CBD Oil For Back Pain: Evidence For Relief Without Medication
If you are suffering from back pain, you will know the struggles of finding an effective medication for relief. Globally, back pain is the single leading cause of disability, and it is estimated that up to 80% of the U.S. population will experience back pain at some time in their lives. Cannabidiol (CBD) oil for back pain may just offer a solution with many other benefits. 
Back pain affects people of all ages, and they are turning to potentially harmful drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids to alleviate symptoms. Unfortunately, most are not receiving the desired pain relief, but are causing greater damage to their health. More about that later.
Let's first look at how CBD and marijuana for back pain can be heaven-sent remedies for this debilitating condition.
RELATED: What is Cannabidiol?
CBD Oil for Back Pain—A Healthy Alternative
Because of its proven anti-inflammatory and analgesic properties, CBD oil is used as an effective remedy that alleviates back pain and inflammation.
A survey found that 19 percent of participants aged 50 and older have used medical marijuana primarily for pain relief, followed by better sleep and managing different health problems. Only six percent of the surveyed marijuana consumers were doing it for the “high.” The company that conducted the survey included 11,600 adults in 26 U.S. states where medical marijuana is legalized for recreational or medicinal use. 
Let’s take a look into the science of CBD oil for back pain relief, as well as how medical marijuana alleviates back pain.
What Research Says about CBD Oil for Back Pain Relief
Regarding chronic pain relief, research shows a potential link between that, CBD and the receptors in your brain and immune system. The role of receptors in the body—tiny protein molecules attached to the cell—is to receive chemical signals from various stimuli and get the cell to respond.
How does this help with pain management? Researchers believe that this chemical interaction between the cell and CBD has an anti-inflammatory and pain killing effect, responses that help alleviate chronic pain, including chronic back pain.
A 2009 review discussed the analgesic potential of cannabinoids in various types of conditions and pains, including inflammatory pain. In some instances, inflammation can lead to the development of conditions that cause chronic back pain, like degenerative disc disease. The review concludes that CBD and THC appear to be a promising combination to treat severe pain in various conditions.
“In cases of pain attributing wholly or partly to inflammation, it may be worthwhile to explore a local route of administering the cannabinoid, and thus avoid systemic side-effects,” was concluded in the review. 
Various conditions can cause back pain, but the vast majority of low back pain cases are a result of mechanical causes. The list includes but is not limited to:
- Sprains and strains
- Intervertebral disc degeneration
- Herniated or ruptured discs
- A traumatic injury
- Spinal stenosis
- Skeletal irregularities
Low back pain is, in many cases, associated with spondylosis (a degenerative disc disease) which is the “general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.” 
A controlled animal study, conducted in 2014, showed that cannabidiol (CBD) could also be useful in the treatment of intervertebral disc degeneration.
Before testing the effects of CBD on the rats, researchers first used needle punctures to “injure” the intervertebral discs of the spines of 19 rats, particularly in the tailbone area. The analysis was performed on three groups of rats, that were later administered CBD in the concentration of 30, 60, and 120 nmol. After the procedure, the researchers examined the discs under a microscope and with an MRI scan.
The MRI results didn’t show much improvement in the rats that were given 30 and 60 nmol CBD compared to those who were given 120 nmol.
In the study, it was concluded that CBD significantly attenuated the effects of disc injury induced by the needle puncture.
“Considering that cannabidiol presents an extremely safe profile and is currently being used clinically, these results suggest that this compound could be useful in the treatment of intervertebral disc degeneration.” 
What Research Says About Marijuana for Back Pain Relief
The endocannabinoid system plays a role in acute and chronic pain management. A 2006 review published in the journal Current Neuropharmacology, examined the role of the cannabinoid system in pain control and management of acute and chronic pain.
One of the analyzed clinical trials is of humans treated with THC and CBD in neurogenic symptoms unresponsive to standard treatment.
The trial was done in a patient population with multiple sclerosis, spinal cord injury, and limb amputation. The patients were given sublingual sprays of THC and CBD (1:1) from 2.5 to 120 mg each day for two weeks. The patients felt “pain relief by both THC and CBD significantly superior to placebo.” 
A 2017 clinical review of the relationship between cannabis and pain suggests that although further research is needed, limited evidence supports the use of cannabis in certain clinical scenarios.
The review discusses several randomized, controlled clinical trials that show cannabis as an effective back pain reliever.
The review concludes that it is wise to use marijuana for back pain or any chronic pain “if a patient with chronic pain and their healthcare provider work together through first—and second-line treatment modalities without success, a trial of cannabis or a cannabinoid may be a reasonable next step.” 
RELATED: How to Use CBD for Pain-Free Days
Dosage of CBD Oil for Back Pain
There are no official dosing guidelines on CBD oil for back pain or medicinal marijuana for back pain as these remedies are currently in the gray zone—in legal terms.
If you are new to cannabis, it would be the best to experiment with doses, after getting consent from your doctor. Here are some recommendations on how to use CBD oil for back pain:
- Start low and increase as necessary. Be mindful with your dose and track your progress by starting on the lowest dose of 2.5 mg and gradually increase. If you find a dose that works best for your back pain, stick with it. Jumping to a high dose of CBD oil may cause some side-effects. If you notice that after a few days of taking the same dose you are not getting the desired results, take a slightly higher dose. That said—in cases of emergency, high doses of CBD can be taken with safety. Side-effects are usually self-correcting and not harmful, and CBD has not been associated with any adverse events, even in extremely high dosages. Do not take high-dose CBD without your physician's consent if you're on medication. 
- Be patient. Back pain can be excruciating, but CBD oil is a natural product and can take up to 30 days for you to feel its effects.
- Only use CBD oil supplied by a reputable brand. Today’s market is flooded with various CBD oil suppliers that derive the oil using a variety of subtraction methods. Here are the most important things to pay attention to when choosing a brand:
- Look for hemp-derived CBD products. These are fully legal everywhere in the U.S.
- Only select brands that offer products made with organically cultivated hemp.
- The subtraction method matters—preferably subtracted using the CO2 method—as the quality, safety, and purity of the final product depend on this.
- Look for quality over quantity. Check the CBD mg per dose, not the percentage of CBD oil per bottle. Lower quantities of high-quality CBD oil will give you better results for your back pain than vice versa.
The Problem With Pharmaceutical Medicines
It is no secret that mainstream medicine is often a mixed bag—its use offers relief in one place, yet it often causes other problems to pop up elsewhere. We call it side-effects, and the more dangerous ones are called adverse events.
Chronic back pain is usually a complex condition to manage, with no easy remedies. This means people take medicine chronically, or in very large doses, a practice that can pose serious problems over time.
For instance, NSAIDs, (non-steroidal anti-inflammatory drugs), which is a common prescription for back pain, can have serious side effects, especially if you take more than the recommended dose. Sometimes even the recommended dose can cause problems.
- Increase the risk of cardiovascular problems (such as high blood pressure, heart attack, and stroke)
- Interact with drugs prescribed to treat heart disease (for example, blood thinners, aspirin, and antihypertensive drugs)
- Cause nausea, stomach pain, and ulcers, kidney failure, gastrointestinal hemorrhaging 
Especially the elderly are a vulnerable population in this regard.
A common concern with NSAIDs is the also the so-called “ceiling effect,” which means that there is a limit to the amount of pain these drugs can control. Unlike full-spectrum CBD oil, NSAIDs won’t provide additional pain relief beyond a certain dose.
Yet, crippling back pain is not something that is likely to go away with a couple of pills. This is where people are turning to opioids, some of them fully aware of the risk of addiction, even overdose. 
Compared to most medications available, marijuana and CBD oil don't pose the same risks. In fact, it shows great promise in alleviating back pain and inflammation safely and effectively. As mentioned, it is important to always first consult with your doctor before taking especially high-dose CBD oil if you are currently on pharmaceutical medication for your back pain.
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3324204/ (Section “Choosing NSAIDs,” below Table 1)
 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430692/ (Table 4)