Managing Sports and Other Physical Activity-Associated Pain With CBD

Introduction (Training, Competition, Pain and Performance)

Individuals place high amounts of stress on the body when participating in physical activity, especially when competing in sports. Often the result of intense pounding, extreme repetitive motions and muscle demands, the stress that is placed on the body can have both a positive and negative effect. Training and exercising stress stimulates adaptation and increased performance, but physical trauma and prolonged wear and tear can lead to injuries and increased pain.

When an individual suffers from an injury to a component of the body, that person is likely to experience an increase in pain sensation. An elevation in pain can have a significant effect on an athlete or individual partaking in any form of physical activity. For example, increased pain in an athlete may diminish his ability to perform at a high-level during practice or competition. Not being able to perform at the highest level possible due to pain can, of course, be extremely frustrating for an athlete or anyone looking to achieve better results in training or in competition.

Current methods for pain management are effective but can also be unsafe in certain situations.  Cannabidiol, a compound also known as CBD, is drawing attention amongst athletes and trainers as a possible alternative and more holistic approach to current methods. Extensive research has shown that the compound has the possibility of introducing many health advantages to athletes, one of them being the ability to alleviate pain symptoms while limiting harmful risk to the user. In this article, we discuss the effects that CBD has on the body and how it compares to current, traditional methods of pain management.

What is CBD?

Before diving into how CBD works, let’s quickly discuss where CBD comes from. CBD is a phytocannabinoid (plant-based cannabinoid) and one of the two major chemical components found within the Cannabis sativa plant. The other major and well-known compound is delta-9-tetrahydrocannabinol (THC), which is the chemical that produces euphoric effects (the “high” effect). Unlike THC, CBD does not produce any euphoric, psychoactive effects but it has gained wide scale attention and popularity because of its potential therapeutic properties. Studies past and present are seeking to define and substantiate this potential. We do know, according to the World Health Organization, that CBD does not exhibit effects that indicate dependence or abuse potential.

As a plant-derived cannabinoid, CBD works by mimicking the effects of compounds we generate internally (also known as endocannabinoids) and interacting with endogenous cannabinoid receptors within the body. These receptors are utilized by the body through the endocannabinoid system (ECS), which includes a group of lipid proteins, enzymes, and receptors that play a role in many physiological processes including regulating mood, hormone levels, energy levels, sleep/wake cycles, and stress. In addition to interacting with the ECS, CBD has demonstrated a capacity to incorporate itself into many other bodily systems. This gives CBD the potential to have a positive effect in many physiological functions critical to the performance of an athlete or anyone engaged in physical activity.^1,2,3

So How Does CBD Impact Pain?

As most athletes and otherwise active adults realize, pain is a common sensation for individuals who partake in sporting activities. This is often due to the intense stress placed on one’s body during physical activity. Whether it is musculoskeletal pain from training and competition or aches stemming from stiff joints, CBD is proving itself to be an effective tool for individuals seeking to manage pain discomfort and improve physical and mental performance. Research is showing that CBD interacts with many signals involved in pain sensitization and offers promise in alleviating pain. It displays its pain-reducing effects by interacting with the endocannabinoid system, serotonin 5-HT_1A receptor, TRPV1 receptor, and the mu and sigma opioid receptors within the body.^4,5

Along with pain, inflammation can be another modality due to participating in physical activity. Pain and inflammation are often times co-existent, although pain can be existent without evident inflammation. The presence of inflammation, however, typically tends to cause pain. And while small amounts of inflammation can be beneficial for competitors because it helps to promote positive training adaptations, excessive inflammation can delay recovery time and deteriorate performance. Interestingly, CBD has the potential to reduce inflammation, along with modulating pain. The compound has shown promise in diminishing an overactive inflammatory response by reducing cytokine production and interacting with CB₂ receptors, TRPV1 receptors, and enhancing adenosine concentrations within the body.^4,5

CBD and Recovery From Sports

The reduction in pain and inflammation in an athlete can be a vital part of recovery and performance. When the body is trained excessively or intensively, pain and inflammation can occur. CBD offers the potential to reduce both pain and inflammation in order to speed up the recovery process for an athlete after a workout or injury. The achieved reduction in pain can also potentially lead to improved sleep which is essential for the recovery and healing processes within the body. Overall, the way that CBD interacts with the body to alleviate pain and swelling while improving rest and recovery periods makes it an interesting and natural alternative to OTC medicines.

Alternative to NSAID’s

Nonsteroidal anti-inflammatory drugs (NSAID’s), such as ibuprofen (Advil) or naproxen (Aleve), are commonly used for pain and inflammation in competitors. Although effective, these types of medications can place unwanted and harmful side effects on an individual. The possible side effects of NSAID’s include high blood pressure, kidney damage, and gastrointestinal bleeding. CBD has the ability to combat both pain and inflammation, while maintaining an exceptional safety profile. In fact, CBD is well tolerated with most people experiencing none or very mild side effects, such as stomach discomfort.⁷

Conclusion

CBD is a natural, non-psychoactive plant-based cannabinoid that when consumed, interacts with the ECS and various other physiological systems throughout the body, making it an extremely interesting compound to participants in the sporting world. Specifically, it can help reduce pain and inflammation; two of the most common setbacks involved with physical activity and competition. The compound also has the potential to offer a safer pain management option, when compared to commonly used NSAIDs. While there is still much research to be done, indications thus far are showing that CBD could be a game changer for athletes looking for safe and natural alternatives to get beyond the challenges associated with pain caused by repetitive training and competition.

References

1. Devinsky O, Cilio MR, Cross H, et al. Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia. 2014;55(6):791‐802. doi:10.1111/epi.12631
2. Kogan NM, Mechoulam R. Cannabinoids in health and disease. Dialogues Clin Neurosci. 2007;9(4):413‐430
3. Pauli CS, Conroy M, Vanden Heuvel BD, Park SH. Cannabidiol Drugs Clinical Trial Outcomes and Adverse Effects. Front Pharmacol. 2020;11:63. Published 2020 Feb 25. doi:10.3389/fphar.2020.00063
4. Manzanares J, Julian M, Carrascosa A. Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. Curr Neuropharmacol. 2006;4(3):239-257. doi:10.2174/157015906778019527
5. White CM. A Review of Human Studies Assessing Cannabidiol’s (CBD) Therapeutic Actions and Potential. J Clin Pharmacol. 2019;59(7):923-934. doi:10.1002/jcph.1387
6. Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis Cannabinoid Res. 2017;2(1):139-154. Published 2017 Jun 1. doi:10.1089/can.2016.0034