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CBD for chronic pain

Placebo-controlled trials of CBD alone for pain, at doses from 20 mg to 600 mg, have almost all found it no better than placebo.

Facts checked 13 November 20266 min readHow we research
Trials show no benefit

Multiple placebo-controlled trials of CBD alone, at doses from 20 mg to 600 mg, found no pain relief beyond placebo.

How we grade evidence

Controlled trials have tested CBD on its own for pain, and it has not worked. Across doses from 20 mg to 600 mg, in back pain and arthritis pain, CBD did no better than placebo.

What the research shows

The individual trials

Trial Who CBD dose Result
CANBACK, Melbourne (Bebee 2021) 100 adults in an emergency department with acute low back pain Single 400 mg dose, on top of usual pain relief Pain at two hours was 6.2 with CBD and 5.8 with placebo. No difference in length of stay, oxycodone use or side effects1
Vela 2022 136 people with hand osteoarthritis or psoriatic arthritis (129 analysed) 20 to 30 mg a day for 12 weeks Difference in pain between groups was 0.23 mm on a 100 mm scale. 22% on CBD and 21% on placebo had a large reduction in pain2
Pramhas 2023 86 people with knee osteoarthritis 600 mg a day for 8 weeks, added to paracetamol Pain scores fell 2.5 points with CBD and 2.4 with placebo. More people on CBD had raised liver enzymes3

The back pain trial tested short-term (acute) pain. The two arthritis trials tested long-term pain. The authors of the knee trial wrote that their results “do not support the use of cannabidiol as an analgesic supplement” (an analgesic is a pain reliever).3 More detail on those two trials is on our arthritis page.

The review of all CBD pain trials

In 2024, four pain researchers reviewed every randomised controlled trial of pharmaceutical-grade CBD that measured pain. They found 16 trials. In 15 of the 16, CBD showed no benefit over placebo. The paper’s title sums up their view: “Cannabidiol (CBD) Products for Pain: Ineffective, Expensive, and With Potential Harms”.4

What about cannabis medicines that contain THC?

Much of what is said about “medicinal cannabis for pain” comes from products containing THC, the compound that causes a high. That evidence cannot be applied to CBD. It is also weaker than often claimed.

  • A Cochrane review of nerve (neuropathic) pain, updated and reported in January 2026, covered more than 20 trials and more than 2,100 adults. The products were mostly THC-containing. It found no high-quality evidence that cannabis products reduce nerve pain more than placebo.5
  • A 2023 Cochrane review of cancer pain covered 14 trials and 1,823 adults. Those trials tested nabiximols (a THC and CBD mouth spray) and THC-like medicines, not CBD alone.6
  • The International Association for the Study of Pain said in March 2021 that it does not endorse the general use of cannabis or cannabinoids for pain, because high-quality evidence is lacking. It added that this is not meant to dismiss the lived experience of people with pain.7

See CBD vs THC for why the two are kept apart.

Creams and balms

Absorption of CBD through the skin into the bloodstream is low.8 Two small randomised pilot studies of CBD cream or gel for muscle soreness after exercise found no meaningful effect.9 See CBD creams and topicals.

What doses were tested

The trials covered a wide range: 20 to 30 mg a day, a single 400 mg dose, and 600 mg a day.123 The Australian limit for pharmacist-only (Schedule 3) CBD is 150 mg a day,10 so trials have tested doses both well below and well above it.

This matters because a common response to a failed trial is that the dose was too low. For pain, the high-dose trial failed as well, and it produced more liver enzyme rises.3

What Australian medical bodies say

  • Faculty of Pain Medicine (ANZCA). The specialist body for pain doctors said in 2021 that the evidence for cannabinoids in chronic non-cancer pain “remains insufficient to justify endorsement of their clinical use”. Its advice to doctors is not to prescribe currently available cannabinoid products for chronic non-cancer pain unless as part of a registered clinical trial. That statement is listed as under review, and we found no revised version as of November 2026.11
  • TGA. The Therapeutic Goods Administration’s guidance urges caution for chronic non-cancer pain. For chronic nociceptive or musculoskeletal pain (pain from tissue, joints and muscles) it says there is no scientific data to support use.12
  • RACGP. The Royal Australian College of General Practitioners says there is some evidence for cannabinoids in general for nerve pain, but that the effect is small.13

More on these positions is on our page about what Australian medical bodies say.

Risks to know about

  • Liver, especially with paracetamol. In the knee osteoarthritis trial, people took 600 mg of CBD a day with 3 g of paracetamol. Raised liver enzymes were found in 15 people on CBD against 5 on placebo.3 See CBD and the liver.
  • Sedating pain medicines. CBD adds to the drowsiness caused by opioids, benzodiazepines and alcohol.14
  • Other interactions. CBD affects liver enzymes that process many medicines, and raised INR (a measure of blood clotting time) and bleeding have been reported in people taking warfarin with cannabinoids.15 See CBD drug interactions.
  • Products containing THC. Many cannabis products prescribed for pain contain THC. The TGA’s guidance says patients should be advised they are not able to drive while being treated with medicinal cannabis.12 See CBD and driving.
  • Cost. The 2024 review described CBD products for pain as expensive as well as ineffective.4 See how much CBD costs in Australia.

If you are considering it

  • Talk to your GP about a pain management plan. Ask which treatments have good evidence for your kind of pain.
  • If CBD is suggested to you, ask what trial evidence supports it for your condition and at what dose.
  • Questions worth asking: Does the product contain THC? How will it interact with my current pain medicines? Do I need liver blood tests? How will we judge whether it is working, and when would we stop?

See also talking to your GP about CBD.

Footnotes

  1. Bebee B, et al. The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Medical Journal of Australia, 2021. https://www.mja.com.au/journal/2021/cannabidiol-no-better-placebo-low-back-pain ↩ ↩2

  2. Vela J, et al. Cannabidiol treatment in hand osteoarthritis and psoriatic arthritis: a randomized, double-blind, placebo-controlled trial (conference abstract; published in Pain, 2022). https://acrabstracts.org/abstract/cannabidiol-treatment-in-hand-osteoarthritis-and-psoriatic-arthritis-a-randomized-double-blind-placebo-controlled-trial/ ↩ ↩2

  3. Pramhas S, et al. Oral cannabidiol as add-on to paracetamol for painful chronic osteoarthritis of the knee. The Lancet Regional Health Europe, 2023. https://doi.org/10.1016/j.lanepe.2023.100777 ↩ ↩2 ↩3 ↩4 ↩5

  4. Moore A, Straube S, Fisher E, Eccleston C. Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. The Journal of Pain, 2024. https://doi.org/10.1016/j.jpain.2023.10.009 ↩ ↩2

  5. ScienceDaily. Report of the 2026 Cochrane review update on cannabis-based medicines for chronic neuropathic pain. https://www.sciencedaily.com/releases/2026/01/260118233547.htm ↩

  6. Häuser W, et al. Cannabis-based medicines and medical cannabis for adults with cancer pain. Cochrane Database of Systematic Reviews, 2023. https://cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014915.pub2/information ↩

  7. International Association for the Study of Pain. Position statement on the use of cannabinoids to treat pain, 18 March 2021. https://www.iasp-pain.org/advocacy/iasp-statements/iasp-position-statement-on-the-use-of-cannabinoids-to-treat-pain ↩

  8. Review of topical and transdermal delivery of cannabidiol, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11172078/ ↩

  9. Randomised pilot study of topical cannabidiol and muscle soreness, 2024. https://pubmed.ncbi.nlm.nih.gov/38980809/ ↩

  10. Therapeutic Goods Administration. Final decision on down-scheduling of low-dose cannabidiol, 2020. https://tga.gov.au/node/284859 ↩

  11. Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists. Medicinal cannabis, including statement PS10(PM), 2021. https://www.anzca.edu.au/patient-information/about-pain-medicine/medicinal-cannabis ↩

  12. Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in Australia: overview. https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-australia-overview ↩ ↩2

  13. Royal Australian College of General Practitioners. Position statement: use of medicinal cannabis products in Australia (2019 update). https://www.racgp.org.au/advocacy/position-statements/view-all-position-statements/clinical-and-practice-management/medical-cannabis ↩

  14. US National Library of Medicine, DailyMed. Epidiolex (cannabidiol) oral solution prescribing information, revised 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec ↩

  15. Systematic review of drug interactions with cannabidiol and other cannabinoids, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11167383/ ↩

Common questions

Does CBD help chronic pain?

Controlled trials say no. A 2024 review found 16 randomised trials of pharmaceutical-grade CBD that measured pain, and 15 of them showed no benefit over placebo. People in the placebo groups often improved too, which helps explain why many users feel CBD works for them.

Does CBD oil help back pain or sciatica?

The one trial in back pain found no benefit. At a Melbourne emergency department, 100 people with acute low back pain received a single 400 mg dose of CBD or placebo on top of usual pain relief, and pain scores two hours later were no different. We found no controlled trial of CBD alone for sciatica.

Is medicinal cannabis with THC better for pain than CBD?

THC products are a different medicine with different risks, and the evidence for them is also limited. A Cochrane review update reported in 2026 found no high-quality evidence that cannabis-based medicines, mostly containing THC, reduce nerve pain more than placebo. The RACGP says there is some evidence for nerve pain but the effect is small.

Why do so many people say CBD helps their pain?

Pain responds strongly to expectation, and pain also rises and falls on its own. In trials, people given a dummy oil often report real improvement. A person's experience is genuine, but only a placebo-controlled trial can show whether CBD caused it.

This page is general information, not medical or legal advice. Laws and evidence change; we show the date we last checked the facts at the top of every page. Talk to your doctor or pharmacist before starting, stopping or changing any medicine.

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