The acceptance of CBD for pain management is taking hold in chiropractic.
Chiropractic care has long been associated with a holistic approach to health with an emphasis on finding root causes of problems and channeling the body’s innate ability to heal when properly supported. As a result, many DCs are continually exploring complementary therapies, such as the use of CBD for pain management, that align with this philosophy.
If you’re looking to enhance the care you provide as a DC, CBD offers your patients a variety of pain management benefits, such as calming of inflammation, better sleep, stress alleviation, reduced anxiety and better bone health, just to name a few. CBD is available in multiple formats to suit your patients’ unique needs.
Derived from the cannabis plant, CBD is a non-psychoactive compound renowned for its potential pain management benefits. This article delves into integrating CBD within chiropractic practice, exploring how it can enhance patient care and outcomes.
Introduction to CBD for pain management
CBD is one of more than 100 cannabinoids found in the cannabis plant. Hemp is a specific, federally legal breed of cannabis that must contain less than 0.3% THC and is typically farmed for its CBD content.
Unlike tetrahydrocannabinol (THC), CBD does not produce a “high,” making it a more accessible option for those seeking therapeutic benefits without psychoactive effects. Whether or not your patients use CBD, they already have cannabinoids in their body due to the endocannabinoid system (ECS). The ECS comprises endocannabinoids (cannabinoids produced naturally by the body), receptors (CB1 and CB2) and enzymes that synthesize and degrade cannabinoids. CB1 receptors are primarily found in the brain and central nervous system, while CB2 receptors are located in the peripheral organs and cells associated with the immune system. CBD’s interaction with these receptors helps modulate pain, inflammation, mood and other physiological responses, making CBD products a promising adjunct to standard chiropractic care.
Research supporting CBD for pain management
Manage pain: One of the primary reasons patients seek chiropractic care is to alleviate acute and chronic pain in order to improve quality of life. Traditional chiropractic adjustments aim to realign the spine and improve nervous system function, thereby reducing pain. However, incorporating CBD into a chiropractic regimen can enhance these outcomes.
Research suggests CBD can modulate pain through its interaction with the ECS. A study published in the European Journal of Pain1 demonstrated that topical CBD application could reduce arthritis pain and inflammation. These findings are particularly relevant for DCs, as topical CBD can be applied directly to patients’ areas of pain, providing targeted relief.
Ease inflammation: Inflammation is a common underlying cause of chronic pain. CBD’s anti-inflammatory properties are well-documented, with studies indicating it can reduce cytokine production and inhibit inflammatory pathways. According to the National Institutes of Health,2 “CBD gel application has therapeutic potential for relief of arthritic pain-related behaviors and exerts an anti-inflammation property.” This makes CBD an attractive option for patients with conditions like sciatica, where inflammation of the sciatic nerve contributes to pain and discomfort. CBD can complement chiropractic adjustments by reducing inflammation, promoting faster recovery and contributing to better overall patient outcomes.
Enhance relaxation and reduce anxiety: Chiropractic care often extends beyond physical adjustments to encompass overall wellness, including mental and emotional health. Stress and anxiety can exacerbate physical pain, creating a cycle that impedes healing. CBD has been shown to have anxiolytic (anxiety-reducing) effects, which can be beneficial for chiropractic patients.
Melt stress: A study in the Journal of Psychopharmacology3 found CBD can reduce anxiety in individuals with social anxiety disorder. The study found that “Relative to placebo, CBD was associated with significantly decreased subjective anxiety (p<0.001), reduced ECD uptake in the left parahippocampal gyrus, hippocampus and inferior temporal gyrus (p<0.001, uncorrected), Incorporating CBD into the treatment plan for chiropractic patients could help them feel more relaxed and receptive to adjustments. This is particularly important for patients anxious about their pain or the chiropractic process.
Improve sleep quality: Chronic pain often disrupts sleep, vital for healing and overall well-being. CBD has been found to improve sleep quality by addressing the root causes of sleep disturbances, such as anxiety and pain. By promoting better sleep, CBD can enhance the body’s natural healing processes, complementing the benefits of chiropractic care.
Support musculoskeletal health: DCs focus extensively on the musculoskeletal system, addressing issues related to muscles, joints and connective tissue. CBD’s potential benefits in this area are significant.
CBD has been shown to possess muscle relaxant properties, which can help reduce tension and improve mobility. For example, a study by the NIH highlighted CBD’s potential to alleviate spasticity in multiple sclerosis patients,4 suggesting broader applications for muscle-related issues in chiropractic care.
Build bone health: Emerging research indicates CBD may also support bone health. A study published by Penn State School of Medicine5 found “CBD could enhance fracture healing by stimulating the expression of specific proteins involved in bone repair.” This is particularly relevant for chiropractic patients with osteoporosis or other bone-related conditions, offering a natural means to support bone density and healing.
Integrating CBD for pain management
Given the benefits of CBD for pain management, DCs may consider integrating it into their practice to enhance patient outcomes. However, this integration must be approached thoughtfully and within professional and legal guidelines.
The legal status of CBD varies by region, so DCs must ensure they comply with local regulations. In the U.S., for example, the 2018 Farm Bill legalized hemp-derived CBD with less than 0.3% THC at the federal level. However, state laws can vary, and staying informed about specific legal requirements in your area is crucial. (State regulations can apply not only to the products, but also to how you market them.)
Product quality and safety
Not all CBD products are created equal, and ensuring product quality and safety is paramount. DCs should look for third-party products tested for purity and potency, free from contaminants such as pesticides, heavy metals and solvents. Reputable brands will provide certificates of analysis (COAs) that verify these factors.
Patient education and communication
As with any complementary therapy, patient education is key. DCs should discuss CBD’s potential benefits and risks with their patients, providing clear guidance on dosage and administration. It’s also important to consider any potential interactions with other medications the patient may be taking.
Application methods
There are various ways to incorporate CBD into chiropractic care, each with its unique benefits:
Topical CBD: Creams, balms and salves can be applied directly to areas of pain or inflammation, providing localized relief. This method is particularly useful for targeting specific musculoskeletal issues.
Oral CBD: Tinctures, capsules and edibles offer systemic benefits, supporting overall wellness. These forms are ideal for addressing anxiety, sleep issues and widespread inflammation.
Inhalation: Vaping or inhaling CBD can provide rapid relief, making it suitable for managing acute pain episodes or anxiety spikes.
Monitoring and evaluation
As with any therapeutic intervention, it’s important to monitor patient responses to CBD and adjust your approach as needed. DCs should track outcomes such as pain levels, inflammation markers and overall well-being to evaluate the effectiveness of CBD in their patients’ treatment plans.
Examples of using CBD in chiropractic care
To illustrate the potential benefits of CBD in chiropractic care, consider the following indications:
Chronic lower back pain
John, a 45-year-old office worker, has been experiencing chronic lower back pain for several years. Despite regular chiropractic adjustments, his pain persists, particularly after long periods of sitting. His DC suggests adding a topical CBD cream to his regimen. After a few weeks of consistent use, John reports a significant reduction in pain and improved mobility, allowing him to sit for longer periods without discomfort.
Anxiety and muscle tension
Maria, a 30-year-old teacher, visits her DC for severe muscle tension and anxiety, which she attributes to her stressful job. Alongside regular adjustments, her DC recommends an oral CBD tincture to help manage her anxiety and relax her muscles. Maria notices an improvement in her overall mood and decreased muscle tension, leading to more effective chiropractic sessions.
Osteoarthritis
Robert, a 60-year-old retiree, suffers from osteoarthritis in his knees, limiting his mobility and quality of life. His DC suggests using a combination of topical and oral CBD to manage his pain and inflammation. Over time, Robert experiences reduced pain and improved joint function, enabling him to engage more fully in physical therapy and daily activities.
Final thoughts on CBD for pain management
Integrating CBD into chiropractic practice offers a promising avenue for enhancing patient care and outcomes. Its potential benefits in pain management, inflammation reduction, stress and anxiety relief and musculoskeletal support align well with chiropractic care’s holistic philosophy. However, DCs must approach CBD use responsibly, ensuring legal compliance, product quality and patient education.
As research into CBD continues to evolve, its role in chiropractic care may become increasingly well-defined, offering new opportunities for natural, effective patient care. By staying informed and adopting a thoughtful approach to CBD integration, DCs can provide their patients an additional tool for achieving optimal health and wellness.
JOE KRYSZAK, MBA, is president of Stirling Professional CBD, the brand built by and for doctors of chiropractic and professional offices, giving back to the chiropractic industry. Since 2014, Stirling has grown, extracted and produced the purest CBD available. Stirling brings amazing CBD+ products to patients with the industry-leading lineup of 2,500-mg CBD lotions, THC and THC-free capsules and gels, and four great solutions for better sleep, bringing affordable solutions to patients. For more information, go to stirlingprofessional.com.
References
- Grinspoon P. Cannabidiol (CBD): What we know and what we don’t. Harvard Health Publishing. April 4, 2024. https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476. Accessed July 12, 2024.
- Hammell DC, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. 2016;20(6):936-948. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/#:~:text=Transdermal%20cannabidiol%20(CBD)%20gel%20application,high%20brain%20centre%20psychoactive%20effects. Accessed July 12, 2024.
- Crippa JAS, et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: A preliminary report. Journal of Psychopharmacology. September 2010. Chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.uniad.org.br/wp-content/uploads/2010/09/CBD_sad_J_Psychopharmacol.pdf. Accessed July 12, 2024.
- Haddad F, et al. The efficacy of cannabis on multiple sclerosis-related symptoms. Life (Basel). 2022:12(5):682. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9148011/. Accessed July 12, 2024.
- Sweger A. CBD and CBG may promote bone fracture healing, manage pain. [Research.] October 24, 2023. Penn State College of Medicine. https://www.psu.edu/news/research/story/cbd-and-cbg-may-promote-bone-fracture-healing-manage-pain/. Accessed July 12, 2024.
