Let's start simple: Endocannabinoids are natural signals in your body that help maintain homeostasis by detecting and regulating hunger, pain, mood, and memory. (They're actually part of your post-workout exercise high.) CBD helps elevate your natural levels of pain-relieving endocannabinoids by blocking metabolism as they're moving around your body.
Science has shown that cannabis is an effective pain reliever, reinforced in a massive new report from the National Academies of Sciences, Engineering, and Medicine. But there's a big difference between ingesting cannabis or its individual chemicals orally and absorbing it topically through your skin.
Hemp pain relief creams or cannabis lotions claim to offer muscle relief for your tired body, but what do experts have to say?
How CBD and Cannabis Might Help Pain Relief
"When it comes to cannabis-based topicals for muscle soreness or other pain relief, there's absolutely no reason why it should be a big deal to try," he says.
There is an argument to be made for the simple fact that science hasn't caught up to the trend (and laws) of cannabis yet. (Here's what research has to say about the potential benefits of CBD and cannabis so far.) And there are doubtlessly researchers testing the efficacy of CBD creams for pain relief as we speak.
These topical ointments, creams, and lotions are infused with CBD, or cannabidiol, a compound found in the cannabis plant. Manufacturers claim it can help alleviate acute pain and muscle soreness. To reiterate for the uninitiated: CBD is not the same as THC because CBD does not have any psychoactive effects — aka it won't get you high.
This brings up an underlying issue with all CBD and hemp products: There is no regulation around how much active CBD or THC is in each cream or how much of the compound is needed to see relief. Read: "If you have three products that say 1 percent CBD infused in coconut oil, one could be great and the other two could be crap—that's the reality of cannabis medicine right now," says Gerdeman. (See: How to Buy Safe and Effective CBD Products)
But at this point, we have no idea how deep the commercially available creams are penetrating. And even if they’re getting to that sweet spot in your skin, we don’t know how much CBD is getting there or how much is necessary to provide an effect.
All of this points to how hard it is to study the specific effects of CBD on its own—which might be why it’s tempting to claim that it’s the cure for everything without a whole lot of research to actually back up all of those claims.
Nevertheless, how do we account for all the people out there (like me) who use these products and feel like they’re doing something? Beyond the placebo effect, it’s possible that something else in the cream could be doing the heavy lifting here. These products don’t just contain CBD, Dr. Tishler points out. In fact, many of them also come with ingredients like arnica, menthol, or camphor, which may all provide a more immediate sensation of soothing or pain relief. So it could be those ingredients (or just the act of massaging the balm into your skin) that makes you feel better.
So…is CBD cream just an expensive placebo?
If you’re worried about a purely topical CBD product getting into your bloodstream, Dr. Tishler explains that’s unlikely. CBD is hydrophobic (meaning it isn’t water-soluble) and lipophilic (attracted to lipids, like oils) and tends to stay on the outer layer of skin or possibly accumulate in the sebaceous glands unless it’s paired with “enhancers” (ingredients designed to help them make it through the skin, at which point they would instead be transdermal). Making a truly “water-soluble CBD” has been a challenge for the industry, although there are a variety of patents out there.
When the National Academies of Sciences, Medicine, and Engineering evaluated decades of cannabis research, they concluded that "in adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms."
More recent research suggests that many of CBD’s effects may occur outside of CB receptors, Jordan Tishler, M.D., medical cannabis expert at InhaleMD in Boston, tells SELF. In fact, according to a recent review published in Molecules, CBD may have effects on some serotonin receptors (known to play a role in depression and anxiety), adenosine receptors (one of the neurological targets for caffeine), and even TRPV-1 receptors (more commonly associated with taste and the sensation of spiciness).
One major issue is that it’s actually somewhat difficult to create a topical cannabinoid product (containing CBD or THC) that penetrates the skin enough to produce an effect, but not so deep that it gets into the bloodstream, Boehnke explains. If the product does get into the bloodstream—if it’s transdermal rather than truly topical—it could potentially reach the brain, possibly producing psychoactive effects if it contains THC.