Neuropathic pain greatly affects the quality of life of sufferers. In addition to the intense pain felt continuously and sometimes throughout the body, mobility, quality of sleep and emotional state are degraded. And unfortunately, to this day there is no cure for this type of pain. The treatments on offer are not always effective, and have serious side-effects.

Faced with such a panorama, many patients suffering from neuropathic pain are turning to natural alternatives such as CBD.

A safe, non-psychoactive molecule, cannabidiol is being studied for its multiple properties. We've compiled the data needed to understand how and why CBD might actually help relieve neuropathic pain.

Neuropathic pain: definition, causes and treatments

To understand how CBD can help relieve neuropathic pain, we first need to understand what neuropathic pain is. The biological framework of this type of pain is very specific.

What is neuropathic pain?

Neuropathic pain results from a disorder of the central and/or peripheral nervous system disorder. In other words, a lesion or dysfunction in the brain, spinal cord or one or more nerves [1].

Neuropathic" pain should not be confused with "nociceptive" pain:

Neuropathic pain is either spontaneous (not triggered by an external stimulus) or excessive (provoked by a simple touch). This is known as "dysesthesia". It also manifests itself continuously, with a sensation of burning and/or electric discharge;
Nociceptive pain is a type of pain that everyone has experienced, since it is triggered by an external stimulus such as a burn, a fracture, a shock, and so on.

Nociceptive pain disappears with its cause. Neuropathic pain, on the other hand, takes a very long time to heal, and generally never does, as the nervous system suffers damage that is difficult to repair. Indeed, once the nerves enter a state of prolonged prolonged overexcitationit is rarely possible to re-educate them in the long term.

What causes these pains?

Neuropathic pain generally occurs following an operation, illness or trauma causing damage to the central nervous system (brain) or peripheral nervous system (spinal cord, nerves).

In concrete terms, the origin of these pains can be caused by :

Compression of a nerve (e.g. herniated disc);
Diabetes or shingles (which affect nerve function);
Stroke or other brain injury;
Amputation (phantom limb syndrome);
Or by abnormal functioning of pain processing without any apparent cause.

Whatever the case, the mechanisms of neuropathic pain are extremely complex. Whatever the cause, it results from overexcited nerves or nociceptors which react disproportionately to a mild or non-existent stimulus.

How is neuropathic pain treated?

As mentioned above, neuropathic pain rarely disappears completely. However, several treatments are available to reduce the sensation of pain.

As opiate-type analgesics are not effective in the long term against this type of pain, treatment is generally based on adjuvant analgesics composed of :

Serotonin reuptake inhibitorsmore commonly known as "antidepressants". In fact, serotonin is a neurotransmitter involved in mood modulation mechanisms, as well as pain;
And anti-epileptics (or anti-convulsants) such as gabapentin, pregabapentin or carbamazepine. These act on the excitation of neurotransmitters located in the brain, reducing the influx of pain-related nerve messages.

These treatments help most people relieve their pain. But this relief comes at the expense of numerous numerous side effects (drowsiness, dizziness, stomach upsets, mood disorders, etc.).

In addition to these medications, the patient may undergo physiotherapy and/or neuromodulation (stimulation of the spinal column) and may also use patches (capsaicin or lidocaine) on the painful area.

How could CBD relieve neuropathic pain?

As we have just seen, serotonin reuptake inhibitors (antidepressants) and antiepileptics are the two types of treatment recommended for neuropathic pain sufferers. And it just so happens that CBD is potentially capable of replacing them.

Anti-epileptic action

Cannabis has been used since ancient times to treat a variety of ailments, including seizures. And now, a CBD-based treatment, Epidiolex, is prescribed to people suffering from certain forms of epilepsy (Dravet and Lennox-Gastaut syndromes), with more than satisfactory results.

As an example, a study [2] conducted on 214 drug-resistant children with epilepsy showed that treatment with pure CBD oil can reduce seizures by half within 3 months. This type of observation is far from marginal, with most experiments concluding that CBD can halve or even totally eliminate the occurrence of seizures. All this without side effects or addiction.

So, if CBD is capable of acting as an anti-epileptic, we can expect it to be equally effective in the treatment of neuropathic pain. Of course, specific studies are required before any claims can be made.

CBD and serotonin

As mentioned above, serotonin is a neurotransmitter involved in key mechanisms such as mood modulation and sleep quality, but also in pain perception. It's for this reason that drugs prescribed for depression and insomnia, such as antidepressants, are also prescribed for neuropathic pain.

CBD, for its part, is particularly popular with people suffering from depression or insomnia, and is also widely used as a painkiller.

These qualities are partly explained by its interaction with our our 5-HT1Areceptors, which are responsible for capturing excess serotonin. In fact, although scientists don't really know how, it seems that CBD is capable of inhibit the reuptake of serotonin in a similar way to antidepressants.

Among the studies conducted on the subject, one [3] showed that a low dose of CBD administered for 7 days was sufficient to induce analgesia in an animal model of neuropathic pain.

Consuming CBD for neuropathic pain

We'll probably have to wait for further evidence before CBD is officially prescribed for neuropathic pain by the medical profession.

However, if if your doctor agreesyou can try it now. CBD is not harmful to your health, and you can buy it over the counter on the Internet or in specialist stores.