how do I choose a CBD product and take it for back pain?
August 30, 2019 5:04 PM   Subscribe

An orthopedist casually suggested I take CBD oil for back pain. I would like advice on how to choose an effective product and how to administer it.

This wasn't a prescription. I was accompanying my kid to an exam by a highly reputable orthopedist, and the doc remarked that if my kid were older, he would be suggesting that they take CBD for the inflammation we were there to see him about. I said "should I take it for my back?" and told him that my back is bad from a combination of arthritis in the spine and tight/weak muscles, which is true. He said sure, that it would help. But I don't remember what he said to take.

Weed is legal in my state; and I've seen CBD products for sale over the counter. I think maybe even Whole Foods has them. But (1) I don't know what kind of product to look for or how to take it; (2) I worry about WF having the same supply chain as Amazon, which after last week's WSJ expose' on fake products I'm feeling very leery of; and (3) I just have no experience with this stuff. And, I don't know if it matters, but (4) THC and I do not get along AT ALL. Does it matter? Please bombard me with your anecdata re taking CBD products for pain (bone and/or muscle), what you use and how it works.
posted by fingersandtoes to Health & Fitness (13 answers total) 23 users marked this as a favorite
Look into the regulations in your state, hopefully you can find products that have been tested for pesticide residue and verified to be extremely low in THC (<0.3% where I am). If not, those are the kind of assurances you want from the producer. Having an herbalist involved in formulation seems to be a good sign, YMMV. Can you ask the ortho if there are brands they recommend?
posted by momus_window at 5:29 PM on August 30, 2019

Hemp based CBD is legal everywhere. Make sure you don't work somewhere that tests for THC because the stated levels can vary widely. My hemp friends buy the hemp bud and vape. I ask for recommendations from our local hard core health food store. It's rather expensive. I love it. You can also go read the reviews for turmeric and curcumin + bioperine on Amazon. It's also an anti-inflammatory. The long game is (theoretically) to eat in a way that reduces your inflammation markers. I am not a medical doctor.
posted by mecran01 at 5:40 PM on August 30, 2019

Sent you a memail with specific product recs that help my back issues.

Many people with chronic pain (myself included) find that a tiiiiiny bit of THC helps the CBD function better in the body*. Since Whole Foods or Amazon can't sell formulations with THC, you have to go to a licensed dispensary to find CBD that works well for pain (or at least I do). My dispensary is great with people who are going there to seek relief for pain, and are used to helping people that don't want a lot of THC but need CBD. My shop even special orders sugar-free candies for a guy that uses CBD for his arthritis but also has diabetes!

I wrote more in a comment here, in case that's useful. TL:DR, start small, work your way up, see which delivery method you like best (I like candy or gummies as opposed to oil or tinctures because the latter hurts my stomach) and which dosage is right for you. Unlike THC it's really, really hard to overdo it on CBD, since you don't feel high at all--just less physical pain.

Good luck! CBD has changed my life and radically increased the number of pain-free days I have, hope it does the same for you!

*I also have very adverse reactions to THC and have never noticed any side effects from the small amounts of THC in the products I use
posted by stellaluna at 5:42 PM on August 30, 2019 [8 favorites]

THC and I are also not friends either but CBD oil has been awesome. I get the CV Sciences brand from a local pharmacy where the clerks would probably literally hiss if I mentioned Amazon. They also have samples of the skin balm out to try and products at a variety of price-points, so if you happen to have access to a quirky non-chain pharmacy with a good reputation, that'd be my recommendation for where to start. This guide looks pretty easy to follow and seems consistent with advice I've gotten.
posted by teremala at 5:49 PM on August 30, 2019

I travel a lot for work. I have a lot of joint pain, like a lot.

I have had 7 joint surgeries. R-knee, R-knee, L-knee, L-ankle, L-elbow, R-Foot, R hand.

Every time I go to a legal place I buy some gummies.

I always get the 5mg THC/CBD.

One of those takes my joint pain away for about 6 hours.

I feel like less than a beer. I'm kinda huge though (6'3" 260lbs).

I lift weights six days a week, and when I come back from my trips to a legal place, I also find that I don't get sore as much when I go to the gym that next day. It's a one day thing, but I have like 15 examples this year alone.

CBD is a thing. THC is a thing. The combination is a revelation to me. I love it.

If I could live without pain? Goddam I want to.
posted by sanka at 6:02 PM on August 30, 2019 [1 favorite]

I've been using a couple CBD products for the last 6 months or so. Started with a CBD muscle and joint rub for the occasional minor tweaked muscle. Nearly every time, the pain was gone in a few minutes, for a few hours. A month or so later I began taking a full-spectrum CBD tincture sublingually before bed to help with sleep. The dosage I settled on is a low-to-moderate one (approx. 16mg of CBD - .5ml in a dropper from a bottle with 1000mg of CBD), but was enough to make a huge difference in my sleep.

To your point, I've had a localized and radiating upper neck pain over the last couple years that has flared up once a week or so to the point where it needed ibuprofen or ice or both to calm. A totally unexpected benefit (probably shouldn't have been) of the CBD tincture I was using for sleep has been the complete elimination of any need for that treatment for my neck from the time I started. There is still an occasional bit of very local discomfort, but nothing anywhere close to requiring any other relief. And even that bit might be eliminated with a higher dose of CBD. I should experiment I guess.

I started taking the full-spectrum CBD tincture because I'd read that the other cannabinoids in it may make it more effective in some circumstances than an isolate CBD tincture (100% CBD), and I had no drug test in my future that the very low amount of THC in full-spectrum (<>
As to trustworthiness, choose a CBD brand that regularly sends its products to an independent lab for at least potency (which should include THC levels if you're avoiding) and microbial testing, and provides the certified/dated results either online or with the product.

Oh, I've been told that CBD isolate tincture has no flavor, or perhaps a bit from the base oil (often coconut?), whereas the full-spectrum tastes like... weed. So if you go with full-spectrum and have a choice, go with a flavored version. Well, unless you like the taste of weed.
posted by ClingClang at 7:51 PM on August 30, 2019 [2 favorites]

should I expect to have to go to a dispensary for this, or is this stuff available by mail? Or Eaze?
posted by fingersandtoes at 8:12 PM on August 30, 2019

Cannabis is a very complex plant, and my wife and I have also experienced what stellaluna wrote, in that you need a small amount of THC in with the CBD to get the full spectrum of anti-inflammatory and pain relief. Actually everything stellaluna wrote is also true of my experience, so just consider me to be adding my voice to theirs on each item. Cannabis evolved as a natural plant to use all of its component parts, so some people find that using both THC and CBD elements together is better at fighting pain and inflammation.

For my wife who has chronic pain, we have settled on a 20:1 or sometimes a 10:1 CBD/THC ratio in the form of tincture liquid drops. We both hate any feeling of being "high" and also strongly dislike the smell of cannabis, so this is the most pure and least smelly way to get it into her system. We had to skip around the three different stores in our small town (also legal here) to finally find a place that could reliably get us pain relief cannabis and not have the idiot 20-somethings working in the stores stop trying to get us high. So be ready to shop around for cannabis advisors until you find one who knows what they are talking about.

For the last year, we have been using the maximum strength "Relief 1000" 20:1 by Green Revolution. If you are starting out, don't buy this stuff-- or only try one drop as your first dose. Try a milder formulation. I like Green Revolution because they print the individual cannabinoid breakdowns for the current batch on each box, which appeals to my desire to do my own research and to buy from a company that has strict quality standards. We have tried other brands and been satisfied with them as well. Anything with a 10:1 CBD/THC ratio or higher, and make sure it is marked on the package that way, and that it is from a reputable grower, and intended for pain relief.

And yes, if you want to follow the recommendation to buy a CBD pain relief product with a small amount of THC in it, then yes, you have to go to a face-to-face store. Because they can't sell anything with THC in it through the mail. You may have to hunt around until you find someone with a scientific/pain relief focus. It might help to ask any cancer survivors you know where they got their pain/nausea cannabis meds from. We also pay cash for our store purchases, because you never know if the law may change again, and we want the smallest paper trail possible with the government.

My wife says if you have more questions she would be happy to answer a memail.
posted by seasparrow at 8:29 PM on August 30, 2019 [7 favorites]

Also, I think I have recommended these five yoga poses for back pain here on MF about ten times in the last few years, but they have literally changed my life, and let me stop back spasms without using any drugs at all.

Since part of your pain is from weak/tight muscles (like mine) you might find similar relief. Don't think you can do what the yoga models in the video do-- on some of these movements I can get only 10% of their range of motion. But it still works for me.

For stiff older people (like me) looping a towel or a belt or the handle of a cane over the back of my foot lets me start the movements with correct form, and apply the stretch as much as I want. If it works for you, you may wish to do as I eventually did and buy a "Body Back Buddy" physical therapy tool, which also lets you give yourself awesome neck and back massage as well.
posted by seasparrow at 8:36 PM on August 30, 2019 [7 favorites]

If you choose to go with a very low THC, full-spectrum CBD tincture route rather than a 100% CBD isolate tincture, I think you should have no problem ordering online and having it shipped as long as the THC level is below .3% (it's what I do). But that wouldn't likely be the case for the 20:1 that seasparrow mentions or anything close to it. Their suggestion to find a knowledgeable dispensary for advice is excellent, especially to start.
posted by ClingClang at 9:39 PM on August 30, 2019 [1 favorite]

If you’re in a legal state, absolutely buy from a dispensary. State marijuana programs are really the only way to get well regulated and tested cbd products in the US right now (hopefully this will change in the future). A full-spectrum tincture in the 20-to-1 to 10-to-1 range is what I’d be looking for in your shoes.
posted by a box and a stick and a string and a bear at 1:08 PM on August 31, 2019 [1 favorite]

You might also look into topicals with THC-a, either with or without CBD, which is completely non-intoxicating.
posted by a box and a stick and a string and a bear at 1:14 PM on August 31, 2019

I’ve been mail-ordering CBD oil for years, long before it was legal where I live. My experience has been that the stuff I can find locally is overpriced and under-strength, and needlessly flavored/doctored. I did a lot of research on the various manufacturers and online distributers before I took the plunge and have been very happy with the results.

I’ll drop you a MeMail with the info on the place I order from.
posted by Thorzdad at 4:04 PM on September 1, 2019

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