have been used for centuries in traditional medicine, both topically and orally, for various conditions. They are believed to have anti-inflammatory and analgesic properties but there is a lack of data to support use or even provide a potential mechanism for which they elicit these properties. A few phytochemicals, however, have been studied more extensively than even commonly recommended OTC topicals, including lidocaine and capsaicin, and are therefore worthy of consideration:
17. US Federal Trade Commission. Release: FTC Announces a Second Case Focusing on Safety Risks of Comfrey Products Promoted via Internet. 13 July 2001. Available at: https://www.ftc.gov/news-events/press-releases/2001/07/ftc-announces-second-case-focusing-safety-risks-comfrey-products
Topical Analgesics: Trends and Limitations of Use
Sesame may help to reduce knee pain. (iStock)
Practical Takeaway: Given the favorable side effect profile and demonstrated efficacy, utilization of Arnica gel may be considered in patients with arthritic pain who are unable to tolerate topical NSAIDs or as an alternative for those who do not benefit from topical NSAIDs.
1. National Institute for Health and Care Excellence. Osteoarthritis: Care and management in adults. NICE clinical guideline 177 (guidance.nice.org.uk/cg177). London: Royal College of Physicians, 2014.