CBD for Back Pain


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By Dr. Frank Michalski

Chronic back pain is an epidemic in our country. According to the Chiropractic Association, more than 31 million people are suffering with chronic back pain today. It’s a reality I see everyday in my chiropractic practice located in Buffalo, New York. In fact, that is why 80% of my patients come to see me.


  • Chronic pain is defined as having pain for 3 months out the year or more. 80% of back pain is chronic.
  • 100 million people annually experience back pain, that’s over 80% of adults at one point in life.
  • Most chronic back pain is due to arthritis. The other 50% is neuropathic, resulting in nerve pain.
  • Back pain is the #1 cause of work-related disability in the US, mostly attributed to arthritis related back pain.
  • Back pain cost in the US have risen from $80 to $240 billion a year.
  • The average medical cost of back pain for an individual is estimated to be $2,580 more than someone without back pain.

The importance of proper diagnosis:

As a chiropractor physician, it is important for me to first understand the root cause of the individual’s pain. This can help determine my recommendations.  I consider if the patient suffers from an autoimmune source of pain such as Lyme disease, MS, RA, fibromyalgia. Does the patient suffer from soft tissue injury such as disc herniation, facet arthritis, sprain/ strain? In many cases, an oral oil may be necessary in conjunction with one of our CBD BioCare pain creams or the roll on.

Types of Pain:

  • Acute pain: occurs locally at the source of injury. This will result in localized swelling and inflammation. This is common after “rolling your ankle” or other accident related injury. For acute injuries the 500 mg pain cream works best! Our roll on is also a great product for acute injuries. Your skin has an abundance of CB2 receptors, perhaps more than anywhere on the body. CBD oil works by binding to these receptors and decreases pain locally. This means you are not just covering up the pain, but rather you are addressing the inflammation, unlike a bio-freeze style product. Personally, I find knee pain, elbow pain, ankle pain, and thumb/ hand pain respond excellent when the source of pain is arthritis. The 500mg cream seems to work instantly.
  • Chronic/ neuropathic pain: Remember 50% of back pain involves the nerves and 80% of it is chronic. People who experience chronic nerve pain have a heightened sensitivity to pain. Something that appears harmless (such as a light pat on the shoulder) may cause these people tons of pain. Why is that? The spine and nerves send pain signals to the brain. People with chronic pain or nerve/ neuropathic pain are stuck in overdrive. Their brain is receiving constant pain signals. Oral CBD oil may be a benefit for these individuals.

 Oral CBD oil works in three ways to reduce pain especially when its chronic:

  •  CBD oil when taken orally reduces the “pain signals/messengers” from the spine to the brain, this will decrease pain perception, similar to opioids without the side effects.

  • Even better CBD stimulates serotonin, one of our feel-good hormones. Anti-depressants are often prescribed to help with chronic pain to stimulate serotonin.

  • Research is showing that people with fibromyalgia have lower levels of endocannabinoids, which may result in widespread chronic pain. CBD oil helps to restore the body’s natural cannabinoid levels.

Most chronic pain patients will suffer from the following:

  •  Depression
  • Anxiety
  • Insomnia
  • Pain
  • Headache
  • Addiction

It is important to note that CBD oil may impact one or all of the above symptoms/ conditions. Perhaps a person may not experience pain relief, but their anxiety and insomnia lessen. Also keep in mind at a low dose CBD oil will not work, at too high of a dosage it may have the opposite effects. I encourage patients to keep journals and track their dosage closely. This is the best way to find the “sweet spot”.


I recommend using one of the CBD pain balms or roll on to use topically at the source of pain. This way the person can experience immediate relief. I also recommend taking our full spectrum CBD oil sublingually. It can be taken once or several times a day as needed.

More is not always better. We encourage patients to begin with 10-20mgs 1-3x a day. Most patients respond between 40-200mg’s daily. More is not always better. We encourage patients to watch the dosing video. If the patient is on medication or opioids it is best, they work with their physician.

Please note: CBD oil can increase the amount of medication present in the blood…. this can be dangerous in some cases, primarily with high doses. This is particularly important with blood thinners, oncology medication, and medication that requires regular blood work are consumed.

When should I use THC?

 At times people may find they need additional pain relief. That is when they want to seek a medical cannabis clinic. THC can have very positive effects on pain relief, mostly due to its direct interaction with CB receptors in the brain.

In our offices we encourage patients to begin with CBD and no THC. THC can have some very unwanted side effects, especially for those suffering from depression and anxiety. Normally if the client is prescribed THC it is in a ratio of 4:1 or 1:1 (CBD:THC). CBD will dull the psychoactive effects of THC, for many who do not want a high, this is great news. CBD does not appear to decrease the levels of THC circulating in the blood, which is great news when people need THC to remain active but do not want a high.

Additional Treatments:

For many, CBD can be a “second chance” or a new light in what can appear to be a never-ending sea of pain and negativity. Sadly, many people with back pain are ignored or discredited in medical settings. We want to do our best to make sure that “second chance” is a success! But there are other natural remedies in addition to CBD. If you are not familiar with the following for back pain, please take some time to check out these alternative treatments.

  •  Low level laser therapy (even better for knee arthritis)
  • Cox Flexion Distraction Decompression (A miracle when it comes to treating low back pain, disc herniation, sciatica, stenosis and SI joint dysfunction, numbness and tingling in the legs, other back conditions). Find a provider near you!
  • Garston or IASTM
  • Cryotherapy
  • RockTape therapy
  • Chiropractic
  • Physical Therapy (McKenzie method)
  • Acupuncture
  • Pilates
  • Hot Yoga (rehab style)
  • Cupping
  • Massage
  • Weight Training (a personal favorite for all ages)
  • Anti-inflammatory nutrition (eating better never killed anyone).

CBD oil is a great product for many people. Not telling them about it is a disservice. But it is important to take a good product like CBD BioCare that is 3rd party tested.  I look forward to providing CBD BioCare customers with new and exciting information. If you have topics you would like to learn more about, please let us know.

In Good Health,

Frank Michalski DC