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Cbd oil dosage for crps

CBD for Complex Regional Pain Syndrome (CRPS)

CRPS is shorthand for Complex Regional Pain Syndrome for which the most prescribed medications can be addictive or harmful if they are used for an extended period. Therefore, an increasing number of people are turning to CBD and medical cannabis to try to treat their symptoms of CRPS. CBD is not addictive, and a tolerance doesn’t develop over time. It is important to note at this juncture that CBD does not get you high or have any psychoactive impact on the user.

What is Complex Regional Pain Syndrome (CRPS)?

CRPS is a chronic pain condition that typically affects a single limb. If the pain persists beyond 6 months it is then deemed to be chronic. CPRS most commonly affects legs, feet, hands and arms. CRPS is more common in women than it is in men, but it can be diagnosed in anyone at any age. However, the peak risk bracket is those who are over 40 years of age. Very few children are diagnosed with CRPS.

How Do You Get CRPS?

The risk of being diagnosed with CRPS peaks at 40 and it is rarely diagnosed in elderly people. This pain syndrome typically develops after surgery or an injury, which could provide an explanation as to why so few children are affected by the condition.

It is believed that CRPS develops because of damage to the peripheral and central nervous system. The central nervous system is made up of your brain and spinal cord whereas the peripheral nervous system involves nerve signalling from the spinal cord to your brain and then onto the rest of your body. Approximately 90% of CRPS cases are linked to trauma and scientists are not sure what differentiates the patients whose condition is a result of trauma and those who develop it naturally.

What are the common triggers for CRPS?

The known common triggers of CRPS are:

○ Soft tissue injuries

○ Minor medical procedures

What are the Symptoms of CRPS?

The symptoms of CRPS can vary in severity and how long they last for. Some cases of CRPS can be mild and eventually cease, while other cases can be totally debilitating last for months or even years. There are various symptoms, you do not have to experience all the symptoms to be diagnosed with CRPS. The symptoms include:

○ Changes in the temperature of your skin

○ Changes in the colour of your skin

○ Changes in nails

○ Swelling in the problematic limb

○ Pain spreading from the injured area to the connected limb

○ Prolonged severe pain that feels like burning pins and needles

How is CRPS Diagnosed?

If you are in consistent pain, you need to see a physician to assess what the cause of the pain is. There is no specific blood test for CRPS, making it a more difficult condition to diagnose. You are reliant on a skilled doctor to recognise the condition as being the potential diagnosis. It is likely that you will have to have X-rays and MRIs to get an understanding of the root cause of the problem.

How is CRPS Treated?

After a doctor has ruled out other potential causes, a variety of treatment options will be presented to you.

Rehabilitation Therapy

Rehabilitation therapy is an exercise program for CRPS and helps to keep your limbs moving and improve blood flow. By increasing your blood flow, you can decrease the impact of the circulatory symptoms you are experiencing. These exercises can improve your strength, flexibility and the function of your limbs.


Psychotherapy can also help to ease the condition. Chronic pain can have a detrimental impact on your mental health and can even damage your entire family’s state of mind. Those who are diagnosed with CRPS can develop depression, anxiety, and PTSD.


Medication is another method that physicians often choose to implement when treating a CRPS patient. There have been no drugs approved specifically for CRPS by either the USA’s FDA or the MHRRA in the UK. Common medications for the condition include:

  • Cortcosteroids – prednisolone and methylprednisolone
  • Opioids – morphine, fentanyl, oxycodone – this has severe side effects
  • Bisphosphonates – alendronate or intravenous pamidronate
  • Non-steroidal anti-inflammatory drugs- ibuprofen or aspirin
  • Seizure & depression medication – gabapentin, pregabalin and duloxetine
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One of the largest issues with these medications is how they impact the body and mind. Some pain medications can be extremely addictive, and patients need to take them under strict supervision.

CRPS can cause consistent pain for extended periods and certain medications should not be taken for the duration of the period the patient is dealing with the illness. People in severe pain are beginning to use medical cannabis and CBD to treat their symptoms and finding that the side effects are far less severe than using opioids or other pharmaceuticals.

What is CBD?

CBD is shorthand for cannabidiol which is a chemical that is contained within the cannabis plant. CBD doesn’t get you high, unlike the most notorious cannabinoid THC (tetrahydrocannabinol). The primary difference between CBD and THC is that CBD doesn’t directly interact with the endocannabinoid system, which prevents it from causing the user to feel high or intoxicated.

CBD operates by indirectly interacting with the endocannabinoid system. The endocannabinoid system is what manages the entire body’s regulation and is responsible for homeostasis. The way the endocannabinoid system controls the body’s functions is through cannabinoid receptors and native endocannabinoids.

CBD for Inflammation

Heightened levels of cytokines, that cause inflammation have been found in the cells of people with CRPS. The has led to researchers to believe inflammation could be integral to the cause of CRPS.

By elevating the 2-AG endocannabinoid, CBD can help with inflammation with the same process it uses to help with pain and retrograde signalling. The 2-AG endocannabinoid tells the CB2 receptors to desist in sending out so many attack cells without compromising the strength of your immune system.

CBD for Pain Management

Although there are few studies that have specifically explored the relationship between CBD and CRPS itself, there have been a number of promising studies that have looked into cannabis and its ability to provide pain relief to sufferers of CRPS.

For example, one oft-referenced study dating back to 2013 and published in the Journal of Pain, examined the effect of vaping cannabis on neuropathic pain. While not all of the participants had CRPS-I, everyone at least had some description of nerve pain.

The participants were initially split into three groups and were given one of; a medium dose, a low dose or placebo cannabis to vape. Participants in the medium and low dose cannabis groups reported significant pain reduction with few, if any adverse side effects.


CRPS is an elusive illness which is hard to diagnose, and it is difficult to definitively treat. CBD and medical cannabis could present an excellent solution to CRPS patients, and the side effects are substantially less than horrific medications such as opioids. This means that the medication that the patient uses over an extended period does not have a detrimental long-term effect on their health and is not addictive.

If you would like to learn more about this, you can read our comprehensive guide to the side effects of CBD.

Does CBD work for CRPS?

Cannabidiol (more commonly known as CBD oil) is an extract of Cannabis indica and Cannabis sativa, the same plants used to make marijuana. From oils and nasal sprays to sweets and soft drinks, CBD is becoming increasingly popular in the UK for treating and helping to relieve various conditions.

CBD is said to provide relief for anxiety, depression and post-traumatic stress disorder, as well as pain relief, and there are said to be some key benefits that CBD oil may have when incorporated it into your daily life.

CBD and pain relief for CRPS

Formerly known as Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS) is caused by an injury to the sympathetic nerves resulting in severe pain. The definition of CRPS has changed regularly through the years and there are now two separate recognised types:

  • Type I – often known as reflex sympathetic dystrophy and shows no evidence of nerve lesions
  • Type II – often known as causalgia and has clear evidence of nerve lesions and damage
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CRPS is a chronic condition that is typically triggered by a traumatic injury to a limb, but the pain does not subside as would usually happen during a usual recovery. Those suffering from CRPS tend to experience pain that is greatly amplified and disproportionate to the severity of the injury itself and it can be catastrophic for many.

Cannabis has been used to treat pain for thousands of years, and in more recent history, scientists and researchers have uncovered that there are specific components of the marijuana plant, including CBD that are responsible for the pain-relieving effect that CBD can have.

Many people use CBD to relieve pain. CBD works in three main ways:

  • reducing inflammation by decreasing the production of inflammatory chemicals called cytokines;
  • by binding to and blocking receptors in the central nervous system that are associated with pain; and
  • reducing anxiety associated with pain by binding to serotonin receptors and giving a natural anti-depressant.

There are few studies that have specifically explored the relationship between CBD and CRPS itself, however there have been a number of promising studies that have looked into cannabis and its ability to provide pain relief to sufferers of CRPS.

CRPS is a poorly understood condition and therefore difficult to treat. There is no known cure for CRPS, however, a combination of physical treatments, medication and psychological support can help to manage symptoms.

Is CBD legal?

CBD is legal in the UK, however the law states that the product has to meet certain criteria to be lawfully available for human consumption. Primarily CBD oil must not contain any trace of THC to be legally sold in the UK (it’s the THC that’s present in the cannabis plant that gets you high). Many CBD products on the high street aren’t always properly authorised, therefore it’s best to buy them from trusted websites, pharmacies or stores and to speak to your doctor before taking CBD products.

To be legal in the UK CBD products must have no THC, so that they’re not psychoactive and won’t get you high. They are becoming increasingly popular for those suffering from various medical conditions, however with all supplements there are possible side effects which could affect you. Our understanding of the role of CBD in pain management continues to evolve and it is important to read the product information and packaging so you’re aware of what could happen and to speak to your doctor before starting to take CBD products to help relieve CRPS symptoms.

If you are suffering from fibromyalgia, CRPS, or any chronic pain condition as a result of an accident that was not your fault, and even if you have an existing claim, get in touch with Brian Barr Solicitors to see if we can assist. It is simple and hassle free to move your claim to Brian Barr Solicitors who are experts in dealing with chronic pain litigation. Call us today on 0161 737 9248 or visit our website ( to find out more.

We do not endorse any research, studies or sources mentioned within our blogs and comments. The blog is for information purposes only as we are not medical professionals, and it should not be relied upon as legal advice as cases may vary depending on the specific facts. We do not endorse any medical advice provided and would strongly recommend anyone seeking medical advice to contact their local healthcare provider before any changes to treatment and / or management of your condition is undertaken. Please note that local laws vary regarding CBD products.

New Guidelines Issued on Medical Cannabis for Chronic Pain

— International task force shares recommendations for dosing, administering

by Ryan Basen, Enterprise & Investigative Writer, MedPage Today September 13, 2020

Chronic pain patients can be treated with medical cannabis following one of three protocols based on patient characteristics, according to an international task force at the virtual PAINWeek meeting.

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Citing limited clinician knowledge about medical cannabis treatment and the opioid crisis, one task force member said the recommendations are timely.

“We as a task force believe it’s extremely important to bring [medical cannabis] to patients,” Alan Bell, MD, of the University of Toronto, told MedPage Today. “Our main focus was to provide directions to clinicians.”

Medical cannabis has been suggested to treat chronic pain, the task force noted, but too many providers still do not utilize it because there has not been accepted guidelines about dosing and administration. Others prescribe medical cannabis without knowing how patients can properly dose.

“There’s a huge knowledge gap and no way clinicians can fall back on a specified dosing regimen,” Bell said.

Led by Arun Bhaskar, MD, of Imperial College Healthcare NHS Trust Pain Management Centre in London, the 20-clinician Global Task Force on Dosing and Administration of Medical Cannabis in Chronic Pain used a modified Delphi process. Among their recommendations:

  • Treat the majority of patients along the “routine” scale. This means starting patients with 5 mg of cannabidiol (CBD) twice daily. Tetrahydrocannabinol (THC) should only be introduced if patients do not respond to at least 40 mg of CBD daily, starting with 2.5-mg daily THC doses. THC doses should be capped at 40 mg daily.
  • Frail and elderly patients, and those with severe co-morbidity or polypharmacy should be treated via a conservative route. This means starting the THC dosses at 1 mg daily and titrating up the THC more slowly.
  • Patients suffering from severe pain and those who have significant prior cannabis consumption can follow the rapid protocol. This mean starting with a CBD-THC balanced dose of between 2.5-5 mg per each compound once or twice daily.

“Tailoring medical cannabis treatment to the individual is a critical component of successful treatment,” according to the group’s poster presentation at PAINWeek.

The task force recommends starting with CBD in most cases because they have seen many patients benefit solely from CBD. Unlike THC, CBD does not have psychoactive properties.

The task force encourages providers to consider medical cannabis for patients dealing with neuropathic, inflammatory, nociplastic, and mixed pain.

The task force did not set a maximum treatment age; many of its clinicians reported seeing best results among geriatric patients, Bell said. They did not set a minimum CBD treatment age, with many treating pediatric patients with high doses of CBD for epilepsy.

The task force did not set a minimum treatment age for THC because they could not come to an agreement, Bell said. That does not mean they endorse treating minors with THC; the brain’s neuroplasticity until age 25 eliminates that possibility, Bell said.

They suggested the best administration method is oral because of “ease of dosing and safety,” according to the poster.

They recommended pregnant and breastfeeding women, and people with psychotic disorders, not be administered medical cannabis. They also cautioned against mixing medical cannabis with anticoagulants, immunotherapy, or the epilepsy medication clobazam (Onfi, Sympazan, Frisium).

The task force needed 75% agreement to adopt any resolutions and Bell said they agreed to most of their recommendations on the first vote.

“There’s way too much of opioids being used for chronic pain despite a lack of evidence and the harms associated with opioids,” Bell said. “We feel this is a major barrier that we are trying to overcome. that may exist because of the knowledge gap” regarding medical cannabis.

The task force featured clinicians from North America, Brazil, Europe, Australia, and Africa, according to the poster. It also included clinicians “with many, many years” of clinical experience working with medical cannabis, Bell said, from practices ranging from primary care to oncology to pediatrics and more.

They began the consensus process by completing clinical practice surveys, then reviewed questions and attended two virtual meetings.

Ryan Basen reports for MedPage’s enterprise & investigative team. He often writes about issues concerning the practice and business of medicine, nurses, cannabis and psychedelic medicine, and sports medicine. Send story tips to [email protected] Follow

Spectrum Therapeutics funded the group’s logistical efforts. No committee members received compensation.