CBD, Pain Tolerance & Exercise
One of the most common uses for CBD is undoubtedly pain. There’s a good body of emerging evidence suggesting that CBD may be useful for various types of pain. There is little data relating to the use of CBD in sport and exercise, aside from the occasional anecdote. But evidence for a painkilling effect is emerging from studies including surveys, clinical trials and case studies.
CBD is an incredible plant compound, because it can have many different effects in the body all at one time - its impact on pain is ubiquitous. Mechanistically speaking, CBD pushes a lot of buttons that modify the sensation of pain.
- CBD increases Anandamide, which is anti- inflammatory and analgesic upon activation of the CB1 receptor within the nervous system (1)
- CBD turns down the volume at mu (μ) and delta (δ) opioid receptors to reduce pain signalling (2)
- CBD turns down the volume at Glycine receptors to reduce pain signalling (3)
- CBD increases the signalling at GABA receptors to overcome the sensation of pain (4)
- CBD activates TRPV1 and TRPA1 receptors to reduce pain signalling (5)
- CBD promotes adenosine A2A signalling which may reduce pain (6)
Opioid drugs which are used as prescription painkillers target mainly just the opioid receptors themselves to manage pain. Because of the focus on modifying a single pain pathway, Opioids may become highly addictive. Just look at the Opioid epidemic with prescription painkillers. They can be useful in certain scenarios, but they have their downsides.
However, because CBD targets many pain pathways, there is less risk of over reliance or addiction. CBD has been found to be non-addictive or habit forming by the WHO. Some studies suggest it may even help reduce addiction to Opioids (7).
In a Washington Post article, Tour De France winner Floyd Landis had the following to say on CBD:
“It’s not something I was exposed to as an athlete, but it was effective in allowing me to wean off opioids,” he says. “Now I use CBD daily as a pain reliever.”
Clinical trials with CBD support the mechanistic studies which suggest it has a painkilling effect. CBD sprays (2.5mg CBD per spray) have been shown to significantly reduce neuropathic pain compared to placebo (8), (9).
A survey also found that pain was amongst the most common use for CBD (10), so it’s good to see real world data supporting the (sparse) evidence for CBD’s effect on pain.
Whilst it’s tempting to say that this evidence translates into a training session with less pain, this still needs to be confirmed by trials with athletes.
However, some athletes certainly attest to its benefits. A lot of athletes (in the States) also have access to THC, and they often choose
to microdose THC alongside CBD (10:1 CBD:THC) for a more pronounced pain killing effect.
Athlete Ben Greenfield had the following to say about using cannabinoids:
“I talked to a lot of athletes, especially in like Colorado for example, who are using THC, and THC edibles, and weed to increase focus and to decrease perceptions of pain during exercise. So I decided to see if I could use CBD. I was experimenting with everything from the 10 to the 50 milligram range of CBD capsules for this, and I've found that I can get a very, very similar effect”
There’s some decent evidence that supports the use of a 1:1 ratio of CBD:THC for managing pain.
Most studies investigating effects on pain use Sativex, a pharmaceutical THC:CBD spray (delivers 2.7 mg THC and 2.5 mg CBD per actuation). These trials have shown that neuropathic pain in Multiple Sclerosis is effectively reduced by a THC:CBD combo (11), (12), (13).
Although CBD (2.5 mg CBD per actuation) was effective at managing pain, the pain killing effect was greater when combined with THC (14). The combination of THC, CBD and other cannabinoids and terpenes forms part of something called the entourage effect.
Even though Gaia Guru products contain <0.01% THC, they do contain complementary ingredients such as Beta-caryophyllene (a dietary cannabinoid from black pepper) which synergise well with CBD to boost the entourage effect.
Andrew Talansky recently told Outside Magazine how CBD has helped him manage lingering pain from a previous hip injury. “I took it for a couple of weeks, and there was a noticeable difference immediately. And it wasn’t just that my hip was feeling better. I was less anxious, and I was sleeping better."
How To Use CBD
There are two main ways CBD can be helpful here, which may depend on what your sport or activity is.
- CBD can be used during training or competition to help modify tolerance to pain.
- It can also be used to help manage pain outside of training.
Using CBD During Training
Increasing your pain threshold to tolerate particularly intense and/or long bouts of exercise no doubt helps you go the extra mile (quite literally).
Some athletes (particularly endurance) use NSAID’s like Ibuprofen prophylactically to manage pain whilst competing. Interestingly, Ibuprofen doesn’t appear to significantly reduce the perception
of pain throughout competition (15) - even though many athletes use it for this purpose.
A few endurance athletes are ditching the ibuprofen for CBD (sometimes with a touch of THC) to help them increase their pain tolerance and focus during exercise.
Whether you’re taking on a particularly tough WAD (workout of the day), slogging through an ultra
or turning up the intensity, CBD may just be the thing that helps take the edge off.
Using CBD After Training
CBD is arguably the most popular choice amongst athletes who compete in sports that are hard on the body - NFL, NHL, MMA, UFC, Rugby, action sports and endurance events. These sports often come with either an acutely or chronically high risk for encountering pain, and many athletes often reach for the medicine cabinet to find relief.
There’s a lot of inflammation that occurs with exercise, and it often hits the muscles and joints the hardest. Inflammation is essential for recovery and adaptation to exercise, but it’s also a by product of pushing your limits, and comes at a cost - it’s painful. That’s why the use of NSAID’s is popular in sport, particularly Ibuprofen.
Interestingly, high doses of Ibuprofen have actually been associated with slowed muscle recovery, reduced strength and hypertrophy after resistance training (16), which could be interfering with the acute inflammatory response to exercise. Normal doses don’t appear to impact muscle pain, soreness or recovery (17). It’s tricky as high doses may be needed for pain relief, but at a burden to the recovery process.
Other downsides of long term use of NSAID’s include gastrointestinal, hepatic, cardiovascular, musculoskeletal and kidney complications (18).
The good news folks, is that CBD is also a powerful anti-inflammatory, which has demonstrated its ability to reduce inflammatory pain and neuropathic pain (19). It also has a great side effect profile (20), which means that side effects are minimal when using it even at high doses and for long periods of time.
A few studies have demonstrated that CBD is safe to use at high doses (1,500mg) (18) and long term (6 months) (19). We’ll talk about dosing later. The World Health Organisation has also declared that CBD is safe (20), which may translate into long term use without the risks associated with NSAID’s.