Trigeminal Neuralgia (TN) is caused by damage or dysfunction in the trigeminal nerve, resulting in severe pain on the face. Can you use CBD oil for trigeminal neuralgia? We take a look at some of the most recent research into cannanoids and nerve pain.
CBD Oil for Trigeminal Neuralgia – August 2022
Trigeminal neuralgia (TN) is a form of neuropathic pain condition caused by dysfunction in the trigeminal nerve, or fifth cranial nerve . The nerve is responsible for carrying sensation signals from the face to the brain.
TN pain has been reported to be so severe that it has been called the “ suicide disease ” (5) .
Slight stimulations on the face, such as touching, brushing, and washing may cause severe facial pain . TN may also cause muscle spasms, feelings of electric shock , and burning sensation .
TN treatments include anticonvulsant agents, antispasmodic agents, and potentially invasive surgical procedures.
Antiepileptic medications, such as gabapentin and carbamazepine, have been used to treat TN (6) . However, the lack of intolerability and efficacy has been observed among these medications after prolonged use (7) .
CBD is a proven antiepileptic treatment (8) . A recent study posted in Molecules mentioned evidence of CBD ’s anticonvulsant and neuroprotective properties. These actions might help reduce spasms and nerve pain (9) .
Studies have not investigated CBD ’s efficacy on spasms caused by TN. However, CBD might have therapeutic benefits for treating chronic pain caused by TN (10) .
A review shared that cannabinoids , such as CBD , might help alleviate neuropathic pain and hyperalgesia (pain sensitivity). The review mentioned that there is evidence that cannabinoids might block the pain pathway ’s neural transmission (11) .
The authors added that the nociceptive effects produced by cannabinoids might be a potential therapeutic approach to the management of trigeminal neuralgia (12) .
The analgesic and anti-hyperalgesic effects of CBD were supported by an animal study published in the Journal of Experimental Medicine (13) .
The study mentioned that CBD possesses therapeutic benefits that might reduce pain and inflammation that causes neuropathy (14) .
Neuropathy is dysfunction or damage in the nerves that may cause pain, tingling and burning sensations , numbness, or muscle weakness.
Moreover, the authors added that CBD was able to mitigate hyperalgesia in mice models. The study concluded that CBD reduced persistent inflammation and neuropathic pain (15) .
Another study shared in the European Journal of Pharmacology demonstrated that CBD may possess potent anti-inflammatory and immunomodulatory effects (16) .
In the study, oral CBD was administered on rat models with induced sciatic nerve compression. Researchers found that CBD treatment reduced hyperalgesia and reduced inflammation (17) .
According to experts, trigeminal nerve pain can be caused by a blood vessel pressing on the trigeminal nerve . This compression causes damage to the trigeminal’s protective coating (myelin sheath) (18) . In severe cases, this vessel may need to be surgically separated from the trigeminal nerve.
Moreover, researchers observed that high blood pressure increases the risk for TN (19) .
A preclinical study acknowledged that CBD has cardiovascular benefits (20) . The authors mentioned that healthy volunteers (age 21-29) whose hypertension is triggered by stress displayed a lower resting blood pressure after taking CBD .
Clinical studies without limitations are needed to confirm CBD ’s potential ability to reduce blood pressure in older individuals.
Most of the studies mentioned have shown results using animals as test subjects. More clinical studies are needed to prove CBD ’s efficacy in alleviating nerve pain .
How CBD Oil Works to Help With Trigeminal Neuralgia
The endocannabinoid system (ECS) is essential in maintaining homeostasis in the central nervous system , peripheral nervous system , immune system, and organs.
The ECS is composed of receptors that are spread across the human body. These receptors include the cannabinoid receptors (CB1 and CB2) and glycine receptor (GLyR) (21) .
Studies acknowledged that modulating the receptors in the ECS might influence bodily functions, resulting in several therapeutic benefits (22) .
Modulatory effects can be triggered or stimulated by cannabinoids , such as cannabidiol ( CBD) , tetrahydrocannabinol ( THC ), cannabichromene (CBC), cannabinol (CBN), and cannabigerol (CBG) (23) .
A study posted by the Journal of Experimental Medicine suggested that modulating the ECS might have therapeutic effects in pain management (24) .
Moreover, the authors mentioned that glycine receptors in the central nervous system are an essential target for alleviating neuropathic pain (25) .
The authors added that cannabinoids , such as THC and CBD , might strengthen nerve impulses in the glycine receptors, resulting in analgesic potency (26) .
Glycine receptors are ion channels that are responsible for neurotransmission.
The study found that oral CBD treatment provided a binding glycine activity that reduced hyperalgesia and neuropathic pain in mice models.
The Pros and Cons of CBD Oil for Trigeminal Neuralgia
- Studies demonstrated that CBD might have therapeutic effects in pain management by modulating receptors in the ECS (27) .
- Researchers acknowledged that CBD might strengthen nerve impulses in the ECS receptors, resulting in analgesic potency (28) .
- Animal studies have shown that oral CBD treatment might be useful in alleviating neuropathic pain and hyperalgesia (pain sensitivity) (29) .
- Studies have shown that CBD might reduce blood pressure . High blood pressure might increase the risk for TN (30) .
- Researchers acknowledge that CBD is well-tolerated and has an excellent safety profile (31) .
- There are not enough clinical studies that support CBD ’s efficacy in treating trigeminal neuralgia .
- Studies mentioned that CBD might cause adverse effects, such as dry mouth, diarrhea, drowsiness, loss of appetite, and CBD -induced drug interactions (32) .
- An animal study has shown that CBD might cause hepatotoxicity (liver damage) when taken in extremely high doses. This hypothesis is supported by the US Food and Drug Administration (FDA) (33) .
How CBD Oil Compares to Alternative Treatments for Trigeminal Neuralgia
There are not many alternative treatment options for painful conditions, like TN. The efficacy of alternative anticonvulsants for treating TN is currently not supported by scientific studies.
A popular alternative treatment for TN is acupuncture. A review mentioned that a 66-year woman suffering from TN believed that she was successfully treated by acupuncture (34) .
Acupuncture is a Chinese tradition that uses microneedles to balance the energy in the body.
Researchers mention that acupuncture may help maintain homeostasis in the ECS and must be investigated. So far, no direct studies have been made on how acupuncture might trigger the cannabinoid receptors (35) .
A study published in Frontiers of Molecular Neuroscience has found that electroacupuncture on osteoarthritis rats was able to increase receptor activity, resulting in reduced chronic pain (36) .
Electroacupuncture is conducted by sending electrical signals through acupuncture needles.
CBD has somewhat similar characteristics to electroacupuncture. A study discussed that CBD ’s modulation of adenosine receptors resulted in reduced pain and inflammation in rheumatoid arthritis mice (37) .
Another alternative treatment for TN is vitamin B12. Studies have shown that vitamin B12 has analgesic properties that might be useful for treating neuropathic pain (38) .
A review from Neural Plasticity cited clinical studies that produced positive results from neuropathic patients following treatments of methylcobalamin (MeCbl), a form of B12. These clinical studies included patients with neuropathic health conditions, such as TN and diabetic neuropathy (39) .
Clinical studies have yet to test CBD ’s efficacy on TN and diabetic neuropathy. However, a study acknowledged that CBD might also possess therapeutic benefits for neuropathic conditions.
CBD ’s modulation of glycine receptors resulted in alleviating chronic pain and hyperalgesia in mice models (40) .
How to Choose the Best CBD Oil for Trigeminal Neuralgia
Full-spectrum CBD oil carries all the major cannabinoids found in hemp plants, such as CBD , CBG, CBC, and 0.3% THC .
Full-spectrum CBD is recommended for treating neuropathic pain . A study posted in Therapeutics and Clinical Risk Management acknowledged the analgesic effects of other cannabinoids present in hemp (41) .
Broad-spectrum CBD contains the same cannabinoids in full-spectrum without THC . Broad-spectrum is recommended for individuals who do not want traces of THC in their system.
Full-spectrum and broad-spectrum types provide individuals with the “entourage effect.” The entourage effect means that all the cannabinoids are working in synergy.
Individuals who cannot tolerate other cannabinoids may opt for CBD isolate. This concentration contains 90% CBD .
Additional tips to consider before buying CBD :
- Customers may check for cannabinoid concentration in the product by referring to the certificate of analysis (COA).
- Checking testimonials and reviews from other customers is helpful.
- Consulting with a neurologist before taking CBD is important.
CBD Dosage for Trigeminal Neuralgia
More clinical trials are crucial in determining the correct CBD dose for health conditions.
The British Journal of Pharmacology published a study that recommended a low dose of less than 1 to 50 milligrams kilograms per day (
Individuals may increase their dose once their bodies get used to having CBD in their system.
Moreover, a clinical study published by the Brazilian Journal of Psychiatry mentioned that a dose-response curve was observed with CBD (43) .
The authors explained that 300mg pure CBD treatment produced positive results, while 150mg and 600mg did not produce any changes.
Also, a high dosage of CBD is not recommended. A study released by Molecules observed that extremely high doses of CBD caused hepatotoxicity in rat models (44) .
How to Take CBD Oil for Trigeminal Neuralgia
CBD oil may be taken orally in forms of capsules, softgels, and gummies. Individuals may also take CBD capsules , gummies, and other edibles with a glass of water.
A study observed that CBD remained in the system three to four hours after oral intake (45) .
Individuals who want a higher potency of CBD may opt for sublingual administration. CBD tinctures may be taken by using an applicator to drop CBD under the tongue.
More studies are needed to determine absorption speed and plasma concentrations for sublingual delivery.
The half-life of sublingual CBD administration has been observed to be dose-dependent. Nevertheless, researchers observed that plasma concentrations are faster when individuals are in a fasted state (empty stomach) (46) .
CBD tinctures may have an earthy taste due to the presence of terpenes. Terpenes are aromatic compounds found in the plants.
Some individuals may want the fastest method for pain relief . Thus, CBD vape pens and cartridges may be recommended.
Studies have shown that the lungs can be very efficient in delivering CBD into the bloodstream (47) . The authors explained that inhaling CBD through vaporization could deliver plasma concentrations to the body in less than 10 minutes.
However, another study reported that vaping might cause side effects , such as chest pain, shortness of breath, allergic reactions, and chemical irritation (48) .
Are CBD Oil and Medical Marijuana the Same?
Some individuals may mistake CBD for medical marijuana . However, these compounds differ in cultivation and concentration.
Medical marijuana or medical cannabis can come from several cannabis strains. The cannabis plant is harvested for its flowers and leaves, after which they are cured and dried for consumption.
CBD is usually extracted from Cannabis sativa, particularly hemp, using CO2 extraction, solvent extraction, or steam distillation.
The extraction method creates a more concentrated version of hemp. The cannabinoids are manufactured into carrier oils, capsules, edibles, vape juice, and other products.
CBD and medical marijuana also differ in terms of THC content.
CBD contains only 0.3% THC or less, making it legal in all 50 US states and territories (49) . Meanwhile, some dispensaries sell cannabis products that may contain up to 25-28% THC (50) .
Recreational and medical use of marijuana is illegal in the US, except for 11 states. These states may require consumers to procure a medical marijuana card (51) .
Although CBD products are legal, the CBD market remains highly unregulated.
Individuals are advised to always look for the certificate of analysis (COA) before buying the product. The COA is a third-party lab test result from ISO-certified laboratories.
These labs test for cannabinoid concentration and harmful chemicals, such as heavy metals, pesticides, and other contaminants.
The COA allows consumers to know that the product is high-quality and safe for humans or pets.
Studies have shown that CBD might be useful in alleviating neuropathic pain and hyperalgesia . This mechanism is due to CBD’s ability to block neural transmission in the pain receptors (52) .
Researchers also acknowledged that CBD might produce analgesic potency by strengthening nerve impulses in glycine receptors (53) .
Moreover, studies have shown that CBD might indirectly reduce TN pain by lowering blood pressure (54) .
More direct studies are needed to prove CBD ’s efficacy in alleviating neuropathic pain .
However, researchers mention that CBD ’s therapeutic potentials showed promise in improving the quality of life of individuals with TN (55) .
Does CBD Oil Help Patients with Trigeminal Neuralgia? [Exploring the Science]
Trigeminal neuralgia is a painful condition affecting the nerves of the face. It can make everyday activities such as eating and talking unbearable and have a significant impact on a person’s life.
Furthermore, traditional painkillers often don’t help numb the agony of trigeminal neuralgia. Doctors sometimes prescribe anticonvulsant drugs, which can ease the pain but come with a long list of potential side effects. This situation has left many patients wondering whether natural remedies like CBD oil could help.
So, does CBD oil help patients with trigeminal neuralgia? Keep reading to find out.
What Is Trigeminal Neuralgia?
Trigeminal neuralgia is sometimes called tic douloureux. It is a condition that affects the fifth cranial (trigeminal) nerve. This nerve is one of 12 pairs that attach directly to the brain, and it connects to the face with three branches. These branches supply the:
- Upper, middle, and lower regions of the face
- Forehead and scalp
- Cheeks and upper jaw
- Lower jaw
Trigeminal neuralgia occurs when this nerve becomes compressed, leading to facial pain. The level of discomfort could interfere with everyday activities and severely reduce one’s quality of life.
Therefore, many patients with trigeminal neuralgia also suffer from depression, sleep problems, and anxiety.
Trigeminal Neuralgia Symptoms
The main symptom of trigeminal neuralgia is severe facial pain. This pain is sometimes unpredictable and arrives suddenly with little warning. Most people describe it as a shooting pain, which can feel like an electric shock in the jaw, teeth, and gums.
These symptoms usually affect just one side of the face. Occasionally, both sides are affected, but usually not at the same time.
Trigeminal neuralgia attacks can last for anywhere between a few seconds and two minutes.
In severe cases, they may occur hundreds of times each day. Bouts can last for days, weeks, or months at a time. At this point, patients may experience a symptom-free period (remission).
However, over time, these periods of remission can become shorter. Eventually, a patient may be left with a continuous throbbing, aching, or burning sensation, even between attacks.
Unsurprisingly, trigeminal neuralgia often causes other symptoms, such as weight loss if a patient is unable to eat properly.
What Causes Trigeminal Neuralgia?
Trigeminal neuralgia is the result of pressure on the trigeminal nerve. In approximately 95% of cases, the condition is due to a blood vessel pressing on the nerve. This is known as primary trigeminal neuralgia.
In other cases, the pressure could come from a cyst, tumor, or cluster of malformed blood vessels. It may also be related to multiple sclerosis or due to an injury or surgical damage. These cases are called secondary trigeminal neuralgia. Nobody is sure why some people develop trigeminal neuralgia and not others. However, it is more prevalent in women and those over 50 years of age.
Trigeminal Neuralgia Triggers
Even the slightest movement or touch can trigger an episode of trigeminal neuralgia. However, in some cases, the symptoms of trigeminal neuralgia can flare up without any apparent cause.
Some common triggers include:
- Washing the face
- Brushing the teeth
- Applying makeup
- Cold drafts/air conditioning
- Head movements
- Vibrations, including walking or traveling by car
Although it is impossible to avoid all of these triggers, patients can help themselves in some situations. Some find that wrapping a scarf around their face and avoiding drafts provide some relief. Drinking through a straw and liquidizing meals are also options, although they are not always practical.
Common Trigeminal Neuralgia Treatments (Not CBD Oil)
Regular painkillers have little effect on trigeminal neuralgia. Therefore, most doctors prescribe anticonvulsant drugs to help manage the condition. Although these medications are designed to treat epilepsy, they have the effect of slowing down nerve signals and relieving pain.
One of the most common examples is carbamazepine (Tegretol). Unfortunately, this medicine comes with a list of unpleasant side effects, including:
- Poor concentration
- Double vision
Furthermore, this drug can become less effective over time, leaving patients searching for an alternative.
Other treatments include surgery and percutaneous procedures. The latter involves intentionally damaging the nerve to block its signals. Therefore, it can leave patients with numbness or pins and needles on the affected side of the face.
Complementary approaches include acupuncture, biofeedback, and meditation to help with pain management. However, there is sparse clinical evidence to support the use of these techniques.
With such limited treatment options available, it’s unsurprising that many patients are dissatisfied. Therefore, many are wondering whether CBD oil can help trigeminal neuralgia. Let’s take a look.
CBD Oil for Trigeminal Neuralgia
Cannabidiol, also known as CBD, is now among the most popular natural health products in the world. It is one of the many active compounds found in cannabis plants.
Unlike THC, CBD does not cause intoxication. However, it does have a wide range of both physical and psychological effects. These effects are primarily due to CBD’s ability to interact with the body’s built-in endocannabinoid system (ECS).
The Endocannabinoid System and Pain
The ECS is a complex network of cell receptors called cannabinoid receptors and chemicals called endocannabinoids. When these components bind together, they trigger a variety of responses that help to maintain a state of homeostasis (balance).
The ECS runs throughout the entire body, including the brain and nervous system. It is involved in controlling mood, movement, memory, and pain.
Scientists are still working hard to determine the exact role of the ECS in pain management. However, it appears to interact with several of the body’s other systems, including the endorphin/enkephalin system. These are the body’s natural analgesics, and it is the system that opioids act upon to relieve pain.
The ECS also has a close connection with pain receptors known as TRPV1. These receptors work to detect both heat and pain. For example, they become active when someone eats spicy food, such as chili peppers. They send messages to the brain via nerve fibers and help to trigger a healing response.
How CBD Could Work for Pain Relief
CBD works by increasing the levels of natural endocannabinoids. In this way, it can enhance the activity of the ECS and aid patients with inflammation and pain. It also has neuroprotective effects, allowing it to potentially protect nerve cells from damage.
There are few studies specifically on CBD for trigeminal neuralgia. However, there is some evidence that it can benefit neuropathic pain. For example, this 2008 review, Cannabinoids in the Management of Difficult to Treat Pain, suggests that these compounds show ‘great promise’ in the treatment of neuropathy.
Research is ongoing, but hopefully, in the future, we will see substantial evidence regarding the efficacy of CBD for trigeminal neuralgia
CBD Oil for Anxiety and Depression Associated with Trigeminal Neuralgia
Due to its debilitating nature, many people with trigeminal neuralgia also suffer from depression, anxiety, and sleep issues. Fortunately, this is another area where CBD oil may help.
A 2014 study for CNS and Neurological Disorders Drug Targets found that CBD has both antidepressant and anti-anxiety properties.
Again, this is due to how the compound interacts with the ECS. It increases the circulating amounts of a specific endocannabinoid called anandamide. This chemical is often referred to as ‘the bliss molecule.’
CBD may also help to support healthy sleeping patterns, as this 2019 study for The Permanente Journal demonstrated. Of its 72 participants, 57 experienced reductions in anxiety scores while 48 experienced better sleep.
How to Take CBD Oil for Trigeminal Neuralgia
Those living in a state where medical marijuana is legal may wish to apply for a medical marijuana card. Several states list neuropathic pain as one of their qualifying conditions. Patients in these locations can benefit from more potent products containing THC alongside CBD.
Those who don’t live in a legal state can try a CBD oil that comes from hemp. Hemp contains less than 0.3% THC and is widely legal in the US.
The most popular way of taking hemp-derived CBD is via an oil. The preferred method of taking CBD oil is to place the oil under the tongue and hold for 60–90 seconds before swallowing. CBD is also available in many other forms, including capsules, edibles, vape products, and topicals.
Each of these forms has its pros and cons. For more information, check out our article CBD Therapy: Which Is Best for You?
One thing to consider when purchasing CBD oil for trigeminal neuralgia is whether the product is full-spectrum or an isolate. Full-spectrum products are potentially more effective since they contain a range of other cannabis compounds alongside CBD.
This is relevant because other cannabinoids, such as CBC and CBG, and some cannabis terpenes also have painkilling properties. Many experts believe that these chemicals work together synergistically to produce enhanced effects.
It is also essential to choose a CBD brand carefully. Some companies are selling inferior goods thanks to a lack of market regulation. Look for a brand that publishes third-party lab reports to confirm the cannabinoid content of their oils. It is also important to read plenty of reviews before buying.
Does CBD Oil Help with Trigeminal Neuralgia? Final Thoughts
Those who have pain due to trigeminal neuralgia may find CBD oil useful. Still, bear in mind that CBD may not be powerful enough to manage the condition by itself. However, it could potentially provide some additional relief alongside other treatment methods.
It should be noted that CBD can interact with many prescription and over-the-counter drugs and could increase the risk of adverse effects. Therefore, patients should consult a medical professional before taking CBD oil for trigeminal neuralgia. They will be able to monitor progress and adjust the amount consumed if necessary.