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cbd dosage for back pain

Understanding CBD (Cannabidiol) for Back Pain

Cannabidiol, commonly referred to as CBD, is a new and relatively understudied treatment for pain, including back pain. Studies suggest it may help relieve inflammation, which is often a factor in chronic back pain. 1

CBD is available in many forms; topical creams and gels have shown promising results for inflammation and neuropathy, which may make them a good option for back and neck pain. 2

CBD requires more research in order to prove and explain its effectiveness as well as to better understand potential side effects (especially long-term) and potential drug interactions.

What Is CBD?

CBD oil is derived from a plant called cannabis sativa. The plant has over 100 chemical compounds, called cannabinoids, that have a range of effects, including anti-inflammatory and analgesic (pain relieving) qualities.

The cannabis sativa plant has two main varieties that are grown for specific purposes:

  • THC content. THC is the compound associated with the “high” feeling of marijuana use.
  • Industrial (non-drug) uses. This form of the plant contains trace amounts of THC (less than .03%) and can be used to make paper, clothing, and some building material. This variation of the cannabis plant is called hemp.

While CBD is present in both varieties, many of the CBD products available to consumers are from the hemp plant. CBD does not come with the high or psychogenic effects of marijuana.

Ways CBD Treats Back Pain

Research indicates that CBD may reduce back pain by:

  • Reducing inflammation 3
  • Combating anxiety, often associated with long-lasting or chronic back pain 4
  • Helping with sleep and improving overall state of relaxation 5

Some studies suggest that CBD can have an effect on how an individual perceives pain, but more robust research is needed. CBD is generally considered a full-body treatment, which means that it does not target back pain specifically—except in the case of topical products—but contributes to an overall feeling of relaxation and pain relief.

Advocates of CBD believe it can be used to treat a range of conditions in addition to back pain, such as anxiety-related disorders. 5

Potential Risks and Side Effects of CBD

Cannabidiol, even in high amounts, is generally safe. Side effects from CBD may include:

  • Drowsiness
  • Dizziness
  • Dry mouth
  • Low blood pressure

More severe side effects, while rare, include:

  • Mental confusion
  • Nausea
  • Vomiting
  • Diarrhea

As with other natural products, there is potential for adverse reactions when taken with other medications, especially those that come with grapefruit warnings, such as certain blood thinners. These warnings indicate that certain medications should not be taken with products containing grapefruit.

CBD use prior to surgery

Before having surgery, all cannabis use, including CBD and marijuana, should be disclosed to the surgeon or anesthesiologist. A recent study suggests that cannabis use may have an effect on medications used to sedate patients. 6

Cannabidiol, or CBD, is a new medical treatment that may be effective for back pain. It has relatively few side effects and does not come with the high associated with marijuana.

CBD Oil Dosage: General Tips to Assess How Much CBD to Take

Written by Jason Brett — Edited by on March 15, 2021

By and large, the acceptance and use of cannabidiol as a therapeutic, healing substance is in its infancy. Medical professionals and scientists are only now beginning to develop dosing schedules for medical marijuana, medicinal hemp, and their extracts (including CBD).

Even with the current wave of states legalizing medical marijuana, many physicians are hesitant to prescribe cannabinoids like CBD. This is for two reasons:

1 – Doctors cannot prescribe (only recommend) cannabinoids, because there’s no recommended daily allowance (RDA) or universal dose for all people.

2 – Most medical schools never cover CBD/cannabidiol therapy in their pharmacology courses (the drug curriculum revolves primarily around substances that can be patented).

Because there is no recommended dose, the information presented on this page is intended to serve only as an informational guide – a starting point of reference – and should never be considered medical advice.

When it comes to cannabinoids, there is one universal truth to keep in mind:

Everyone Is Different

While we wish we could provide the public with a mathematical CBD dosage calculator, it isn’t quite that simple – very rough estimates are about as good as it gets.

With these facts in mind, most people who are new to cannabidiol begin their journey by starting with the minimal suggested CBD dosage on any product, then gradually increasing the dose until they achieve the desired results.

We at CBD Oil Review (COR) have created an official COR Serving Standard through an extensive analysis of hundreds of CBD products .

The (COR) Serving Standard is 25mg of CBD, taken twice daily.

Additionally, our analysis suggests increasing the amount of CBD you take every 3-4 weeks by 25mg until you attain symptom relief (inversely, decrease by 25mg if symptoms worsen).

Additionally, you might find it useful to record your daily experiences in a notebook so you can accurately narrow in on what works and feels best for you. With that understanding in place, it is now time to learn more about CBD oil and how to find the right CBD oil dosage for you.

How Much CBD Oil Should I Take?

Mayo Clinic suggests CBD dosages based on scientific research, publications, traditional use, and expert opinion. Cannabinoid dosages and duration of treatment depend mainly on the illness (and countless other factors).

The Mayo Clinic provides specific dosage recommendations for various illnesses, including:

  • Loss of Appetite in Cancer Patients: 2.5mg of THC (orally), with or without 1mg of CBD for six weeks. [ S ]
  • Pain Relief: 100-150mg of CBD, or 25mg when combined with THC.[ S , S , S ]
  • Epilepsy: A daily dose of 20 – 25mg of CBD per Kg bodyweight. [ S , S ]
  • Movement Problems Due to Huntington’s Disease: 10mg of CBD per kg of body weight daily for six weeks (orally). [ S ]
  • Sleep Disorders: 40mg-160mg of CBD (orally). [ S ]
  • Multiple Sclerosis (MS) symptoms: Cannabis plant extracts containing 2.5-120 milligrams of a THC/CBD combination daily for 2-15 weeks. Patients typically use eight sprays within any three hours, with a maximum of 48 sprays in any 24-hour period. [ S ]
  • Schizophrenia: 40-1,280mg oral CBD daily. [ S ]

Learn the Types of CBD Products

CBD hemp oil comes in seemingly endless forms, each with a different concentration of CBD and other phytocannabinoids. Determining how to use CBD oil first starts with choosing your route of administration – in other words, choosing the best way to take CBD oil for your needs and lifestyle.

Ingestibles:

  • Liquid hemp oil, like CBD tinctures or CBD drops
  • CBD concentrated into a thick paste (often referred to as Rick Simpson Oil, or RSO)
  • Encapsulated CBD oil
  • Phytocannabinoid-rich sprays/spritzers (generally designed for application beneath the tongue)
  • Bottled water containing nano-sized CBD particles
  • CBD-infused chewing gum
  • On-the-go dissolvable powders containing CBD (oftentimes blended with other adaptogenic herbs)
  • Cooking oils (such as coconut oil or olive oil) with added cannabinoids
  • CBD-infused edibles (i.e., gummies, brownies, cookies, etc.; generally for individuals who are sensitive to smoking/vaping)
  • Crystalline isolates
  • Wax (similar to THC-containing marijuana concentrates called “shatter”)
  • CBD-rich eLiquids and/or vape cartridges (akin to an e-cigarette)
  • Transdermal patches with CBD (similar to a nicotine patch)
  • Cannabidiol-infused salves,balms, lotions, shampoos, or soaps (for topical use)
  • Bath bombs infused with CBD

Decide How to Use CBD Oil

While many options like chewing gum need no instructions, we have compiled these tips on how to take CBD oil:

Liquid CBD Oil/Tinctures/Extracts: Drops or tinctures should have a “suggested serving size” and the total milligrams of CBD listed on their packaging. From there, you can determine the amount of CBD you would like to ingest. Simply place the correct quantity of drops under your tongue using the dropper and hold the CBD oil in place for a minimum of 60 seconds. The 60 second hold allows for absorption via the blood vessels underneath your tongue – efficiently bypassing first-pass metabolism. Once 60 seconds has passed, swallow the CBD oil.

CBD E-Liquid/Vape Cartridges: Vaping is excellent for people looking for an immediate response, as inhalation is the fastest way to deliver CBDs to your brain and body. To use vape simply exhale gently the air from your lungs then inhale through the mouthpiece slowly for 3 seconds. Then fill your lungs the rest of the way with additional breath and hold for a few seconds, exhaling when ready. There are pre-filled, cost-effective vape pens and cartridges available as well as more expensive vaporizers that you can refill with CBD-infused e-liquid.

CBD Edibles: With edibles, the only required steps are open, eat, and enjoy! This method of consumption will result in more drawn-out effects that also take longer to kick in than some of the other options. Edibles are great for those seeking sustained effects, or for those who want to be subtle about their usage of CBDs.

CBD Isolates/Concentrates: Anyone familiar with smoking hash or other cannabis concentrates like wax and BHO will be no stranger to this delivery method. Simply sprinkle some into a vaporizer or water pipe, ignite, inhale, and enjoy! We find that this option is useful for individuals looking to elevate their regular consumption of CBD-rich cannabis flowers or other smokable herbs.

For quick reference, refer to this chart of ingestion methods for the pros and cons of each delivery method so can decide for yourself the best way to take CBD oil:

Delivery Method Pros Cons Time of Onset Duration of Effects Recommended if you…
Ingestibles (E.g. edibles; capsules; oil drops; drink powders) Convenient; Dosage control; Discreet; Familiar; Doesn’t harm the lungs Slow to take effect 30-60 minutes Edibles/Capsules:4-6 hours; Tinctures/Drops: 2-4 hours Consider discretion a top priority and/or want more control over dosage
Smokables (E.g. Vapes; flower) Fast acting; Easy to use; Social; Familiar Non-discreet; Smoking/Vaping are illegal in many public settings; Can feel harsh on the lungs Instant 45 minutes-1 hour Are trying to quit cigarettes or need fast-acting relief
Topicals (E.g. Lotions; balms; gels) Can be applied directly to affected area; Bypasses liver metabolism; Long-lasting; Can be worked into daily hygiene routine Slow to take effect Varies widely due to factors like hair growth and amount of fatty tissue Typically 5+ hours Experiencing local pain of the skin or joints or into body care in general.
Transdermal Patches Longest lasting effects;Bypasses liver metabolism;Steady release of CBD into the bloodstream May take hours to feel effects Varies depending on amount of fatty tissue and hair on the skin 1-2 days Have chronic pain or will go a long period of time where the other delivery methods aren’t available

Choose a CBD Brand with a Dosage You Can Trust

Figuring out how much CBD oil to take can feel like trying to navigate through a complicated maze. The sheer volume of CBD brands on the market can create confusion for consumers, and when you take a closer look, it’s not difficult to understand why. Not only do vendors use different source materials (CBD-rich cannabis vs. industrial hemp, different strains, etc.), but they also implement different extraction techniques .

Adding to the confusion, many vendors recommend excessive doses, while others suggest amounts that are a fraction of what experts would consider effective.

As with a fermented food like kombucha, slight natural variations are normal and to be expected in a product such as CBD oil because it is made from living plants. Changes in the weather, soil, and water can all impact the biology of the source material. While we verify Certificates of Analysis (and take many other criteria into consideration during our review process), even the most reputable five-star companies have no way to control for every variable in this organic process.

While perhaps not as ideal as a CBD dosage chart, we at CBD Oil Review (COR) have created an official COR Serving Standard through an extensive analysis of hundreds of products.

The (COR) Serving Standard is 25mg of CBD, taken twice daily.

Additionally, our analysis suggests increasing the amount of CBD you take every 3-4 weeks by 25mg until you attain symptom relief (inversely, decrease by 25mg if symptoms worsen).

Consider Why Your Health Would Benefit from CBD

Cannabinoids such as CBD have a dizzying array of functions in the human body, influencing everything from inflammation to anxiety and depression. You don’t necessarily need to have a serious illness to benefit from CBD; even healthy individuals can experience a remarkable increase in their quality of life with its use.

The following is a chart of illnesses/conditions that whose symptoms may be relieved by CBD:

Keep in mind that this CBD benefits list is in no way complete; we are only beginning to discover how cannabinoids can help.

Know You Cannot Overdose on CBD

There is no established lethal dose of CBD, and chronic use/high doses of up to 1500 mg per day ( 30x MORE than the COR Serving Standard!) have been repeatedly shown to be well tolerated by humans.

As with any natural product, it is important to speak with your physician prior to beginning use. There are some slight risks associated with using CBD in high doses or for extended periods of time, including:

  • Mild Low Blood Pressure
  • Dry Mouth
  • Lightheadedness
  • Sedation
  • Reduced activity of T and B Cells
  • Decreased Fertilization Capacity
  • Reduced p-Glycoprotein activity
  • Reduced activity of Cytochrome P450 (CYP450) Enzyme

Keep in mind that these side effects illustrate worst-case scenarios with CBD, and are not necessarily typical.

There is one major exception to the “generally harmless” attitude about CBD and that is the negative effect cannabinoids can have on the functioning of the liver’s CYP450 enzyme . Approximately 60% of all pharmaceutical drugs are degraded by this enzyme, and CBD can slow the metabolization of these drugs:

  • Steroids
  • HMG CoA reductase inhibitors
  • Calcium channel blockers
  • Antihistamines
  • Prokinetics
  • HIV-antivirals
  • Immune modulators
  • Benzodiazepines
  • Antiarrhythmics
  • Antibiotics
  • Anesthetics
  • Antipsychotics
  • Antidepressants
  • Anti-epileptics
  • Beta blockers
  • PPIs
  • NSAIDs
  • Angiotensin II blockers
  • Oral hypoglycemic agents
  • Sulfonylureas

Before you start taking CBD, please read about drug interactions .

It is important to note that even something as benign as grapefruit juice can cause the same CYP450 enzyme inhibitory action as CBD.

The most important things to do before taking CBD (or any other herbal product) are research any possible drug interactions and talk with your physician to address any additional questions regarding CBD drug interactions or overdose concerns. You and your doctor together will always know best!

Understand How Your Genetics Impact CBD Dosing

As if you didn’t have enough factors to consider when deciding your ideal CBD oil dosage, now you have to think about how your own genetics can impact this amount.

Some individuals have been found to have mutations on the CNR1 gene, which is responsible for coding the CB1 receptor (a type of receptor in cells throughout your body that interacts with cannabinoids). Issues with the CNR1 gene can ultimately result in a poorly functioning endocannabinoid system , which is an important variable when figuring out how to use CBD oil.

How lifestyle choices impact the effect of CBD

Various substances can profoundly affect CB1 receptors. Certain lifestyle choices can impact how your body metabolizes CBD.

We are only beginning to understand which factors influence CBD metabolism, and as such it’s a good idea to take anything related to this emerging science with a grain of salt. As with any natural substance, consult with your physician about any questions and/or concerns you may have regarding CBD and how to use CBD oil.

Rest Easy Knowing CBD Oil Is Not Physically Addictive

People often ask us, “ Can I get addicted to CBD oil ?” This is a tricky question, and the answer ultimately depends on your school of thought.

Based strictly on chemistry, the answer is no. Cannabidiol is not physically addictive in the same way substances like heroin, cocaine, alcohol, opiates, benzodiazepines, and related substances can be. Further, CBD cannot produce any physical withdrawal symptoms in and of itself upon cessation of use.

(Interestingly, CBD is currently undergoing study for its ability to minimize withdrawal from drugs with severe cessation symptoms, like opiates.)

However, human beings can get addicted to just about anything that isn’t chemically addicting: exercise, music, sex, and food are great examples.

Those who take CBD daily to relieve symptoms of chronic illness and other severe conditions may find that their unpleasant sensations return shortly after they miss a dose. This is no different than one’s headache returning once the effects of ibuprofen wear off.

However, because CBD can alter the levels of essential liver enzymes , it is crucial to do your research, talk to your physician, and figure out the best way to take CBD oil for your specific situation. Information and education will be your allies in your quest for healing.

Get the Most Bang for Your Buck

If you’ve been using CBD products for some time without verifying the potency through their vendors, it’s highly probable you’ve been using a minimally effective formulation that hasn’t been delivering as much CBD as you thought (or as much as you’ve paid for!).

This is why CBD Oil Review exists, why we’ve created our five-badge rating system, and why we’ve enlisted independent reviewers to verify that CBD companies are being ethical.

Becoming a CBD Oil Review member not only supports our mission, but members also get new deals on five-star brands only , delivered directly to their inbox. If you are looking for which brands to trust or which products to purchase, take a look at our buyers guides here:

Consider a Cannabis Doctor to Answer Your Difficult Questions

Most doctors don’t specialize medicinal cannabis and CBD oil. This means they may not be able to help you as thoroughly as you had hoped and they may be unable to offer guidance when it comes to helping you decide how much CBD oil to take. It is also worth noting that many patients feel uncomfortable talking to their doctor about cannabis and CBD.

If you have detailed questions about how much CBD oil to take, how to take CBD oil, drug interactions, or just want to know what to do next, consult with a cannabis doctor today!

CBD oil dosage depends largely on the disease. Everyones dosage needs are different, it is best to start with a small CBD dose and increase slowly…