From patient trust to emerging evidence: Expert insights behind CBD and chronic pain management

Summary

• September is Pain Awareness Month, which this year focuses on the importance of taking an individualized, multidisciplinary and multimodal approach to pain management to better support the billions of people who suffer from chronic pain globally.
• Many people choose cannabidiol (CBD) as part of their personal journey towards managing chronic pain. Moreover, public and patients’ perceptions of the pain-relieving effects of CBD are increasingly supported by emerging evidence from pre-clinical and clinical studies. 
• In this blog, dsm-firmenich, an expert partner in CBD-based research and product development, presents five key takeaways from the current field of research around CBD and pain relief. Read on to explore insights from patients, the latest science and emerging opportunities.

Affecting over 30% of people worldwide, chronic pain is a prevalent issue.¹ Its diverse causes, many of which remain unidentified, complicate treatment strategies. As a result, patients often turn to over-the-counter (OTC) treatment options, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and paracetamol, as well as increasingly popular treatments like cannabidiol (CBD).

In this blog, we explore the anecdotal evidence and rising scientific interest in CBD for chronic pain management, highlighting its promising therapeutic potential. Read on to explore five scientific takeaways and expert insights from Anne Birkett, Translational Science Manager HNC, and what this evidence could mean for the future of pain treatment. 

1. 60% of CBD users aged 26-76 choose it for pain relief

Following changes in legislation over the last few years, CBD has become more accessible worldwide, leading to increased awareness and growing popularity of OTC CBD products. As a result, there is a wealth of anecdotal evidence on the health benefits of CBD, and when it comes to pain relief, one thing is clear – people trust and believe in CBD’s benefits. In surveys of CBD users, pain relief is consistently among the major benefits cited as reasons for use.^2,3,4,5,6,7

One of the most compelling examples of this anecdotal evidence is a 2024 Forbes Health survey of 2,000 adults living in the US. The survey found that 60% of respondents have tried or used CBD products, and pain relief was the second most common reason cited. In fact, among users aged 26-76, between 60 and 62% said that they use CBD to relieve pain.²

Anne Birkett said, “Anecdotal reports of the benefits of CBD for pain relief are incredibly encouraging. That’s even before considering the other benefits that CBD may provide in alleviating secondary effects of chronic pain, such as anxiety and sleep disturbances. This evidence provides impetus for continued scientific and clinical research into CBD use for pain relief, and importantly, demonstrates that there’s significant public and patient awareness and trust in its potential benefits.”  

2. Common pain targets include arthritis, joint and musculoskeletal pain

There are different types of pain that affect people in a variety of ways. Common pain categories indicated in multiple anecdotal surveys of CBD use include arthritis, joint and musculoskeletal pain.^3,4,6 In one large survey of 2,409 CBD users, chronic pain and arthritis or joint pain were the two most frequently reported medical conditions that respondents sought to treat with CBD. Users more frequently reported that CBD treated these types of pain “very well by itself” or “moderately well by itself”.³

These forms of pain are widespread, with up to one fifth of adults suffering from long term musculoskeletal pain⁸ or arthritis⁹ in some populations. For those affected, pain relief is a major factor for improving their quality of life – affecting mood, movement, the ability to work and much more. 

Anne Birkett adds, “In addition to those highlighted by surveys of CBD users, other therapeutic targets for CBD within the pain realm include athletic pain and pain associated with cancer treatment, which are also the subject of published and ongoing clinical trials. Pain is a diverse issue, with many causes and extensive effects on people’s lives and wellbeing.”

3. CBD has anti-inflammatory and analgesic properties 

Emerging pre-clinical research on CBD and the endocannabinoid system reveals multiple mechanisms by which CBD might provide pain relief, lending scientific support to its strong anecdotal reputation. Many of the receptors that CBD is known to interact with – including serotonin receptors and the ion channel TRPV1 – have been suggested as key targets for inducing analgesic and anti-inflammatory effects.^10,11

Other key targets for CBD include the cannabinoid receptors, CB1 and CB2. These receptors – and other elements of the endocannabinoid system – are expressed throughout pain pathways, from peripheral nerve endings where tissue damage ignites pain signaling to brain regions associated with pain processing.¹² This indicates multiple physiological sites at which CBD could modulate pain. For example, there is evidence that the antagonistic effects of CBD on CB2 play a role in reducing inflammatory responses associated with pain.^10,11

Anne Birkett explains, “Multiple potential targets and mechanisms of action for CBD in pain modulation are emerging as a result of exciting pre-clinical research. Additionally, various pre-clinical studies have demonstrated CBD’s anti-inflammatory and analgesic properties, with many reporting reduced joint pain and improved movement, as well as decreased inflammatory markers.^11,12 This growing scientific foundation provides important backing for clinical studies.”

4. 11 published trials report improvement in pain with CBD treatment

When looking at clinical data for CBD and pain, the results are often viewed as inconclusive. Many studies examining CBD treatment for pain report no statistically significant effect, and disparities between studies in terms of pain types, dosage and duration make comparisons and meta-analysis difficult. However, this does not mean that there is no promising evidence. 

At least five published clinical studies have reported improvement in pain with orally administered CBD-based treatments.^{13,14,15,16,17} These cover multiple conditions and types of pain, from post-surgical recovery to chronic pain that was previously managed with opioids. The data for topically applied CBD-based solutions is more consistent – out of seven published studies, six show improved pain with CBD treatment.^{18,29,20,21,22,23} Interestingly, four of these published studies examined topical CBD-based solutions for treatment of arthritis, and three of those reported improvements in measures of pain. ^18,19,20

Anne Birkett said, “While the overall clinical evidence for CBD and pain is evolving, there are many encouraging studies emerging. Moving forward, there will be opportunities to solidify existing data as we learn more about CBD, improve and diversify delivery forms, and standardize study designs. There is rich potential for future investigation within this research and development field.”

5. Research investment means that there is more data coming

As more exciting studies are completed and published, we will continue to learn about the potential of CBD-based treatments in chronic pain management. There are currently 29 ongoing clinical trials registered in the US alone that are investigating CBD rich products for pain-related intervention.²⁴ These studies cover a wide range of pain targets from arthritis to dental pain, post-operative pain and endometriosis. Continued investment in research will guide the future use of CBD for pain relief and highlight the conditions where CBD-based treatments will be most effective.  

Anne Birkett summarizes, “There are so many opportunities for research around CBD for pain management. As more data emerges and investment continues, we will be able to bolster existing knowledge and potentially create new treatment routes for patients suffering from various forms of chronic pain. Yet, this is just one of many areas in which CBD may elevate patient health, which is why dsm-firmenich is committed to advancing the science behind CBD-based treatments.”  

What's next? 

Anecdotal evidence showing that CBD is effective in the management of chronic pain is now increasingly supported by science, and ongoing investment in research is unlocking exciting opportunities for further investigation and innovation in this area. As organizations and researchers advance in this field, collaborating with the right CBD partner is key for successful product development. 

dsm-firmenich is a trusted, expert, end-to-end partner for patient-inspired CBD-based drug development. We are passionate about pioneering this next frontier of medicine to transform therapeutic possibilities for patients worldwide. Together with Brains Bioceutical, we offer the highest quality CBD active pharmaceutical ingredients as well as technical, clinical and regulatory expertise to support you in creating innovative CBD-based treatments for the management of chronic pain.