Let's start simple: Endocannabinoids are natural signals in your body that help maintain homeostasis by detecting and regulating hunger, pain, mood, and memory. (They're actually part of your post-workout exercise high.) CBD helps elevate your natural levels of pain-relieving endocannabinoids by blocking metabolism as they're moving around your body.
The fatty tissue can only hold so much oil, so, theoretically, if you apply enough of a cannabis cream to your skin, it might leak down into your skeletal muscle just out of diffusion, adds Sexton. But there's no study to show this, and that means you're going to be rubbing on a whole lot of the stuff.
How CBD and Cannabis Might Help Pain Relief
There is an argument to be made for the simple fact that science hasn't caught up to the trend (and laws) of cannabis yet. (Here's what research has to say about the potential benefits of CBD and cannabis so far.) And there are doubtlessly researchers testing the efficacy of CBD creams for pain relief as we speak.
These topical ointments, creams, and lotions are infused with CBD, or cannabidiol, a compound found in the cannabis plant. Manufacturers claim it can help alleviate acute pain and muscle soreness. To reiterate for the uninitiated: CBD is not the same as THC because CBD does not have any psychoactive effects — aka it won't get you high.
This brings up an underlying issue with all CBD and hemp products: There is no regulation around how much active CBD or THC is in each cream or how much of the compound is needed to see relief. Read: "If you have three products that say 1 percent CBD infused in coconut oil, one could be great and the other two could be crap—that's the reality of cannabis medicine right now," says Gerdeman. (See: How to Buy Safe and Effective CBD Products)
As it turns out, topical CBD products may offer some anti-inflammatory properties to help alleviate pain through cannabinoid receptors within the skin. These receptors are a part of the body's endocannabinoid system, or ECS, that governs functions such as our ability to process pain, as well as inflammation, mood, and sleep. The cannabis plant contains phytocannabinoids like CBD that interact with our ECS, which is why hemp has therapeutic properties.
These are some of the most important considerations when selecting most CBD oil products, including topicals like a CBD pain cream.
Can CBD cream actually help with pain?
This article has been medically reviewed by Ashley Jordan Ferira, PhD, RDN, the Senior Editor of Health & Wellness Strategy at Remedy Review, an independent CBD reviews site. Dr. Ferira completed her PhD in Foods & Nutrition at The University of Georgia, where she researched the role of vitamin D in pediatric cardiometabolic disease. The products featured in this article were tested at ProVerde Laboratories in Milford, MA and Avazyme, Inc. in Durham, NC.
Now that we've explored the background on CBD topicals and how they might aid in pain management, let's dive into our top five product recommendations for the best CBD cream for pain. Continue on to learn more about CBD cream usage and selecting the product right for you.
Plant People prides itself in selling high-quality hemp products, which are organic, lab-tested, non-GMO, and gluten free. The brand's Soothe+ Balm topical is made with full spectrum hemp extract that includes minor cannabinoids, including cannabichromene (CBC) and cannabigerol (CBG). Plant People is also a certified B Corp, making this a pain cream from a top-notch organization.
The lack of regulation has also left the door open for products to be subject to both “contamination and adulteration,” Dr. Tishler says. One study, published in JAMA in 2017, found that almost 70 percent of CBD products—including vape cartridges, tinctures, and oils—sold online did not contain the things they claimed to in the right amounts. That’s why Boehnke recommends only buying CBD products that you can verify (via a certificate of analysis) do contain what they’re supposed to. And Boenhke offers the same advice he does for all cannabinoid products: Start at a low dose and, if you decide to increase it, go slowly. (Start low, go slow.)
It’s totally possible (and actually pretty likely) that any effect you get from a commercially available topical CBD product is a placebo effect or related to some other aspect of the product. But there are a few things going on here that are more complex than they seem.
Another study published in 2016 in the European Journal of Pain also looked at arthritis in rats but did so with a topical formulation of CBD. After the rats received an injection into one knee joint to model arthritis, they received a gel that contained either 10 percent CBD (in four different total amounts) or 1 percent CBD (the control) on four consecutive days. The gel was massaged into the rats’ shaved backs for 30 seconds each time.
So…is CBD cream just an expensive placebo?
In fact, the most compelling research they found for using cannabinoids for pain came from a large review and meta-analysis published in JAMA in 2015. For the study, researchers looked at results from 79 previous studies of cannabinoids and various medical conditions, including chronic pain. However, of those studies, only four involved CBD (without THC)—none of which were looking at pain. So although we might assume that CBD is doing something to help address pain—according to the studies involving the whole cannabis plant—we don’t have great evidence to prove it.
“Cannabidiol is a super messy drug,” Ziva Cooper, Ph.D., research director of the UCLA Cannabis Research Initiative in the Jane and Terry Semel Institute for Neuroscience and Human Behavior and the department of psychiatry and biobehavioral sciences, tells SELF. “It has lots and lots of targets and it’s not clear how much of its effects on each target contribute to the potential pain relieving effects.”
The only thing that comes close is a Phase 2 clinical trial using a proprietary CBD transdermal gel (meaning it’s meant to go through the skin into the bloodstream) in 320 patients with knee osteoarthritis over 12 weeks, which has not been peer-reviewed to date. Unfortunately, in almost all of the study’s measures of pain, those who received CBD didn’t have statistically different scores from those who got placebo. But “they found some reductions in pain and improvements in physical function,” Boehnke says.
“It actually is a very promiscuous compound,” Kevin Boehnke, Ph.D., research fellow in the department of anesthesiology and the Chronic Pain and Fatigue Research Center at the University of Michigan, tells SELF. “It will bind to receptors in multiple different pathways,” which makes it difficult to know how it might cause noticeable effects.