cbd oil for chronic tension headaches

The Use of Cannabis for Headache Disorders

Headache disorders are common, debilitating, and, in many cases, inadequately managed by existing treatments. Although clinical trials of cannabis for neuropathic pain have shown promising results, there has been limited research on its use, specifically for headache disorders. This review considers historical prescription practices, summarizes the existing reports on the use of cannabis for headache, and examines the preclinical literature exploring the role of exogenous and endogenous cannabinoids to alter headache pathophysiology. Currently, there is not enough evidence from well-designed clinical trials to support the use of cannabis for headache, but there are sufficient anecdotal and preliminary results, as well as plausible neurobiological mechanisms, to warrant properly designed clinical trials. Such trials are needed to determine short- and long-term efficacy for specific headache types, compatibility with existing treatments, optimal administration practices, as well as potential risks.

Introduction

Headache is a major public health concern, with enormous individual and societal costs (estimated at $14.4 billion annually) due to decreased quality of life and disability. 1 Each year, ∼47% of the population experience headache, including migraine (10%), tension-type headache (38%), and chronic daily headache (3%). 2 A sexual dimorphism exists for headache disorders, with women 2–3 times more likely to experience migraine 3 and 1.25 times more likely to experience tension-type headache than men. 4

The present review will focus largely on migraine, tension-type headache, trigeminal autonomic cephalalgias (specifically cluster headache), and medication-overuse headache (MOH). Migraine is classified as a 4–72 h headache that is typically unilateral, pulsating, of moderate-to-severe intensity, and associated with photophobia and phonophobia. 5,6 Tension-type headache is classified as frequent, infrequent, or chronic, typically presenting with bilateral tightening pain of mild-to-moderate intensity and lasting minutes to days. 6,7 Cluster headache is defined as severe unilateral pain in orbital, temporal, and/or supraorbital locations, lasting 15–180 min and typically occurring frequently and at regular intervals. 6,8 MOH is a chronic condition (occurs more than 15 days per month) that develops from frequent use of anti-headache medications. 6,9

The pathophysiology of headache disorders is still under investigation. However, it is believed that migraine and cluster headaches are initiated in the brain in areas such as the hypothalamus, brainstem, or possibly cortex. 6 Tension-type headaches can not only originate in the central nervous system but may also be triggered by myofascial tissue, often developing in response to stress. 10 Regardless of origin, headaches usually involve overactivation of the trigeminovascular pathway, resulting in the release of vasoactive peptides, such as calcitonin gene-related peptide (CGRP) and substance P, as well as vasoactive mediators such as nitrous oxide (NO), which can lead to further sensitization of nociceptive receptors in the head and neck. 11 Serotoninergic signaling, parasympathetic efferents, inflammation, and increased intracranial pressure also play important roles in headache disorders. 12,13

Treatment depends on the underlying headache condition; however, some popular options include NSAIDs for mild headaches and triptans, anti-depressants, verapamil, or ergotamine for more severe or chronic headaches. 14 These may be complemented by nonpharmacological interventions such as cognitive-behavioral therapy or relaxation training. 15 Despite many treatment options, less than half of headache sufferers experience remission, and many continue to develop more severe or chronic headaches throughout their lifetime. 16 Moreover, headache disorders are often underrecognized and undertreated. 17 This current situation warrants an exploration of additional treatment options for headache disorders, with favorable side-effect profiles and efficacy in refractory patients.

One such option, cannabis, has been ignored in the United States for the past several decades but has an established history in the treatment of headaches. Assyrian manuscripts from the second millennium BCE recommended cannabis to “bind the temples,” 18 and Ayurvedic preparations in the third and fourth centuries BCE were indicated for “diseases of the head” such as migraines. 19 The prescription of cannabis was even recommended in ancient Greece, with Pedanius Dioscorides describing its use in his De Maternia Medica as a treatment for “pain of the ears.” 20 Other citations documenting the use of cannabis for headache disorders arise from the ninth century in the Al-Aq-rabadhin Al-Saghir, the earliest known document of Arabic pharmacology. 19 Further recommendations are found in Persian texts from the 10th 21 and 17th centuries. 22 Prominent physicians of the Middle Ages, including John Parkinson 23 and Nicholas Culpeper, 24 also recommended the use of cannabis for headache.

The reintroduction of cannabis to the West in 1839 25 began a century of its use as an effective treatment for headache disorders 26 until its illegalization in 1937. 27 Notable physicians who espoused the benefits of cannabis for headache disorders included John Russell Reynolds, the personal physician of Queen Victoria, 28 American neurologist Silas Weir Mitchell, 29 the president of the New York Neurological Society Edouard C. Seguin, 19 William Gowers, a founding father of modern neurology, 30 and Sir William Osler, often considered the father of modern medicine. 31

When cannabis was deemed illegal by the U.S. government, its therapeutic use and research into its medical potential was largely discontinued. To this day, there are few clinical investigations of the use of cannabis for headache; however, the studies that have emerged demonstrate potential efficacy. In addition, numerous pre-clinical investigations 18 have validated the role of endocannabinoids in preventing headache pathophysiology, which suggests a mechanistic role of cannabis in the treatment of these disorders. Although the cannabis plant comprises more than 100 cannabinoids, there has been little study of the individual effects of these cannabinoids on headache disorders; therefore, the present review will focus largely on the clinical potential of the cannabis plant as a whole.

The present review has four unique aims: (1) Highlight common historical trends in the use of cannabis in the treatment of headache to inform future clinical guidelines. (2) Briefly present the current clinical literature on this topic, with a focus on more recent publications that have not been discussed in past reviews. (3) Compile various preclinical studies into a prospective integrated model outlining the role of cannabinoids in the modulation of headache pathogenesis. (4) Outline several 19,32–35 future directions that warrant exploration based on the limited, but promising findings on this topic.

Materials and Methods

The material presented was drawn from standard searches of the PubMed/National Library of Medicine database, influential sources of current medical literature, and past review articles. Search keywords included cannabis; cannabinoids; headache; migraine; cluster headache; medication-overuse headache; tetrahydrocannabinol; cannabidiol; clinical trial; placebo; and double blind. CliniacalTrials.gov was also queried for studies that have not yet been published. Individual articles were selected based on historical, clinical, or preclinical relevance to cannabinoids or cannabis as a treatment for headaches.

Historical Use of Cannabis for Headache

Historical reports, though not ideal forms of evidence, are important resources for understanding the potential use of cannabis in the treatment of headache disorders. Clinical publications between 1839 and 1937 provide valuable insights into the most effective practices, challenges, and benefits during an era when cannabis was commonly used to treat headache. A summary of historical treatment practices using cannabis for migraines can be seen in Table 1 . Historical sources indicate that cannabis was used as an effective prophylactic and abortive treatment for headache disorders. Although dosing varied among physicians, most prescribed alcohol extractions of the drug in the range of ¼ to ½ grain (16–32 mg). 28,32,36–40 This dose was likely chosen to minimize the effects of intoxication while also providing effective therapeutic relief. Other providers suggested that doses should be progressively increased until modest effects of intoxication were felt. 19 For prophylactic treatment, these doses were usually administered two to three times daily for weeks or even months. 28,32,36–38 Acute treatment often involved higher doses taken as needed and, in some cases, smoked cannabis was recommended. 19,41–42

Table 1.

Historical Reports of the Use of Cannabis as a Treatment for Headache (19th and Early 20th Century)

Usage Administration Sample Result Source
Migraine A: 0.03 fluid ounce of alcohol extract 1 h before pain onset 4 Case studies Distinct termination of migraine. All patients experienced improvement, some were cured. Donovan 41
Migraine A: 21.6 mg 2 Case studies Immediate relief and elimination of headache for 14 months after treatment. No lasting harm. Reynolds 27
  P: 21.6 mg—three times daily      
Migraine/headache P: 21.6 mg, 1–2 times per day (can increase to 43.2 mg) 9 Case studies and clinical experience Responses in majority of cases. Usually lasting relief, sometimes curative. Palliative during headache. Greene 35 ; Russo 18
Clavus hystericus and migraine P: 21.6 mg to 43.2 mg every night Textbook Palliation even in severe cases. Waring 36
Migraine or sick headache P: Taken before each meal (Women: 21.6 mg increased to 32.4 after 2–3 weeks; Men: 32.4 increased to 48.6) Clinical experience Majority of patients reported migraine relief for months. Seguin (1878) cited in Russo 18
Migraine or sick headache A: 21.6–32.4 mg at beginning of attack. Clinical experience Found to be the most effective drug for migraine. Can abort attacks in some cases. Ringer 37
  P: 21.6–32.4 mg, 2–3 times daily, for weeks or months continuously.      
Migraine P: 8.1–16.2 mg of solid extract twice a day. Clinical experience Helpful prophylactically and abortively, even in cases of migraine refractory to other treatments. Hare 40
  A: Take as needed      
Chronic daily headache P: 21.6–32.4 mg (increasing if necessary), 2–3 times per day for weeks to months. 4 Case studies Cured complaints in a majority of cases. Mackenzie 38
Migraine P: 16.2 mg twice a day continuously Short report Given immediately will stop attack, given periodically will reduce severity and frequency. Suckling 39
  A: Take 16.2 mg during onset of attack      

A, abortive; P, prophylactic.

Early reports of cannabis for the treatment of headache appear to be largely positive, with many patients experiencing a decrease in the frequency and intensity of their headache episodes. In some cases, headache was cured entirely even after cannabis discontinuation. 28,32,36–42 Furthermore, these early clinical reports praise the apparent safety of long-term cannabis use, as well as its added benefits of mollifying the nausea and anxiety that often accompany headaches. A common emphasis was placed on the importance of specific purity, preservation, and administration of the cannabis as well as patient adherence in the efficacy of treatment.

Clinical Studies on Cannabis Use for Headache

The schedule 1 classification of marijuana in 1970 has made rigorous clinical studies on the treatment efficacy of this substance difficult. Currently, there are no placebo-controlled clinical studies examining the use of cannabis for headache; nevertheless, there have been a number of other studies published that give insight into its therapeutic efficacy ( Table 2 ). 19,43–58 However, care should be taken when interpreting the findings from these studies. With one exception, 53 these studies did not include a control group, and given that the placebo effect can be altered by the context of treatment, 59 it is reasonable to expect a significant placebo response given the pre-existing public popularity and notoriety of cannabis. Moreover, self-reports and case studies may have a bias toward immediate improvement without awareness of possible dependence, rebound, or withdrawal responses, which are important concerns in headache treatment. 60 In fact, studies show that headache can be induced in 23.2% patients undergoing cannabis withdrawal. 61

Table 2.

Clinical Reports of the Use of Cannabis or Exogenous Cannabinoids as a Treatment for Headache

Subject population Type of study Significant findings Source
3 Chronic smokers Case series Migraines after cannabis cessation. Remission of headache with return to use in one patient. El-Mallakh 42
Patient with migraine Case report Women found superior relief of migraine with cannabis compared with beta-blockers, opiates, and ergots. Petro (1997) cited in Russo 18
Patient with migraine Case report 18 years of treatment failure with standard pharmaceuticals, found success with smoked cannabis. Grinspoon and Bakalar 45
Patient with migraine Case report Successful treatment with cannabis that did not produce inebriation. Terwur (1997) cited in Russo 18
121 Patients prescribed cannabis for migraine Retrospective study Migraine occurrences decreased from 10.4 to 4.6 per month; 39.7% had a positive effect, 19.8% had decreased frequency, and 11.6% had aborted pain. Rhyne et al. 46
5 Cases of chronic migraine headache Case series All cases successfully treated with dronabinol or cannabis. In one case, cannabis improved response more than dronabinol. In three cases, cannabis was used to abort headache in the prodromal phase. Mikuriya 48
1655 Patients seeking physician recommendation for medical cannabis Survey 40.8% of applicants reported improvement of headache symptoms with cannabis. Nunberg et al. 49
3 Subjects with chronic headaches Case series Smoking cannabis caused relief similar or greater than ergotamine and aspirin. Noyes Jr. and Baram 50
30 Outpatients with medication-overuse headache Clinical Trial (RDAC—Crossover) Nabilone was superior to ibuprofen in reducing pain intensity, analgesic intake, and medication dependence while improving quality of life. Pini et al. 52
Patient with refractory cluster headache Case report Smoked cannabis or dronabinol at the beginning of cluster headache provided complete immediate headache relief. Robbins et al. 53
113 Patients with chronic cluster headache Survey 26% regularly used cannabis. Use as treatment unknown. Donnet et al. 54
139 Patients with chronic cluster headache Survey Overall, 45.3% had used cannabis, and 19.4% had used it to treat cluster headache; 25.9% found efficacy, and the remainder found variable or negative effects. Leroux et al. 55
Patient with pseudotumor cerebri Case report Complete resolution of headache with smoking cannabis in <5 min without reoccurrence. Evans and Ramadan 56
112 Patients with MS-associated trigeminal neuralgia Survey Overall, 70% found relief from trigeminal neuralgia, and 90% found chronic pain relief. Consroe et al. 57

MS, multiple sclerosis.

Nabilone, a synthetic cannabinoid mimicking tetrahydrocannabinol (THC), has been shown to decrease analgesic intake while reducing MOH pain in a double-blind, placebo-controlled trial. 53 In this study, 26 patients with treatment refractory MOH completed a course of either nabilone (0.5 mg) or ibuprofen (400 mg) for 8 weeks, then after a week-long washout period, completed a second 8-week course of the previously excluded medication. Oral cannabinoid administration was chosen over an oromusocal THC spray, both because oral administration avoids the concentration peaks that can lead to euphoric effects and because chronic administration better overcomes individual differences in bioavailability. Although both substances showed improvement from baseline, nabilone was significantly more effective than ibuprofen in reducing pain intensity, analgesic intake, and medication dependence, as well as in improving quality of life. This study also examined the safety of nabilone as a treatment for headache and found that patients only experienced mild adverse effects that disappeared after discontinuation of the medication. The results of this study are significant, especially given that MOH is exacerbated by many pharmacological treatments. This study also highlights the potential value of cannabis in combination therapies, as a supplement to traditional treatments, or as a secondary treatment in refractory cases. Currently, a multicenter, double-blind, placebo-controlled study is being performed to examine the safety and efficacy of a dronabinol, or synthetic THC, metered dose inhaler for the treatment of migraine (clincaltrials.gov, NCT Identifier: <"type":"clinical-trial","attrs":<"text":"NCT00123201","term_id":"NCT00123201">> NCT00123201). When published, this study could give valuable insights into the efficacy and risks of cannabinoids for the treatment of migraines.

Cannabis and cannabinoids have been studied clinically for other conditions, showing efficacy in the treatment of neuropathic/chronic pain, spasticity, and nausea. 62–66 These three conditions are associated mechanistically and qualitatively with the experience of headache and, although the clinical literature for each of these conditions exceeds the scope of this review, it is plausible that their efficacy will carry over in the treatment of headache disorders as well. For example, the analgesic properties of cannabis seen in the treatment of neuropathic pain will likely apply to chronic headache, the antispasmodic properties seen in the treatment of multiple sclerosis could apply to muscle strain known to induce tension headaches, and the antiemetic properties seen in the treatment of chemotherapy-associated nausea might also palliate migraine-induced nausea.

Many individuals are currently using cannabis for the treatment of migraine and headache with positive results. In a survey of nine California clinics (N=1746), physicians recorded headaches and migraines as a reason for approving a medical marijuana ID card in 2.7% of cases, and 40.7% patients self-reported that cannabis had therapeutic benefits for headaches and migraines. In another California survey of 7525 patients, 8.43% of patients reported that they were using medical cannabis to treat migraines. Another survey of 1430 patients found that 9% of patients were using medical cannabis to treat migraines (subdivided into 7.5% for classical migraines, 1% for cluster headaches, and 0.5% for others). Other studies have reported the use of cannabis for migraine or headache relief, with specific estimates including 5% (N=24,800) and 6.6% (N=128) for migraines and 3.6% (N=128) and 7.4% (N=217) for headache.

Other studies have looked specifically at the change in the occurrence of headache disorders with use of cannabis. 52 One retrospective study described 121 patients who received cannabis for migraine treatment, among whom 85.1% of these patients reported a reduction in migraine frequency. 47 The mean number of migraines at the initial visit was 10.4, falling to 4.6 at follow-up visits after cannabis treatment. Moreover, 11.6% of the patients found that, when smoked, cannabis could effectively arrest the generation of a migraine. These results indicate that cannabis may be an effective treatment option for certain migraine sufferers.

Reports from 139 cluster headache patients 56 indicate that cannabis could have value in treating a portion (25.9%) of these patients as well. However, cannabis was reported to provoke cluster headache attacks in some patients (22.4%) as well. One possible explanation for this provoking effect is that cannabis is known to increase heart rate, increase blood pressure, and cause systemic vasodilation. 67 Cluster headache sufferers seem to be highly sensitive to vasodilation of the carotid tree and increased oxygen demands, findings that are supported by evidence that alcohol is a reliable trigger and supplemental oxygen is an effective abortive therapy. 68 The increased oxygen demand and/or the vasodilation effects of cannabis could theoretically be responsible for this exacerbation in some cluster headache sufferers. Interestingly, cluster headaches appear to show improvement with treatment using hallucinogens such as d-lysergic acid amide (ergine or LSA), psilocybin, and lysergic acid diethylamide (LSD). 33 As such, it is possible that the psychoactive properties of THC could play a role in the treatment of cluster headaches.

Case reports also give insights into the mechanisms behind the anti-headache action of cannabis. Smoking cannabis has been reported to relieve pain associated with pseudotumor cerebri, 57 a condition that is characterized by an increase in the intracranial pressure of an uncertain etiology. This suggests that the therapeutic effect of cannabis in some headache conditions could be a result of reducing intracranial pressure. In fact, dexanabinol, a synthetic cannabinoid, has been found to relieve intracranial pressure and improve outcomes after traumatic brain injury. 69

Cannabinoids and Headache Pathophysiology

The pathophysiological mechanisms of many headache disorders are not entirely understood. Nevertheless, preclinical data examining the effects of endocannabinoids on the neurological and vascular systems demonstrate the influence of endocannabinoids in modulating several major components of migraine pathogenesis ( Table 3 and Fig. 1 ). 35,70–85

Should I use CBD for Severe Headaches?

The short answer is, yes, potentially. Too much CBD oil may also cause a headache for some users, however. Below, we will discuss how CBD oil affects the body and how it may be a treatment option for your headache troubles from mild pain to severe migraines and tension headache.

In this article, we’ll cover everything you need to know regarding CBD oil’s effect on tension headache causes and symptoms, so please keep reading to learn more.

While trying CBD oil for yourself is the best way to determine how CBD oil affects you, research has shown promising results for assessing the effects of cannabis on chronic pain and inflammation, known causes of head pain.

CBD has been all over the media, reviewed as a natural alternative to many addictive prescription options, like opiates. It is safe to use for most people aside from some drug interactions. You can even give CBD oils to your child.

Why Should I take CBD for my Headache?

Cannabidiol (CBD) is one of more than 120 cannabinoids found in cannabis. It is most commonly extracted from hemp, a cannabis plant which contains only traces of tetrahydrocannabinol (THC), a compound that produces the “high” feeling like with medical marijuana.

CBD products does not alter your mind or inhibit your daily function, but comes with a host of benefits!

  1. Studies have shown CBD oil to rival medical marijuana when it comes to treating chronic pain.
  2. It has anti-inflammatory benefits.
  3. It appears to be an effective treatment of migraine without worrisome side effects.

While analgesics can temporarily relieve migraine symptoms, their side effects are troubling with extended use. This is where CBD oil (cannabidiol) comes in.

Beyond the specific relief CBD oil can offer you for your headache, it has a lot of holistic properties for your body as a health supplement and helps to regulate your body’s overall function which may relieve the root causes of your pain, simultaneously relieving your head pain.

What is a Tension Headache?

According to WebMD , a Tension Headache consists of dull pain with tightness and pressure around the skull with pressure around your forehead or back of your head and neck. They are the most common form of headache and are also often called “Stress Headaches.”

A headache generally goes further than typical body aches associated with stress or allergies. This pain can last from 4 to 72 hours, even the most common activities may worsen your symptoms.

The World Health Organization (WHO) states that almost half of all adults worldwide will have a headache in a given year.

A headache can be a sign of stress or emotional anxiety, or it may be a result of a medical condition such as a migraine headache from high blood pressure, anxiety, or depression. This can lead to other problems. People with chronic migraines, for example, may have difficulty with regular work or school.

What Causes Migraines & Tension Headache?

Everyone, at some point in their life, has experienced a tension headache because it is one of the most common ailments. But what causes this type of headache? Several reasons are responsible for this condition. For example, a simple throat irritation can be a starting point of a migraine.

Stress: Stress often creates a sense of “struggle or escape” and is accompanied by other symptoms such as:

  • Shallow breathing
  • Increased heart rate
  • Hypertension

Nutrition: Your diet and sensitivity to foods are some of the leading causes of head pain, especially migraines.

  • Variations in blood glucose.
  • Caffeine withdrawal, or too much caffeine.
  • Food additives

Dental Abscess: A dental abscess may cause a severe headache, especially in the event of an infection.

Hormones: Hormones allow you to feel pain. In this case, sex hormones may be associated with head pain, especially in women. Whether before or after menstruation, if the levels of hormones are low, as a woman, you may have severe migraines.

Vision: People with vision problems are probably well acquainted with head pain because it is a prevalent symptom. A headache may be triggered when eye muscles become tense.

  • Glaucoma is another disease associated with the eye that may result in a headache.
  • Other causes may be due to disorders in the ear, nose, and throat.

In some cases, even adrenaline can be the cause of headaches, but the most common causes are:

  • Sinus Congestion
  • Labyrinthitis
  • Body infections
  • Physical trauma

There are many causes for your symptoms; CBD oil may be effective treatment for your migraine headache.

How Does CBD Oil Treat Tension Headache Symptoms?

The 2017 study published in Cannabis and Cannabinoids research investigated the benefits of oral cannabis.

In the six-month study period, 26 people were treated with either ibuprofen or nabilone (a FDA approved CBD synthetic) with oral cannabis to treat their symptoms. Each combination was used for a while (eight weeks at a time).

They also took eight weeks between two rounds.

At the end of the study, participants reported pain relief and improved quality of life when using the cannabis-nabilone formula. It is vital to keep in mind that a combination of substances, not just cannabis, was used for this study.

In 2016, Pharmacotherapy published a study on the use of CBD for medicinal purposes for treatment of migraine headache.

Researchers found that out of 40 respondents, about 40% reported less migraine pain in general. Drowsiness was the main objection, while others had difficulty in determining the correct dose.

Current Treatment Options For Tension Headache

If you are currently suffering from migraine headache pains, but have not yet received treatment, it is vital to identify what may be causing your symptoms.

Some headaches are minor and easily solved with a glass of water, while some more serious head pains require a doctor’s visit.

While CBD is not a cure for any disease, it has been shown to help with symptoms you may be experiencing. If you want relief and think CBD may be a solution for you, be sure to check out Mana Artisan Botanics™

Medical Treatment

Pharmacological treatment is considered to be one of the most popular methods of treating chronic headaches. There are two categories of medication for chronic headache. There are abortive and preventive drugs on the market, which you may find helpful for your specific condition.

Abortive medications stop headache progression, while preventive drugs prevent them before they happen. Examples of abortive are NSAIDs and acetaminophen.

Preventive drugs would be antihypertensive, antihistamines, sedatives and anticonvulsants, etc. Headache medications are prevalent because, apart from the fact that doctors recommend it, many studies have proven them as effective treatment options.

Alternative Treatment

Biofeedback is an alternative method that can help you with your headache. It uses some instruments to make your body more conscious of its condition, and through this, you can knowingly overcome it.

A simple example would be to take your temperature when you have a fever. Since you now know that your body temperature is high, you also know that you have to correct it, which leads to taking actions known to lower your body temperature.

If stress is a leading cause of your pain, simply removing yourself from the stressful situation can provide immediate relief.

Medical Marijuana is another alternative which is available in some states as a legal option for your migraines. Be sure to review the laws in your state before you search for medical marijuana. As of right now, even CBD oil derived from a marijuana plant is illegal according to the FDA.

The marijuana plant (THC-heavy cannabis) contains many of the same cannabinoids as hemp (CBD-heavy cannabis), and offers many similar effects of CBD.

It does, however interact with the body’s endocannabinoid receptors in a different way, which inhibits the firing of specific neurotransmitters. Click to learn more about the endocannabinoid system.

How to take CBD Oil for Headaches and Pain

CBD oil can be used to relieve your symptoms:

  • as an ingredient in food or drink
  • in the form of a capsule
  • inhalation or vaping, but there are specific lung risks and toxicity risks
  • In a topical application for your skin.
  • In caps or sprays used in your mouth.

Studies on the effects of CBD oil for Headache treatment are limited, and like many new treatments, there is no standard dose or recommended treatment method for everyone.

Tension Headache

There may be mild to moderate general pain that may feel like a rope tightening around your head. This type of headache can be mild to severe and last for long durations.

Migraine Headache

It is often severe pain in one part of the head, often in front or on the side. You may experience nausea, vomiting, and sensitivity to light or noise.

Which CBD is best for Migraines?

Fortunately, the way CBD works, you can consume it in many different ways. Some users find that vaping CBD causes head pain due how quickly they feel the effects.

Cluster Headache

They can cause severe pain, often around your eye. Symptoms may extend over 1 to 2 months.

How Can CBD Treat The Causes Of Tension Headaches?

CBD has been shown to interact with cells in the brain and the nervous system. These molecules are called cannabinoid receptors (CB1 and CB2).

Although the relationship between these cells and receptors is not fully understood, their interaction is believed to affect the immune system.

For example, CBD can prevent the source of a trusted body in the metabolism of anandamide. This is a compound associated with the body’s regulation of headaches. Maintaining high levels of anandamide in the blood can reduce the pain associated with your headache.

Studies show that CBD oil limits inflammation within the body, which can reduce pain and keep other immune system reactions in check.

Since CBD may also decrease anxiety and stress in patients, mild to moderate headaches caused by stress may be treated before they appear. The effects of CBD for you may differ.

Can too much CBD Oil cause headaches?

Yes. CBD may cause head pain in some individuals. Although it is used to treat headache and migraine symptoms, as anecdotal evidence from thousands of users confirms, your headache may be a side effect of taking CBD.

Why do I get a Headache After Taking CBD Oil?

CBD Oil headaches can be avoided by seeking high quality CBD products. Before you make a CBD purchase, ensure you are dealing with a reputable company with a high standard. A couple reasons why you may experience a CBD headache are:

  1. You purchased a lower quality CBD oil product – If the product contains solvents like ethanol or isopropanol, a by-product of alcohol extraction methods. CO2 is a much better extraction method and is a crucial characteristic of higher quality CBD.
  2. You took too much too quickly – Our bodies are not infallible. When we shock the system, our bodies may react in unexpected ways. Most providers recommend starting with small doses and slowly increasing them until you reach your desired result.

What’s the CBD Dosage for Tension Headaches?

Based on widespread anecdotal evidence only, the standard CBD dosage recommendation may depend on your body weight. Start with 1 to 6 mg for every 10 pounds of body weight.

We’ve built a calculator for you so that you can find the lowest starting dose for your body weight below:

The above dosage recommendation is general and merely a suggestion. Your case may differ in that you may need a lot more, while others may need a lot less. Please consult with your physician before supplementing your treatment with CBD.

FINAL THOUGHTS

More published studies are is needed before CBD oil is considered a widely distributed option for treating your headache, but it is worth discussing with your doctor if you are interested as it may provide better relief for your symptoms and overall health.

If you want to know more about CBD and how it can be used to treat other conditions, study the other resources on our website.

If you decide to try CBD oil, treat it as you would with any other headache option treatment. It may take some time to work, and you may need to adjust the dose to best suit your needs.

Remember that the FDA still has not completely legalized CBD in all forms. Before you take any CBD product, be sure you review all the information you can about its contents to make sure you stay right with the law.

Best CBD Oil for Migraines

If you have tried just about every standard over-the-counter painkiller for migraines without much effect, you might want to consider using cannabidiol (CBD) oil for relief. Below are some of the best CBD oil products that we recommend to relieve your headaches and the pain associated with migraines.

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Best CBD Oil for Migraines

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Natural remedy for various illnesses. NuLeaf Naturals’ CBD oil is a whole-plant extract containing a full spectrum of naturally occurring synergistic cannabinoids and terpenes.

3. Spruce 2400mg Lab Grade CBD Oil
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The largest bottle of CBD oil that Spruce offers contains 2,400mg of CBD. This is full-spectrum CBD oil, which is the maximum possible potency. Each high potency dropper full contains 80mg of CBD. There are no flavorings in it, which allows for the most CBD to fit in the 30ml bottle.

4. Avida Full Spectrum CBD Oil Tincture 500mg
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Avida Extracts Full Spectrum CBD oil is the latest iteration of the brand’s advanced Avida CORE Spectrum technology. They use a proprietary full spectrum blend, resulting in the highest naturally occurring Phyto-cannabinoids and Terpenes with THC (<0.3) to support your health.

5. cbdMD CBD Oil Tincture Natural 1500mg
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cbdMD’s CBD oil tinctures are made using only CBD sourced from medical hemp and MCT oil as a carrier oil. Tinctures are offered in orange, mint, natural, and berry flavors. Safe for daily use, the oil tinctures are packaged with a built-in rubber dropper to adjust CBD dosage easily. The packaging is made to be easy to transport and discreet to use.

6. CBDistillery THC Free CBD Oil Tinctures
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CBDistillery’s Isolate CBD Oil Tinctures harness the power of pure CBD. CBD Isolate Oil Tinctures include 0.0% THC. When you use CBDistillery CBD Isolate Oil Tinctures, you can be assured you’re using the highest quality CBD on the market.

7. NuLeaf Naturals 300mg Full Spectrum Hemp CBD Oil
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This is one of several concentrations from NuLeaf Naturals. As the lowest concentration, it is the company’s best option for those new to CBD oil. The product is lab-tested and fully organic. It is full-spectrum, so it contains THC in small quantities.

8. cbdMD CBD Oil Tincture Natural 750mg
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A 750mg bottle of cbdMD’s Broad Spectrum Oil Tincture does not contain THC. It also has a fairly wide flavor range which is perfect for those who prefer other taste. Vegan consumers are considered since cbdMD offers Vegan products. Aside from all of that, another reason why people love cbdMD is because it’s free from harmful chemicals.

9. Hemp Bombs 750mg CBD Oil
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Hemp Bombs offer CBD Oil Tinctures that come in a 30ml bottle containing 750mg of CBD. They provide a wide range of flavors perfect for those that have a knack for sweets. Consumers can safely intake this because it’s free of chemicals and pesticides. Hemp Bombs also offer a 20% off on products upon subscription.

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How CBD Works for Migraines

CBD interacts with the human body’s endocannabinoid system (ECS) to help regulate pain sensation s . The ECS maintains the body’s equilibrium and keeps balance in several bodily functions , such as mood, appetite, metabolism, anxiety, memory, sleep, and immune response.

A 2018 study noted that migraine and several mental state disruptions are connected to disturbances to the functionality or supply of endocannabinoids (1) . A separate study reported that cannabinoids , such as CBD and THC (tetrahydrocannabinol) , may help reduce neuropathic, acute, and chronic pain (2) . Cannabinoids are compounds that occur naturally in Cannabis sativa plants.

The ECS contains cannabinoid receptors located in different parts of the body, mainly distributed throughout general pain sensation pathways (3) . These pain pathways are mostly found in the peripheral nervous system (PNS) and the central nervous system (CNS).

CBD and other cannabinoids, both natural and synthetic, bind to the endocannabinoid receptors, which affects the body’s functionality.

CB1 and CB2 are the primary types of cannabinoid receptors associated with the ECS.

CB1 receptors are associated with cognitive functions (4) . These include movement, emotion, mood, thinking, memories, pain, and appetite. Meanwhile, CB2 receptors are associated with pain and inflammation (5) .

Although cannabinoid receptors are found throughout the body, certain types tend to be concentrated in one area more than others. For instance, CB1 receptors are abundant in the brain, making them a potential target for treating migraines (6) .

Meanwhile, CB2 receptors are prevalent in the immune system (7) . These receptors have potential anti-inflammatory properties and represent an alternative response to migraine (8) .

CB1 and CB2 receptors also interact with anandamide, a naturally occurring cannabinoid in the body (9) . In 2011, researchers collected data from an animal model and examined the effects of anandamide on migraine . The authors’ study is published in the Journal of Headache and Pain (10) .

Upon combining their data with related literature, the researchers hypothesized that a dysfunction in the endocannabinoid system potentially contributes to the development of migraine attacks.

The same study suggested that the pharmacological modulation of CB1 and CB2 receptors may be useful in treating chronic migraine pain.

Meanwhile, a 2017 study presented evidence that migraine sufferers have anandamide deficiency (11) . The study’s researchers noted that migraine is not associated with a generalized anandamide deficiency. Instead, they attributed migraine to a localized deficiency.

How CBD Works for Tension Headaches and Cluster Headaches

In chronic tension headaches and cluster headaches, existing research focuses on assessing massage therapy effects in alleviating pain from these conditions. Tension headaches occur when the scalp and neck muscles contract and become tense. Meanwhile, cluster headaches are one-sided head pains that occur in cyclical patterns or “cluster periods.”

In a 2002 study with human subjects, researchers provided structured massage therapy treatment to patients (12) . Massage therapy targeted the patients’ neck and shoulder muscles.

Although the results did not yield any positive effect s on headache intensity, researchers noted that the duration of headaches decreased during massage periods.

As such, the researchers stated that muscle-specific massage therapy might help reduce chronic tension headaches.

CBD products come in transdermal options, which you can apply directly to your skin . When applied topically, they may have some potential benefits in relieving pain and inflammation.

There is no substantial evidence to support CBD oil’s benefits in treating tension headaches. However, coupling CBD oil products with massage therapy may increase the migraine relief offered by both treatment options compared to when used separately.

Benefits of Using CBD for Migraines

Several studies have backed CBD’s purported benefits in relieving migraine symptoms, including headaches, vomiting, nausea, inflammation, and general pain. Moreover , the World Health Organization (WHO) showed approval for CBD, saying that it is “generally well-tolerated with a good safety profile (13) .”

Patients considering taking CBD to treat their migraines may rest assured that the substance is not habit-forming. During a 2015 conference, Nora Volkow, MD , the director of the National Institute on Drug Abuse (NIDA), stated that CBD does not produce euphoria, intoxication, or addiction, unlike opioid medication (14) .

CBD has shown promise in relieving pain associated with migraines. According to Dr. Stephen Silberstein of the American Migraine Foundation and director of the Headache Center at Jefferson University Hospital in Philadelphia, CBD topicals are a viable option for patients who experience joint and muscle pain linked to migraines (15) .

Dr. Silberstein stated that taking CBD oil is reasonable among patients who experience a lot of neck pain or soreness. He also said that CBD oil may prevent vomiting and nausea. Some studies support Dr. Silberstein’s claims about CBD’s antiemetic properties.

In 2019 , a study in the British Journal of Pharmacology cited significant evidence that manipulating the endocannabinoid system regulates vomiting and nausea among humans and animals capable of vomiting in response to a toxic challenge (16) .

According to the study, preclinical research indicated that CBD and other cannabinoids are potentially useful in treating both vomiting and nausea caused by treatments, such as chemotherapy.

Meanwhile, a 2013 review in the European Journal of Pharmacology discusses the potential of utilizing cannabinoids in the regulation and treatment of debilitating conditions, specifically vomiting and nausea (17) .

The National Headache Foundation has also estimated that nearly 40 million people, or 12% of the United States population, are experiencing migraines (18) .

The organization further explains that the pain from migraine headaches results from signals interacting with blood vessels and the nerves surrounding the brain. Blood vessel nerves are activated when you experience a headache. This occurrence also results in the nerves sending pain signals to the brain.

The pain results from the swelling of blood vessels surrounding the nerve endings. This occurrence happens when overactive nerve cells send impulses to the blood vessels, causing the release of substances, including serotonin and prostaglandins.

Serotonin is a body chemical required by nerve cells and the brain to function, while prostaglandins are lipids that regulate blood flow and inflammation.

In 2005, researchers studied migraine as an inflammatory disorder (19) . CBD allegedly possesses anti-inflammatory properties, which can help with migraines related to inflammation.

The 2005 study published in the Neurology journal of the American Academy of Neurology explained that migraine is not usually associated with heat, redness, and swelling. As such, migraines are not traditionally classified as an inflammatory disease.

Years after , a 2017 study published in the Physiological Reviews journal of the American Physiological Society showed that intense sensory nerve stimulation might be partially responsible for the pain from migraine headaches. Inflammatory agents during a migraine attack cause this stimulation (20) .

Some studies support the purported anti-inflammatory properties of CBD. In particular, a 2018 study published in the Journal of Pharmacology and Experimental Therapeutics highlighted CBD’s potent anti-inflammatory properties (21) .

Meanwhile, a 2012 study noted how CBD inhibit ed neuropathic and inflammatory pain by targeting glycine receptors (22) . Glycine is an inhibitory neurotransmitter involved in the processing of motor and sensory information that allows movement, vision, and audition.

The study’s findings suggest that glycine assists cannabinoids in the suppression of chronic pain.

Although studies have documented CBD’s potential as an analgesic, CBD requires more longitudinal analysis to substantiate its purported benefits as a pain reliever against migraines.

Risks of Using CBD for Migraines

CBD oil companies marketing their products as dietary supplements or medicine for any condition is prohibited , according to the United States Food and Drug Administration (FDA) (23) . The FDA is responsible for ensuring the safety, efficacy, and security of drugs for human and animal patients to protect public health (24) .

There is a lack of evidence on CBD as a viable treatment for migraines or other debilitating conditions, aside from the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome in children over the age of one .

The FDA has approved Epidiolex as a CBD treatment for children who experience seizures caused by rare and severe forms of epilepsy only . Epidiolex is the first FDA-approved narcotic that contains a pure, marijuana-derived drug substance (25) .

In terms of migraine treatment, researchers in 2017 conducted a review of related literature and noted a potentially useful role for medical cannabis in treating migraine. Unlike CBD products, medical cannabis may exceed the federally legal amount of 0.3% THC on a dry weight basis.

The review of studies is published in the Cannabis and Cannabinoid Research journal (26) .

Despite the collection of studies centering on the potential of medical cannabis in treating migraines, there is a lack of structured experiments on using CBD oil specifically for migraines.

In addition to the lack of CBD-specific research, migraine patients have different responses to existing modes of treatment (27) . The complex nature of migraines challenges researchers to define the exact criteria for future clinical assessments.

Although CBD has a good safety profile according to the WHO, CBD usage has shown potential side effects. Some of which include dry mouth, liver damage, changes in alertness, loss of appetite, gastrointestinal problems, mood swings, drowsiness, diarrhea, and fatigue (28) .

A 2017 research noted CBD’s potential to interact with other drugs that people with migraines may already be taking. Potential interactions with prescription medications may alter the body’s capacity to metabolize certain medications (29) .

Before turning to CBD to treat your migraine, you should also beware of getting scammed by unreliable CBD brands. Unlike some of the best CBD oil for migraines we have listed here, a 2017 review exposed inaccurate labeling in some CBD products.

Upon conducting laboratory analyses, the researchers noted that some product labels listed CBD contents that exceeded the actual amounts (30) .

Other risks include the presence of pesticides or other harmful substances. This finding highlights the need for CBD brands to be transparent with their CBD products’ third-party lab tests, including the item’s manufacturing processes to prove that it is pesticide – or GMO-free.

With these precautions, you can rest assured that you are investing in quality products.

How Soon Can CBD’s Effects in Migraines Be Felt?

Individuals with migraine may turn to CBD oil as a natural alternative to the over-the-counter (OTC) drugs they take to relieve headaches . However, currently, there is no substantial evidence of CBD as a migraine treatment.

Paracetamol, ibuprofen, and aspirin are common OTC painkillers and pharmaceuticals that reduce migraine symptoms. Meanwhile, you may seek a doctor’s recommendation to use triptans, which were developed specifically to treat acute migraine headaches (31) .

Paracetamol may need up to an hour upon ingestion to take effect (32) . Meanwhile, the time it takes for CBD to take effect may depend on the application method of your preferred CBD product format . There are multiple ways to use CBD oil for migraines.

CBD oil products may come in tincture (dropper) form, which patients can take sublingually . This method involves applying CBD oil under the tongue and waiting for about 90 seconds before swallowing the product.

The body absorbs CBD through the mucous membranes, so CBD avoids passing through the liver (33) .

Sublingual administration of CBD oil may take between 30 minutes to an hour before the user feels its effects. Once CBD takes effect after 60 minutes, you may continue to feel the results up to four to six hours after administration.

A 2010 study showed that peak blood levels, or the highest concentration of drugs in your bloodstream , of most substances taken sublingually are achieved within 10 to 15 minutes. Additionally, the sublingual application allows the body to absorb a more significant percentage of the dose compared to oral ingestion (34) .

Other ingestible forms of CBD include edibles, gummies, pills, and capsules. CBD food and drink products also come in different flavors, which people might prefer over the natural, earthy flavor of pure CBD oil.

A study noted that CBD remained in effect three to four hours after CBD was taken in capsule form (35) .

In 2018, authors of a study published in the Frontiers in Pharmacology journal suggested that consuming CBD orally after meals allow s for more efficient absorption of the compound (36) . They hypothesized that CBD’s highly lipophilic nature (state of being soluble in fats or lipids) enable s it to be easily dissolved in food’s fat content.

While such methods may be convenient for migraine patients turning to CBD for the first time, ingestible formats may take longer for patients to feel the purported pain relief effects of CBD as the body must digest the compound first.

CBD oil products also come in vape form, which you can inhale to avoid having the product go through the digestive system. Vaping may be the fastest method to get CBD into the body as the product enters the bloodstream through the lungs.

However, individuals who are considering vape for the first time must consult with a medical practitioner first . Vaping poses possible health issues, including chemical irritation or allergic reactions to various substances in the inhaled products (37) .

Meanwhile, topical CBD exists in the forms of lotions, salves, creams, transdermal patches, or massage oil. Topical administration of CBD is ideal for the effective treatment of inflammation in a specific body area. You can apply topicals directly to your painful body parts during a migraine attack.

Transdermal CBD with proper formulation may work instantly upon application, relieving patients of their pain within 15 minutes (38) . CBD topicals target localized cannabinoid clusters through the skin, meaning it does not have to interact with the ECS as a whole .

A 2016 study using a rat model noted the positive effects of CBD’s transdermal application in reducing inflammation and pain-related behaviors of arthritis (39) .

Some CBD brands may claim that their CBD products’ effects last up to 12 hours, which is questionable because of the current lack of longitudinal clinical trials to support CBD’s effects .

What Is the Dosage for Migraines?

Currently, there is no official recommended CBD dosing for migraines, high blood pressure, or any medical condition. Doctors with experience in cannabis use may offer medical advice and recommend that patients start with low doses to get the body acclimated to the substance slowly.

Users may then gradually increase their dosage until they experience the desired results. Still, determining the appropriate amount of CBD to take for migraines might be a trial-and-error process.

Other factors affecting CBD dosage may include the frequency of migraine attacks, the severity of migraine symptoms, age, and body chemistry. The CBD format may also affect the dosage.

For example, gummies or capsules may be easier to ingest as CBD comes in pre-measured doses . In contrast, CBD oil tinctures usually come with a dropper, which people can use to adjust the amount they intend to take.

Patients who live in a state where CBD products are legally available as OTC drugs in licensed dispensaries may look at the instructions listed on a CBD product’s label.

CBD manufacturers and brands are likely to have guidelines for doses printed on the product label, the accompanying paperwork, or the brand’s website.

Legality of CBD

Only 47 out of the 50 states in the USA (United States of America) have allowed the federally legal use of CBD with varying degrees of regulation per state (40) . Per federal laws, people may travel through the states with CBD, granted that the state they are coming from and traveling to have placed similar policies on CBD usage.

CBD’s legality in the US is typically associated with the Agriculture Improvement Act of 2018 or the 2018 Farm Bill (41) . This law declassified hemp plants as marijuana plants, thus removing them from the Schedule I category of the 1970 Federal Controlled Substances Act (42) .

Before the 2018 Farm Bill’s passage, both hemp and marijuana plants belonged under the Schedule I drugs category, which consist s of potentially addictive or abusive substances without any accepted health benefits.

The 2018 Farm Bill redefined hemp plants as cannabis plant varieties that contain less than 0.3% THC on a dry weight basis, while marijuana plants contain more THC than the established limit. CBD and THC may come from cannabis plant species, like Cannabis sativa .

Apart from the redefinition of hemp-based on its THC content, the 2018 Farm Bill granted the FDA permission to regulate CBD’s circulation on the market (43) . The agency reserves the right to penalize CBD companies that make unproven claims about the health benefits of CBD products.

CBD and THC are the most abundant cannabinoids in cannabis plants, meaning both compounds are present in both hemp and marijuana. The difference in THC concentrations implies that CBD oil from hemp does not have psychoactive effects.

THC’s psychoactive properties make people experience euphoria or get them high. Thus, this phenomenon plays a significant role in the legality of CBD products.

CBD oil within the legal limit of 0.3% THC does not produce a high in users and allows them to get the purported benefits of cannabis plants.

Since marijuana contains more than 0.3% THC, it remains in the Schedule I category of drugs with a high potential for abuse (44) . For this reason, CBD oil derived from marijuana plants is federally illegal in the US.

Only qualified patients with certifications from licensed healthcare providers may purchase CBD oil that exceeds the federal THC limit. These patients may apply for a medical marijuana card, which has varying qualifications depending on the state of their residence.

Despite federal laws, US states have their local laws on CBD and marijuana use.

While the 2018 Farm Bill removed legal restrictions on owning hemp-derived CBD products, local laws may supersede federal regulation s since the state is the primary enforcement authority for drug-related offenses (45) .

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