By Miguel Ordoñez

Conventional medicine will tell you that ibuprofen is one of the most effective means of treating pain. Since the 1960s[1], it’s been the go-to medication for run-of-the-mill malaises like headaches, toothaches, and back pain.

On the flip side, you have cannabidiol, a promising compound from the cannabis plant. CBD, as it’s most commonly known, has been a subject of study for several conditions, including pain. But, unlike ibuprofen, it does not have approval from medical experts yet.

Regardless, CBD remains in conversation as a natural, versatile compound with intriguing effects. But, how effective is it really? This article aims to answer that question.

How Ibuprofen Works

Ibuprofen is one of the most common forms of nonsteroidal anti-inflammatory drugs (NSAIDs). Additionally, it is effective in eliminating fever and headaches.

Ibuprofen works by reducing the hormones that cause both pain and swelling. It inhibits the release of prostaglandins[2], chemical compounds responsible for controlling inflammation and blood flow.

Ibuprofen specifically targets the COX-1 and COX-2 enzymes by decreasing their activity. These two enzymes trigger inflammation and fever[3].

But, when it comes to benefits, ibuprofen goes beyond just pain control. It’s proven to be effective against rheumatoid arthritis and diseases, minor musculoskeletal injuries, and fever, and it also helps prevent the formation of blood clots.

CBD vs Ibuprofen

We now have a general idea of how ibuprofen works. So, let’s shift our attention to CBD and how it operates in the body.

CBD primarily interfaces with the body via the endocannabinoid system. It doesn't bind directly to innate receptors in this system (CB1 and CB2), but it can enhance natural endocannabinoid levels and benefit the system in other ways[4]. The ECS is responsible for regulating several major functions, including sleep, pain, immune system response, and appetite. Thus, any compound capable of boosting this system's efficacy is deemed worthy of exploration.

But, if ibuprofen is so effective, why would we even be courting CBD for its potential? Well, because taking ibuprofen carries several risk factors that are definitely worth taking into account. According to the FDA, NSAIDs including ibuprofen may increase the risk of heart attacks and strokes, even with short-term use[5]. Symptoms may arise within a few weeks.

Ibuprofen is derived from propionic acid, the same fatty acid present in processed food. It is primarily used to fight off mould and bacteria, and may severely irritate the skin upon direct interaction. However, the FDA deemed it to have little toxicity[6] in humans.

As for CBD, it is extracted from the hemp plant with the help of a solvent like ethanol or carbon dioxide. The cannabidiol is then transformed into oil, topical, or capsule gel form for consumption.

Can You Take CBD and Ibuprofen Together?

On the one hand, you have a fast-acting synthetic drug with known side effects and health risks. On the other, you have an organic substance that’s perceived to have its own benefits—without the risks[7]. Looking at it on paper, combining the two isn’t such a bad idea.

And it may not be. This 2019 study[8], for one, reports no direct interactions between ibuprofen and CBD. However, that isn’t the case with other NSAIDs like naproxen and celecoxib. Experts advise against the co-administration of cannabidiol and these aforementioned drugs.

The likelihood of side effects may vary between individuals. Your best bet here would be to consult your doctor before taking CBD alongside ibuprofen.

How Does CBD Affect Pain?

We previously mentioned CBD’s interaction with the endocannabinoid system as the jumping-off point for scientific interest in this domain. Now, let’s take a deeper look at the research.

  • CBD for Acute Pain

If a person is experiencing acute pain, they will likely be prescribed an analgesic. It could be in the form of paracetamol, or NSAIDs like ibuprofen. For severe cases, doctors can turn to opioids like oxycodone and morphine.

However, research[9] is investigating whether CBD’s effects could serve analgesic functions as well. Take, for example, a phase III study[10] published in 2009 on cannabinoids as a plausible medium for pain management.

One of the focal points of the study concerned Sativex, a cannabis extract containing both CBD and THC, versus a THC-dominant extract and a placebo. It was found that the Sativex achieved significant pain relief compared to both the THC-dominant extract and placebo.

That’s not all. According to a 2006 study[11] performed on mice, CBD also promoted the signalling of adenosine receptors. Adenosine receptors[12] are scattered throughout the entire body. One of their primary roles: pain and inflammation regulation.

Antioxidants are also known to be effective in fighting pain[13]. Studies are testing the antioxidant capacity of CBD[14] to see how it fares against popular supplements used for this purpose.

CBD for Acute Pain

  • CBD for Peripheral Pain

Peripheral pain, otherwise known as peripheral neuropathy[15], is a condition resulting from nerve damage. Usual symptoms are numbness, pain, and weakness. Some people also feel a tingling sensation in their fingers.

Instead of going for steroids and immunosuppressants for treatment, could cannabidiol be another plausible option?

As this 2004 study[16] on CBD derivatives shows, cannabidiol didn’t have a direct effect on the central nervous system. However, it did display peripheral effects related to antinociception and immune signalling.

CBD for Peripheral Pain
  • CBD for Chronic Inflammation

It’s one thing to experience mild inflammation in certain parts of the body. But if it lasts for several months, even years, then you’re suffering from chronic inflammation.

Chronic inflammation happens when your body is in constant fight mode, a supposed reaction against diseases. But, in this case, the immune system is attacking healthy tissues by mistake. Experts see it more as an autoimmune disorder.

Like with pain, chronic inflammation can be treated by taking NSAIDs and steroids. Experts also prescribe certain supplements[17] like fish oil and lipoic acid. They are now also looking to CBD’s effects profile for answers.

Take this 2012 study[18] on rodents, which shows that CBD and its modified derivatives targeted α3 glycine receptors. Glycine receptors play crucial roles related to pain and motor control.

CBD for Chronic Inflammation

  • CBD for Migraines

If you’re experiencing a dull, impairing headache with episodes of nausea and hypersensitivity to light, you’re dealing with a migraine. The throbbing, pulsing sensation is usually felt on one side of the head.

Doctors usually prescribe over-the-counter medication like NSAIDs, codeine, even caffeine as a form of migraine treatment. But, since the early part of the 20th century, cannabis has been considered as an alternative.

A 1998 review[19] explored the current body of research on the cannabinoids in marijuana as they relate to migraine mitigation. Noting antiemetic (anti-nausea and vomiting) and vasodilator (blood vessel dilation) properties, the authors concluded that cannabinoids are of great interest in the conversation of migraine treatment.

CBD for Migraines
  • CBD for Fibromyalgia

People who suffer from fibromyalgia know how disruptive this condition can get. Widespread physical pain can cause a person to feel constantly fatigued, lose sleep, and basically be deprived of living a normal life.

The causes of fibromyalgia vary from genetics to physical and emotional trauma. Antidepressants and anti-seizure medication are usually given to patients who deal with this disease.

As this study notes[20], endocannabinoid deficiency is also identified as one of the potential underlying causes of fibromyalgia. In this case, CBD was deemed as a potential solution to boost endocannabinoid levels.

CBD for Fibromyalgia

Could CBD Replace Ibuprofen in the Future?

Dr Stewart Adam’s discovery of ibuprofen in the 1960s is still considered one of the biggest breakthroughs in modern medicine. Thanks to this happy accident[21], pain and discomfort aren’t as debilitating as they were in decades past.

At the same time, you have cannabidiol, a compound that has garnered significant attention for its wellness-boosting potential. But could CBD replace ibuprofen in the near or distant future?

Right now, more studies need to be conducted. A lot of questions still need answers. However, existing research has done the groundwork for more in-depth trials.

External Resources:
  1. A brief history of ibuprofen
  2. Prostaglandins: What They Are and Their Role in the Body
  3. COX-2 Inhibitors Drug Class Information on
  4. Cannabidiol (CBD) — what we know and what we don’t - Harvard Health Blog - Harvard Health Publishing
  5. FDA strengthens warning that NSAIDs increase heart attack and stroke risk - Harvard Health Blog - Harvard Health Publishing
  6. Propionic Acid - ScienceDirect
  7. WHO Expert Committee on Drug Dependence Critical Review: Cannabidiol (CBD)
  8. Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use
  9. Cannabinoids in the management of difficult to treat pain
  11. Inhibition of an equilibrative nucleoside transporter by cannabidiol: a mechanism of cannabinoid immunosuppression - PubMed
  12. Frontiers | The Role of Adenosine Receptors in Psychostimulant Addiction | Pharmacology
  13. Antioxidant therapy for pain relief in patients with chronic pancreatitis: systematic review and meta-analysis - PubMed
  14. Cannabidiol and (-)Delta9-tetrahydrocannabinol are neuroprotective antioxidants - PubMed
  15. Peripheral neuropathy - Symptoms and causes - Mayo Clinic
  16. (+)-Cannabidiol analogues which bind cannabinoid receptors but exert peripheral activity only - PubMed
  17. Chronic Inflammation: Definition, Symptoms, Causes, and Treatment
  18. Cannabinoids suppress inflammatory and neuropathic pain by targeting α3 glycine receptors - PubMed
  19. Cannabis for migraine treatment: the once and future prescription? An historical and scientific review - PubMed
  20. Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? - PubMed
  21. The hangover that led to the discovery of ibuprofen
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