There is a great demand for topical analgesics. According to recent statistics, the global topical analgesics market targeting mild to moderate pain is worth $10.26 billion.
Many topical pain agents were originally developed as oral or injected drugs and later reformulated in a dosage more suited to topical administration (e.g., creams, gels, ointments). These include salicylates, nonsteroidal anti-inflammatory drugs (NSAIDs), capsaicinoids, corticosteroids and opioids. Physicians currently recommend these medicines to treat localized eczema, contact dermatitis, psoriasis, abrasions, muscle aches, etc.
Given their established therapeutic efficacy, the major benefit of topical pain agents is the ability to treat localized pain while minimizing systemic dosing, adverse events and drug interactions: For example, with clobetasol, a prescription-only corticosteroid used to treat swelling and itching, side effects occur in one-third of patients receiving the drug orally, but are absent when the drug is applied to the skin.
Topical CBD absorption, although generally ineffective against deep tissue pain, allow precise targeting of localized pain while providing systemic safety, rapid onset and low risk of tolerance or abuse.
The case for topical cannabinoids
Patients and physicians often turn to “natural,” non-pharmaceutical approaches for the relief of mild to moderate pain. Examples include both oral (e.g., turmeric, pycnogenol, ginger) and topical (capsaicin, willow bark) agents. Some, like capsaicin patches, have been approved by the U.S. Food and Drug Administration for treating nerve pain.
Cannabinoids are an emerging group of compounds with the potential for both oral and topical administration for pain relief. Found mainly in cannabis products, cannabinoids act on one or both cannabinoid receptors: CB1 receptors, which arise mostly in the brain, limbic system and the eye, and CB2 receptors, which are located in immune cells.
Of the more than 80 cannabinoids, non-psychotropic cannabidiol (CBD) acts as a complex agonist and antagonist on more than 70 distinct molecular targets, including enzymes, ion channels, G-protein coupled receptors, transporter proteins, and nuclear receptors, many of which mediate pain, inflammation and mood.
Randomized, controlled clinical trials on cannabis in pain relief tend to be small and often include full-spectrum cannabinoids rather than CBD alone. The studies thus far undertaken, however, are encouraging.
Topical CBD absorption study results
A preclinical study on a knee osteoarthritis using CBD gels found that “topical CBD application has therapeutic potential for relief of arthritis pain-related behaviors and inflammation without evident side-effects.”
One small crossover study examining the topical application of commercial CBD oil on 29 patients with peripheral neuropathy concluded that “the transdermal application of CBD oil can achieve significant improvement in pain and other disturbing sensations in patients with peripheral neuropathy. The treatment product was well tolerated and may provide a more effective alternative compared to other current therapies in the treatment of peripheral neuropathy.”
A 2020 randomized, double-blind crossover study in humans examined the effectiveness of topical CBD for treating neuropathic pain. Investigators found “a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group,” and no adverse events. They concluded that transdermal CBD “may provide a more effective alternative compared to other current therapies in the treatment of peripheral neuropathy.”
Why topical CBD products are a safer alternative
Topical CBD products are seen as a much safer alternative to oral pain relievers and painkillers, helping users avoid the risks of gastrointestinal (GI) bleeding, myocardial infarctions, and strokes related to NSAIDs as this study documents.
Topically applied CBD absorbs through the skin to focus on relaxing tense muscles or overworked joints (compared to ingested alternatives which distribute the benefits throughout the full body). As a result, the area of application receives many of the anti-inflammatory and pain-relieving advantages, mitigating swelling and aiding in recovery.
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