Pain and inflammation are part of everyone’s life. These events are natural reactions of our body triggering a self-healing attempt, which is often successful. When pain increases, it’s likewise natural to seek help from outside the body. Nonsteroidal anti-inflammatory drugs, or NSAIDs, are the most common painkillers and anti-inflammatory drugs for conditions that are not too severe.

Ibuprofen is one of the most common anti-inflammatory drugs, discovered in 1961 and today available under several trade names. Other common NSAIDs include aspirin, diclofenac, ketoprofen, and a few more. They are effective in reducing or eliminating pain, inflammation, fever, headaches, rheumatoid arthritis and more, but these drugs have serious potential side effects, such as ulcers, heartburn, headaches, dizziness, liver or kidney diseases, high blood pressure, heart attack, and stroke.

Ibuprofeno vs Cannabis for Fighting Inflammation

HOW IBUPROFEN WORKS

When the body suffers an injury, compounds called prostanoids are produced. These include prostaglandins, which are involved in inflammation, and thromboxane, which is involved in blood clotting. These compounds are produced by cyclooxygenase enzymes called COX-1 and COX-2.

Like other anti-inflammatory and pain-control drugs, ibuprofen inhibits the release of these chemical compounds generated by our body’s response to an injury, trauma, or infection. Ibuprofen inhibits the production of prostaglandins by decreasing the activity of the enzyme cyclooxygenase, but, just like aspirin, ibuprofen is a non-selective COX inhibitor. This means it inhibits both COX-1 and COX-2 enzymes, potentially causing more side effects than other select NSAIDs. However, ibuprofen is effective against the symptoms of general pain, head pain, joint inflammation or damage, fever, rheumatoid arthritis, gout, minor musculoskeletal injuries, and rheumatic diseases. Still, a lot of people make large use of this drug without being fully aware of its side effects and risks for their health.

NEW BIOCHEMICAL CHANNELS FOR PAIN CONTROL

The endocannabinoid system is mainly active in pain control at the central nervous system level, but it’s also active in peripheral systems against painful and itchy symptoms of inflammation generated by dermatitis and allergies. Through their action on our endocannabinoid system, endogenous and exogenous cannabinoids are able to modulate pain thresholds and inhibit the release of proinflammatory molecules, just like ibuprofen. Moreover, they exert synergistic effects with other systems in our body that modulate pain, such as the endogenous opioid system.

Preclinical[1] and clinical studies have implicated the anti-inflammatory and pain-controlling potential of cannabinoids, suggesting the cannabis derivatives may prove useful for conditions related to acute or chronic pain—even conditions that are often refractory to conventional therapies. In particular, one study suggests[2] that CBD reduces the inflammatory response by lowering the production of proinflammatory cytokines by the immune system. A second research paper[3] claims that the compound may also inhibit some of the receptors responsible for pain perception.

Several clinical trials have proposed the safety and potential efficacy of THC and CBD for those with central and peripheral neuropathic pain[4], rheumatoid arthritis, and cancer pain. In fact, the World Anti-Doping Agency (WADA)[5] recently removed CBD from its list of banned substances. This has allowed many professional athletes to join others in using CBD before and after competing or exercising.

Scientific investigation into cannabinoids for pain has influenced thousands of patients to reconsider what they take to manage pain and its associated symptoms. As opposed to many prescription drugs, THC’s side effects are generally well-tolerated, while the side effects of CBD are reported to be minimal by the World Health Organisation[6]. As part of their 2018 review into the compound, the WHO found that "CBD is generally well tolerated with a good safety profile. Reported adverse effects may be as a result of drug-drug interactions between CBD and patients’ existing medications".

 

CBD AND PAIN

Today, we can find plenty of CBD products on the market. Along with CBD oils, there are capsules, sublingual tinctures, edibles, topical creams, liquids for vaporization, and, of course, CBD-rich cannabis strains. Smoking, vaporizing, oral consumption, and sublingual administration offer vastly different levels of bioavailability, leading some individuals to combine different administration methods: a few oral applications a day, inhaling vapor as needed, and a topical cream on affected areas.

The WHO review also found that, "To date, there is no evidence of recreational use of CBD or any public health-related problems associated with the use of pure CBD", going on to add, "In humans, CBD exhibits no effects indicative of any abuse or dependence potential".

However, most users start out with low doses, slowly increasing intake over a period of days or weeks until they reach their required dosage. The main precaution when using CBD is to understand that it may affect the way other drugs are metabolised, potentially augmenting or decreasing their effectiveness. If you are currently on medication and wish to start using CBD, do consult your physician first.

Some cannabis users find that cannabis strains, or derivatives, rich in THC work best against painful symptoms, while others prefer products that contain little or no THC, or a balance of both CBD and THC. Cannabis terpenes also display attributes that may be complementary to pain treatment[7], and this is the reason why a full spectrum extract is usually preferred to a single isolated cannabinoid, according to the “entourage effect” theory[8].

There is still an incredible amount to learn regarding CBD's interaction with other medications, our pain receptors, and what an ideal dose may look like. Thankfully, research is ongoing, with our understanding of the compound’s intricacies developing in kind. We may not be able to give a definitive answer on CBD as a future alternative to NSAIDs, but what we can say is, watch this space for future developments!

External Resources:
  1. Role of the Cannabinoid System in Pain Control and Therapeutic Implications for the Management of Acute and Chronic Pain Episodes https://www.ncbi.nlm.nih.gov
  2. Cannabinoids as novel anti-inflammatory drugs https://www.ncbi.nlm.nih.gov
  3. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors. - PubMed - NCBI https://www.ncbi.nlm.nih.gov
  4. Cannabinoids in the management of difficult to treat pain https://www.ncbi.nlm.nih.gov
  5. What is Prohibited | World Anti-Doping Agency https://www.wada-ama.org
  6. CANNABIDIOL (CBD) Critical Review Report https://www.who.int
  7. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evid... - PubMed - NCBI https://www.ncbi.nlm.nih.gov
  8. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects https://www.ncbi.nlm.nih.gov
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