Cannabidiol (CBD) is thought to provide relief to people with chronic pain, without the psychogenic effects or high associated with marijuana. This article will overview CBD including its benefits, potential risks and side effects, where it comes from, the different ways CBD is extracted, and how to choose the right products.

Can CBD Really Treat Chronic Pain?

CBD is a relatively new and understudied medical treatment for chronic pain. Advocates believe it can be used to treat a range of conditions, including arthritis, essential tremors, multiple sclerosis,1 and more.

See Common Conditions That Cause Chronic Pain

Research suggests that CBD can:

  • Reduce inflammation and other signs of pain2
  • Combat anxiety, which is often associated with chronic pain3

In addition, advocates suggest CBD can help with sleep as well as improve a person’s overall state of relaxation. Some research suggests that the use of CBD has an effect on pain perception; however, more in-depth studies are needed.4

See Understanding Chronic Pain: The Gate Control Theory


Potential Risks and Side Effects of CBD

CBD, even in high amounts, is generally safe. A person may experience these mild side effects:

  • Drowsiness
  • Dizziness
  • Dry mouth
  • Low blood pressure

As with other natural products, there is potential for adverse reactions with other medications. It is important to check with a health care provider before using CBD.

See Non-opioid and Topical Medications for Chronic Pain

Is CBD legal?
CBD derived from the hemp plant is legal in all 50 states. CBD derived from marijuana plants with high levels of THC is only legal in states where marijuana has been legalized for medical or recreational use. How the CBD was derived should be on the product’s ingredient list.

See Complementary Health Approaches and Marijuana for Chronic Pain

The Food and Drug Administration (FDA) does not consider CBD or products that contain CBD to be dietary supplements. This is because CBD has been studied and approved for use as a new drug to treat epilepsy, which means it is outside the definition of a dietary supplement.5 There may be products available that are marked as dietary supplements, however the amount of cannabidiol they claim to contain may not be accurate.

In This Article:

Where Does CBD Come From?

The cannabis sativa plant has around 100 chemical compounds, called cannabinoids, that have a range of effects.

The cannabis sativa plant has two main varieties that are grown for specific purposes:

  • THC content. THC is the compound associated with the “high” feeling of marijuana use.
  • Industrial (non-drug) uses. This form of the plant contains very trace amounts of THC (less than .03%) and can be used to make paper, clothing, and some building material. This variation of the cannabis plant is called hemp.

While CBD is present in both varieties, the CBD available to consumers is generally from the hemp plant.


How CBD Oil Is Extracted

CBD is an oil and can be extracted from the plant in several ways:

  • Carbon dioxide (CO2) extraction. This method uses special machines to extract CBD from the plant product. The machines use carbon dioxide in a variety of different temperature and pressure controlled environments to extract a concentrated CBD oil.
  • Liquid solvent extraction. This method uses a liquid solvent, such as butane or ethanol, to strip plant matter of CBD and turn it into a liquid. The liquid is then evaporated leaving a concentrated CBD oil.
  • Oil extraction. This method requires that the plant product be heated to a certain temperature in order to activate the chemicals. Once activated, they are added to oil (typically olive oil) and heated to extract the CBD. Unlike other methods, the extracted CBD is not concentrated and is not as potent.

Once extracted, CBD may be packaged and sold or used as an ingredient in food, lotions or other products.


  1. Corey-Bloom J, Wolfson T, Gamst A, et al. Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial. CMAJ. 2012;184(10):1143-50.
  2. Russo EB. Cannabinoids in the management of difficult to treat pain. Therapeutics and Clinical Risk Management. 2008;4(1):245-259.
  3. Crippa, J. A. S., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., ... & Filho, A. S. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of Psychopharmacology, 25(1), 121-130.

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