If you suffer from debilitating chronic pain that lasts for three months or more, you know it is one of the most challenging conditions to treat. More than 20% of Americans are affected by chronic pain at any time. Managing chronic pain often involves addictive opiates and painkillers. Fortunately, studies demonstrate that THC and CBD in cannabis have healing powers, especially for pain and inflammation.
But is THC or CBD better for chronic pain? Here we look at the pros and cons of THC and CBD for pain, what types of pain they work best for, and what products deliver the best results.
How THC and CBD Work for Pain
THC and CBD are the two main active ingredients in marijuana. THC gives marijuana its psychoactive effects, inducing feelings of relaxation, sedation, and a “high” feeling. CBD is non-psychoactive and won’t make you feel high on its own. The reason marijuana is effective for pain comes down to how these compounds interact with receptors in the body.
The human body contains a complex network of neurotransmitters and cannabinoid receptors known as the endocannabinoid receptor system (ECS). Research suggests that cannabinoids interact with receptors in ECS and throughout the body to help balance many functions, including mood, memory, appetite, and pain. THC and CBD support pain management in various ways. For example:
- CBD and THC help control the body’s pain signals responsible for detecting pain and regulating pain thresholds.
- CBD and THC act as anti-inflammatories, inhibiting damaging cytokine production, which can be helpful for inflammatory causes of pain, like autoimmune disorders.
- CBD and THC change the way receptors receive pain signals, a key reason medical cannabis can replace opioids.
THC and CBD work independently and together in the body to amplify each other’s pain-fighting effects. This synergistic action is called “the entourage effect,” the theory that cannabis compounds work better jointly than alone, targeting multiple receptor systems simultaneously.
What Types of Pain THC and CBD Work Best For
Chronic pain often involves conditions such as fibromyalgia, neuropathic (nerve pain), and arthritis—all conditions that the THC and CBD in cannabis have shown to help treat. Patients with neuropathic pain typically respond better to THC. However, inflammatory pain caused by inflammatory bowel disease or fibromyalgia often responds better to high CBD dosages.
THC for pain
A review of cannabis research in the Annals of Internal Medicine journal gathered from 25 studies, and 15,000 participants found that cannabis with higher THC ratios could be more effective for soothing chronic pain than CBD. That may be because THC binds directly to the body’s natural cannabinoid receptors within the nervous system and brain, primarily the “cannabinoid receptor type 1,” or CB1.
CB1 receptors outnumber many other receptor types in the brain, acting like traffic cops to control the levels and activity of other neurotransmitters. As a result of this action, THC effectively controls the body’s pain signals and response.
THC’s psychoactive effects may also play a role in its pain-fighting powers.
- Within 20 minutes, the circulatory system carries THC molecules to every tissue in the body, including the brain, where it can alter how our minds perceive pain quickly.
- When THC hits brain cells, it causes them to release dopamine, a feel-good brain chemical. The Annals of Internal Medicine review also said that mood is a huge part of treating chronic pain, and THC euphoria can significantly help patients.
CBD for pain
CBD emerged as a promising pharmaceutical agent to treat pain, inflammation, seizures, and anxiety without the psychoactive effects of THC. Studies show CBD reduces pain by acting on biological processes in the body. However, CBD has little binding affinity for the cannabinoid receptors and acts on other receptor channels instead.
- CBD binds to TRPV1 receptors known to mediate pain perception, inflammation, and body temperature, which help it work as an anti-inflammatory and reduce oxidative stress.
- A study on mice found that CBD may interact with neurological receptors in the spinal cord that suppress chronic inflammatory pain.
- CBD may also strengthen the effects of AEA, a cannabinoid that reduces pain.
Research shows CBD may be best for treating inflammation and alleviating localized pain for brief periods. CBD can also reduce the anxiety people living with chronic pain often experience.
Best THC and CBD Product Types for Pain
THC and CBD products come in many forms. Oral products and sublingual extracts with high THC-to-CBD ratios appear to show the most improvement when treating chronic pain. These include:
- Flower for smoking
- Oils, extracts, and tinctures
- Oral capsules or pills
Because THC and CBD edibles such as gummies must go through the digestive system, it slows and intensifies their effects. As a result, gummies often provide longer relief ( 4 or more hours) than smoked cannabis.
Oils and tinctures are also versatile pain management options. These products usually come in tinted glass bottles with a dropper, so patients can easily add a few drops to food or beverages or place them directly under the tongue.
Many patients use topical CBD oil for arthritis and joint-related swelling, but only high-dose products are effective. Consensus says benefits start at 10 to 25 milligrams of CBD twice daily. Other patients need 50 to 100 milligrams of CBD to feel the results.
Full-spectrum products with both THC and CBD often prove the most effective overall rather than THC or CBD alone.
Another option some patients consider is THCA. Wondering what is THCA and how it is different from THC? THCA is the acidic precursor to THC that exists in freshly harvested marijuana plants. It is not psychoactive like THC (because it doesn’t bind to CB1 receptors in the brain) but has significant therapeutic potential, including pain management.
Products with a higher THC-to-CBD ratio might cause side effects, such as:
- Dizziness and sedation
- Dry mouth
- Upset stomach
Too much CBD can also cause side effects, including:
- Abnormalities in the liver
- Issues with the male reproductive system
- Interactions with other essential medications, like blood thinners and heart medications
Most negative effects are mild and reversible, especially when compared to opiates.
The Bottom Line
So, is THC or CBD better for chronic pain? The answer largely depends on pain type and symptoms. Cannabis with higher THC ratios proves better for nerve damage-related pain because THC acts on receptors in our brains and central nervous system. THC’s psychoactive effects also provide an essential mood boost, which can significantly impact pain perception. CBD affects receptors more closely related to inflammation, assisting with joint pain and swelling. CBD can also ease anxiety during pain treatment. Potential side effects are mild, but patients should consult their physician before self-medicating.