Should You Use Oral Or Topical CBD For Pain? An Expert Weighs In

June 10, 2023

As CBD continues to gain popularity, many experts believe it will play a huge role in the future of pain relief. More research than ever is being dedicated to studying how hemp CBD may help with pain management—and scientists are trying to better understand how the cannabinoid interacts with your body to prevent discomfort.*

If you’re hoping to use hemp CBD to help with pain, here’s everything you need before making a purchase, including information on whether oral or topical CBD is better for pain.

CBD or cannabidiol is one of the compounds found in the Cannabis sativa plant. The cannabinoid has been linked to a range of potential benefits, such as promoting a more even mood or better sleep.*

When purchasing a hemp CBD product, you’ll have the choice between broad-spectrum hemp, full-spectrum hemp, and CBD isolate. Here’s what that means:

Full-spectrum hemp: Full-spectrum hemp has the “full spectrum” or array of the hemp plant’s cannabinoids—including CBD—as well as other beneficial native compounds, like terpenes, flavonoids, and fatty acids. This full array of intrinsic botanical bioactives is thought to facilitate the “entourage effect.” By law, full-spectrum hemp extracts in the U.S. can have up to 0.3% THC by dry weight (i.e., trace levels).

Broad-spectrum hemp: Broad-spectrum hemp retains many of the beneficial compounds found in full-spectrum hemp but filters out any THC. These extracts are sometimes referred to as “THC-free” products.

CBD isolate: CBD isolate products have a single cannabinoid: CBD. As a result, they won’t provide the “entourage effect” from the full array of hemp bioactives.

The best way to understand CBD’s impact on your body is through knowing the basics of your body’s endocannabinoid system or ECS. Discovered in the 90s, the ECS is a cellular-level communication network. It’s responsible for maintaining homeostasis across all the body’s organs and physiological functions, including stress resilience, mood, sleep, appetite, inflammatory balance, and pain modulation.

The ECS is made up of cannabinoids, cannabinoid receptors, and specific enzymes. Cannabinoids can either be produced by the body (called endocannabinoids) or introduced from plants. The latter are called phytocannabinoids. CBD is just one of the more than 100 cannabinoids found in the cannabis plant.

Each cannabinoid interacts with the body differently; THC is thought to bind directly to your cannabinoid receptors, which is why it may have psychoactive effects.

Researchers are still working to understand how CBD interacts with cannabinoid receptors. Current theories1 suggest that CBD suppresses the breakdown of the body’s naturally occurring cannabinoids.

This is important because low cannabinoid levels have been linked to a variety of health concerns, including migraines. (Read more about endocannabinoid deficiencies here.)

Outside factors like nutritional deficiencies, stress, and environmental toxins can all cause low cannabinoid levels. For example, stress causes the body to create an enzyme that breaks down cannabinoids.

Introducing phytocannabinoids is a helpful way to support your body’s natural cannabinoid levels so it continues to perform as its best—which means supporting your body’s inflammatory response.

Of course, we’re still in the early stages of truly understanding how CBD helps with pain management, and the science (and theories) are sure to evolve as research continues.

While the research is limited, here’s what we do know from animal studies. A 2017 study2 found that a localized injection of hemp CBD could help with joint comfort in rats.* Another preclinical animal study using topical application of hemp CBD3 had similar findings, showing it could help reduce joint swelling and discomfort. 

This research is also backed by anecdotal evidence: 59% of participants in a 2021 study survey 4found that CBD helped relieve their pain.

The two main CBD products formulated for pain management include topical products or ingestible formulas, like oils, gummies, and capsules. When it comes to choosing between the two types of CBD, you should consider your type of pain and personal preferences, according to Mandy Bliss, APRN, FNP-BC, PMHNP-BC, the lead clinician at Serenity Health in Louisville, Kentucky.

“Some people appear to benefit more from the oral preparations,” says Bliss. Unlike topical applications of CBD, oral ingestion will allow the hemp to enter your bloodstream. As a result, it can encourage a more even mood along with promoting pain relief.*

If you have neuropathic pain or localized joint pain, Bliss says you’re more likely to benefit from topical applications. Both are more targeted types of pain that are felt just under the skin. As a result, a more pinpointed tactic should offer relief faster. (Uncover more CBD products for nerve pain here.)

Our picks for the best CBD for pain management:

Best organic oil: Cornbread Hemp CBD Oil

Pros:

• USDA certified organic
• No added flavors

Cons:

• Not for those with tree nut allergies (specifically coconut)

Potency:

Moderate, 25 mg of CBD; Strong, 50 mg of CBD

Cornbread Hemp is a Kentucky-based CBD brand that sources ingredients from a single local organic farm. The full-spectrum oil features a “Flower Only” formula that includes a range of compounds and up to 2 mg THC per serving. You can choose from two bottle sizes with a choice of 25 mg CBD or 50 mg CBD for a gentle or strong option.

Sustainability and Sourcing: Cornbread Hemp controls its entire production process, and the entire supply chain occurs in less than 100 miles. Like many of the brand’s other offerings, this formula is USDA certified organic.

View COAS here.

Best cream for athletes: Joy Organics CBD Sports Cream

Pros:

• Added benefits of menthol & camphor
• Sustainably & socially conscious brand
• Made in the USA

Cons:

• Menthol & camphor have a strong scent
• Not USDA-organic certified like many Joy Organic products

Potency:

1000 mg of CBD per container

Servings:

Varies by application

Cost per mg of CBD:

$0.04

Designed with athletes in mind, the Joy Organics CBD Sports Cream is formulated to help encourage joint and muscle comfort.* Along with 1000mg of broad-spectrum hemp CBD, the cream also has menthol, camphor, and peppermint. These provide an immediate cooling effect for instant relief upon application.

What’s more, the lotion also has organic aloe leaf juice, lavender, and rosemary. These additions offer additional benefits, like hydrating the skin and making the formula smell less potent.

Sustainability and Sourcing: Joy Organics sources ingredients from organic farms and farms that use regenerative practices whenever possible. The brand also uses carbon neutral shipping and recycled materials for packaging.

View COAs here.

Best cooling cream: Aspen Green Relief Cooling Cream

Pros:

• USDA certified organic with food grade ingredients
• Physician formulated
• Menthol offers cooling effect

Cons:

• Has trace amounts of THC (if that’s not your thing)

Potency:

1000 mg of CBD per container

Servings:

Varies by application

Cost per mg of CBD:

$0.09

Aspen Green’s cooling cream is formulated by physicians with food grade ingredients, including USDA certified organic hemp. You won’t find any artificial preservatives or synthetic ingredients on the label. Instead you’ll just get 1000mg of full-spectrum hemp CBD, tea tree oil, and menthol (which provides the namesake cooling effect).

We love that the formula is water-based for easy application and quick absorption. Simply apply to your skin and massage on areas where you want to experience relief from aches and discomfort, such as neck, back, and shoulders.

Sustainability and Sourcing: Aspen Green’s plants are grown on USDA-organic farms in Colorado.

View COAs here.

Best CBD oil for relief: CBDistillery Full Spectrum CBD Oil Tincture

Pros:

• Made from USA-grown hemp
• No added flavors

Cons:

• Not for those with tree nut allergies (specifically coconut)
• No organic ingredients

Potency:

Moderate, 33 mg of CBD

Cost per mg of CBD:

$0.06

CBDistillery’s Full Spectrum CBD Oil Tincture is the brand’s most popular product. It’s made from U.S. Hemp Authority certified non-GMO ingredients, including American grown industrial hemp. Each tincture has 33 mg of CBD per serving, allowing you to start with a moderate strength and dose up if needed.

Since this is a full-spectrum oil, all the compounds in the formula work together to provide the entourage effect, a synergistic phenomenon that experts say may provide enhanced results. In a 2019 customer survey, a majority of participants self-reported that this full-spectrum oil helped with relief from pain after physical activity.*

Sustainability and sourcing: Products are made using non-GMO, US grown industrial hemp. Natural farming practices are prioritized.

View COAs here.

Best flavored: Charlotte’s Web Max Strength CBD Oil

Pros:

• USDA certified organic
• Available in 3 flavors
• Certified B Corporation

Cons:

• Not for those with tree nut allergies (specifically coconut)

Potency:

Strong; 60 mg of CBD per serving

If you don’t like the natural taste of CBD oil, try a flavored option like Charlotte’s Web full-spectrum tincture. The USDA certified organic CBD oil comes in three flavors: Orange Blossom, Lemon Twist, and Mint Chocolate.

A popular option for advanced CBD users, it offers 60mg of CBD per serving—which puts it higher on the potency scale.

Sustainability and Sourcing: Charlotte’s Web prioritizes using hemp grown on local organic farms that use regenerative agriculture methods. The brand is also a Certified B Corporation, or a company that meets specific criteria for ethical practices, environmental impact, transparency, and legal accountability.

View COAs here.

Best budget topical: Lazarus Naturals CBD Tincture

Pros:

• USDA certified organic
• Certified Kosher (OU)
• Available in e flavors

Cons:

• No subscription option

Potency:

Strong; 50 mg of CBD per serving

Cost per mg of CBD:

$0.03

This $40 full-spectrum tincture is highly rated, affordable, and USDA certified organic—which makes it a great pick in our books. The strong tincture has 50 mg of CBD per serving, so Lazarus Naturals recommends starting with one serving and waiting two hours before increasing dosage. Plus, it’s available in three flavors including an earthy classic flavor, refreshing chocolate mint, or strawberry lemonade.

Since this tincture contains full-spectrum hemp, you can look forward to the potential benefits of the entourage effect of cannabinoids and terpenes working together to create a potent experience.

Sustainability & Packaging: Lazarus Naturals oversees the entire production process, from growing and harvesting the item to packaging each item in good manufacturing process (GMP) facilities. The organic hemp used in the brand’s CBD products is grown in central Oregon.

Views COAs here.

Best cream for pain pamanagement: One Farm Turmeric Relief Cream

Pros:

• Hemp grown on a USDA certified organic farm
• Includes additional ingredients for inflammation
• Has hydrating and soothing ingredients

Cons:

• Features ingredients with strong scents

Potency:

425 mg per container

Servings:

Varies by application

Cost per mg of CBD:

$0.16

One Farm’s Turmeric Relief Cream doesn’t just feature CBD—it also has additional botanicals known for reducing inflammation.* These traditional Ayurvedic ingredients include turmeric, cayenne, and piperine. (Ayurveda is an ancient system of medicine that originated in India.) You’ll also fine soothing antioxidant-rich ingredients like aloe, arnica, and eucalyptus.

Simply apply the cream topically to problematic areas where you are experiencing aches or discomfort.

Sustainability and Packaging: One Farm controls cultivation and harvesting of hemp, as well as the extraction process for hemp CBD. The hemp is grown on the brand’s USDA certified organic farm in Colorado.

View COAs here.

How we picked:

• Gentle: Less than 20 mg of hemp CBD per serving
• Moderate: 20 to 39 mg of hemp CBD per serving
• Strong: 40+ mg of hemp CBD per serving

When it comes to topical products, some added ingredients may provide additional comforting effects. Often these are botanical ingredients linked to specific benefits.

For instance, popular cooling ingredients include menthol and camphor for pain relief. Some brands also add ingredients expected to support your body’s inflammatory response, like turmeric and arnica. Generally, you can also look to topical hemp CBD products to hydrate your skin with additions like aloe and eucalyptus.

Similarly to topical products, other botanicals may be added to oral tinctures for additional benefits. For instance, a tincture that is designed to support better sleep may include ingredients linked to calming effects, such as lemon balm, valerian root, or chamomile.*

With oral tinctures, you should also look at what is used for flavoring. Many brands add artificial additions, including sweeteners. We recommend searching for the simplest formulas possible and avoiding unnecessary excipients.

As registered RDN and certified holistic cannabis practitioner Emily Kyle, M.S. previously told mindbodygreen, the potential side effects of CBD are mild. These include dry mouth, fatigue, and some some digestive issues like loose stools.

However, some of these side effects might not be a result of ingesting the CBD but rather due to the other ingredients included in the supplement, “such as MCT oil,” per Kyle.

FAQ:

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.