Cannabidiol (CBD) oil may relieve pain and reduce inflammation. Some research suggests that CBD may help treat migraine headaches.

A growing body of research suggests that CBD may help relieve pain, particularly neurological pain, linked with various conditions.

Specifically, CBD oil has promise as a treatment for migraine, as the American Migraine Foundation report. While they acknowledge that no scientific evidence proves that CBD is an effective treatment, they point out that this may be due to a general lack of formal research into CBD.

The foundation conclude that CBD “may still be a viable topical option for some patients with joint and muscle pain associated with migraine.”

Still, due to the lack of evidence that CBD is a safe or effective migraine treatment, the Food and Drug Administration (FDA) have not approved it for this use or as a way to relieve any pain.

Below, we explore how CBD might benefit people with migraine and look into its effectiveness, safety, and legality.

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CBD is one of more than 100 cannabinoids present in the cannabis plant. It is different from tetrahydrocannabinol (THC), which is the compound in cannabis that produces a high.

There is no evidence that CBD produces a high. It does have other effects in the body, which might include relieving pain and reducing inflammation.

CBD may ease pain because it affects specific receptors in the brain. These receptors are part of the wider endocannabinoid system, which plays a role in pain and inflammation throughout the body.

Research has linked medical cannabis with the following effects, which are relevant to migraine treatment:

  • pain relief
  • easing nausea
  • reducing inflammation
  • anticonvulsive effects

However, there has been very limited research into the safety and effectiveness of cannabis, or CBD specifically, for migraine — partly due to legal restrictions on research involving the cannabis plant.

In a 2017 review of studies, researchers noted that cannabis might help treat migraine.

Still, CBD oil may have different effects, and no research has shown that the oil can help treat migraine. Overall, more studies are necessary.

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According to the National Centers for Complementary and Integrative Health, some evidence suggests that cannabis — and specifically CBD — could have modest benefits for chronic pain.

Likewise, a 2020 review has found that CBD can help relieve chronic pain, improve sleep, and reduce inflammation in some circumstances.

The results of a 2016 study indicate that medical cannabis may reduce the frequency of migraine headaches. The study did not investigate CBD specifically, however.

A 2018 review of the relevant research also reports that cannabis seems promising as a method of relieving pain, including pain from migraine.

A 2017 review concluded that there is enough anecdotal evidence and preliminary findings to warrant further research and high-quality clinical trials.

The bottom line is that more research is necessary. If CBD proves effective, researchers will then need to find the most effective dosages and formulations.

Meanwhile, researchers have explored whether cannabis compounds may treat chronic pain in people who have been taking opioids for long periods and want to reduce their use.

Authors of a 2009 study found evidence to support this, but a 2018 study found no link between the use of cannabis and reductions in pain or opioid use. However, the results of the latter study were based on participant-reported cannabis use, and most of this was not legal use.

Hemp and hemp-derived products with THC contents of less than 0.3% are legal under the 2018 Farm Bill.

However, the legal status of CBD and other cannabinoids varies by state. If a person in the United States is thinking of trying CBD, they can check their local laws here.

In June 2018, the FDA approved a purified CBD oil, which contains no THC, to treat two rare, severe types of epilepsy. The oil is only available with a prescription.

Over-the-counter CBD products do not have FDA approval. As a result, there is no way to ensure that they are safe or contain what the packaging advertises. If possible, speak with a doctor before using CBD.

A person can use CBD oil:

  • as an ingredient in foods and drinks
  • in capsule form
  • in oral drops or sprays
  • by inhaling or vaping it, though either can be dangerous

Meanwhile, researchers are investigating the potential benefits and legal and ethical implications of CBD in other forms, such as those that can be administered rectally, in the eye, or via the skin.

Because no definitive studies have investigated the effects of CBD oil on migraine in humans, there is no standard dosage or method of using the oil.

However, a doctor in an area where CBD oil is legal may be able to recommend a safe, low dosage to start with. Overall, it is best to start with a very low dosage and see whether it helps.

The FDA do not regulate over-the-counter CBD products like they regulate medications. These products may be mislabeled or misrepresent their contents. For this reason, it is important to research and find a quality product.

When it comes to CBD, one of the most significant risks concerns the lack of regulation.

The FDA have not approved any cannabis products, including CBD products, as migraine treatments.

In the U.S. there is no regulation over the potency or marketing of over-the-counter CBD oil. As a result, some CBD products have incorrect information on their labels. They may contain more or less CBD than advertised, and some contain significant amounts of the inhibiting psychoactive substance THC.

A healthcare provider is likely to recommend proven treatments and other approaches to care for someone with migraine.

Identifying and avoiding triggers can reduce the frequency of migraine episodes. This involves different things for different people, but it may look like:

  • practicing stress management techniques
  • avoiding bright lights
  • avoiding caffeine, alcohol, and other dietary migraine triggers
  • finding ways to get regular high-quality sleep

Also, while no one treatment plan works for everyone, various medications can reduce the frequency of migraine episodes and the intensity once they start.

Some approved migraine treatments include:

  • over-the-counter pain relief medications, such as acetaminophen
  • nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen or aspirin
  • prescription medications for migraine pain, such as triptans, ergots, and nerve blocks at the occipital region of the brain
  • drugs that help prevent migraine episodes, including beta-blockers, antidepressants, and anti-seizure medications
  • Botox treatments

Many people try a few treatments before finding one that works. A person may benefit most from a combination of approaches.

Working closely with a healthcare provider and keeping track of the frequency and intensity of episodes can help determine the best treatment.

Find tips for instant migraine relief here.

Anyone with migraine should speak with a doctor, who can make specific recommendations about the right approach to treatment.

It is particularly important to consult a doctor before trying CBD oil or any other natural remedies — some, including CBD, can have dangerous interactions.

Is CBD legal?The 2018 Farm Bill removed hemp from the legal definition of marijuana in the Controlled Substances Act. This made some hemp-derived CBD products with less than 0.3% THC federally legal. However, CBD products containing more than 0.3% THC still fall under the legal definition of marijuana, making them federally illegal but legal under some state laws. Be sure to check state laws, especially when traveling. Also, keep in mind that the FDA has not approved nonprescription CBD products, and some products may be inaccurately labeled.

Q:

Various websites recommend different kinds of cannabis to treat headaches. What would you recommend?

A:

There has been some research into cannabis and migraine, but not enough to specifically recommend a potency, dosage, or frequency.

Someone with chronic migraine who wants to reduce reliance on medication might look into cannabis products, such as CBD oil.

But because there have been no specific studies, these recommendations found on websites are not based on science. These statements might reflect the experience of only one person, or someone might have created them from no evidence, as a marketing ploy.

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHTAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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