More and more people are interested in using CBD to treat multiple sclerosis.
A survey from the MS Society UK found that 1 in 5 patients would consider using cannabis or cannabis-related products to help with their MS symptoms (1). This makes sense because the usual treatments can have serious side effects whereas cannabis and CBD are seen as safer alternatives (2).
Although early studies suggest that CBD could be helpful, more high-quality clinical research is needed. In this article, we’ll look at what the science tells us so far about using CBD to help with multiple sclerosis.
Table of Contents
What Does the Research Say?
Early studies suggest that CBD, THC, other cannabinoids, and whole-plant cannabis may have benefits for multiple sclerosis (MS).
However, most of the available research uses either whole-plant cannabis or Sativex, a 1:1 THC/CBD cannabis medicine, so it’s difficult to tell how much CBD contributes to the beneficial effects.
One of the most relevant studies looked at the effects of low-dose cannabis oil (CBD-rich, THC-rich, or 1:1) in 29 people with MS, finding that it reduced pain intensity, spasticity, and sleep problems while being safe and well-tolerated (3).
Spasticity is a common symptom experienced by patients suffering from multiple sclerosis, with one survey suggesting that about 84% of MS patients suffer from it (4).
One 2019 systematic review of 14 studies found that 42-83% of MS patients taking Sativex experienced a 20% reduction in spasticity scores. The medication was well-tolerated without any significant side effects (5).
Another 2012 clinical trial evaluated the efficacy of smoked cannabis for the management of muscle spasticity. Unlike placebo, cannabis was found to be effective in managing the symptoms (6).
Pain is another common debilitating MS symptom that CBD might help with. A 2016 study evaluated the impact of Sativex on pain management in MS patients, reporting a significant reduction in neuropathic pain (7).
Meanwhile, a 2012 trial with 303 patients with MS-related neuropathic pain reported that Sativex was superior to placebo in providing pain relief (8). A similar 2018 study of Sativex reported significant reductions in pain in 19 MS patients (9).
There is also evidence that cannabinoids may help with sleep; it’s estimated that half of patients with multiple sclerosis experience insomnia (10).
A 2007 review of Sativex for sleep found that it had noticeable benefits for patients with MS and other chronic pain conditions, with 40-50% of study participants achieving good or very good sleep quality (11).
Patients with multiple sclerosis frequently experience bladder dysfunction. Research shows that cannabinoids may be helpful here as well. One 2017 study in MS patients found that Sativex resulted in fewer “overactive bladder” symptoms (12).
In summary, cannabinoids like CBD and THC hold real potential in relieving MS symptoms. The most recent 2023 review which analyzed 25 clinical studies with 3763 participants concluded that: (13)
- Cannabinoids significantly reduce muscle spasticity
- Show some improvement in chronic pain
- Improve the patient’s impression of their health
But it also called for further research and reported that a large number of people discontinued treatment due to side effects and an increased risk of nervous and psychiatric disorders, likely from the THC.
How Does CBD Help With MS?
CBD is just one of the several bioactive compounds present in the cannabis plant. It might help manage the symptoms of multiple sclerosis through multiple mechanisms.
CBD and The Endocannabinoid System
The exact mechanism of action of CBD is not yet fully understood, but one way it might help is by interacting with the endocannabinoid system.
A complex signaling network that plays an important role in maintaining homeostasis (a state of healthy balance), the endocannabinoid system regulates key functions including sleep, appetite, emotion, metabolism, immunity, pain, cognition, and digestion (14).
It consists of endocannabinoids, cannabinoid molecules made by our bodies, which interact with CB1 and CB2 receptors, and enzymes that build and break down endocannabinoids.
Another way CBD works is by interacting with non-cannabinoid receptors such as TRPV1 and TRPV2. TRPV1 might have a role in the pain-signaling pathway. CBD inhibits the TRPV1 receptor which might help in pain relief (17).
How to Best Use CBD For MS?
CBD is commercially available in a variety of forms including oils, capsules, gummies, vapes, and topical products. Each form of CBD has its pros and cons.
Generally speaking, CBD oil is your best bet because it has high bioavailability (absorption), long-lasting effects, is easy to dose up or down, and is cost-effective.
You can also vape CBD if you want the fastest effects but vaping does come with certain health risks and also wears off faster than other methods — after about 1-4 hours (20).
Another option is gummies and capsules. However they have one key downside — because of first-pass metabolism in the digestive tract and liver, only a small amount (6-24%) of the CBD is absorbed and has a beneficial effect (21).
Finally, topical CBD products can be helpful for localized relief of MS spasticity or pain but are not ideal for body-wide symptoms.
Whatever option (or combination) you choose, we recommend going for full-spectrum CBD formulations because they may offer greater benefits from the synergy between their many beneficial components (the entourage effect) (22).
At present, there is no officially recommended dose of CBD for the treatment of multiple sclerosis. The right dose depends on individual factors such as body weight, gender, genetics, and the type of product you’re using, so a personalized approach is necessary.
It’s best to go with the “start low and go slow” approach — start with a small amount like 10 mg and gradually increase the dose until you feel the desired effects (23).
CBD is considered a generally safe substance. According to a 2020 systematic review, CBD was well-tolerated with mild side effects in most clinical trials (24). Some potential side effects associated with CBD include (25):
- Dry mouth
- Decrease in appetite
A 2021 safety study of low-dose cannabis oils in multiple sclerosis also found that they were generally safe and well-tolerated (3).
CBD may potentially interact with over-the-counter and prescription drugs, including those used for MS treatment (26).
Since patients with multiple sclerosis might be taking several prescription medications, there is a risk of drug interactions so it’s important to talk to your doctor before taking CBD.
Promising But More Research Needed
CBD and cannabis as a whole are receiving growing attention from both researchers and MS sufferers because current treatment options can be ineffective or cause significant side effects.
Although more research is needed — particularly on pure CBD and hemp-derived, full-spectrum extracts — current evidence suggests that cannabinoids may help with the symptoms of MS.
If you’re considering giving CBD a try, we recommend trying a high-quality full-spectrum CBD oil and gradually raising the dosage until you start to experience the desired relief.
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- Gustavsen, S., et al. “Safety and efficacy of low-dose medical cannabis oils in multiple sclerosis.” Multiple Sclerosis and Related Disorders 48 (2021): 102708.
- Fernández, Óscar, et al. “The broad concept of “Spasticity-Plus Syndrome” in multiple sclerosis: a possible new concept in the management of multiple sclerosis symptoms.” Frontiers in Neurology 11 (2020): 152.
- Akgün, Katja, et al. “Daily practice managing resistant multiple sclerosis spasticity with delta-9-tetrahydrocannabinol: cannabidiol oromucosal spray: a systematic review of observational studies.” Journal of central nervous system disease 11 (2019): 1179573519831997.
- Corey-Bloom, Jody, et al. “Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial.” Cmaj 184.10 (2012): 1143-1150.
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- Langford, R. M., et al. “A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis.” Journal of neurology 260 (2013): 984-997.
- Turri, Mara, et al. “Pain modulation after oromucosal cannabinoid spray (SATIVEX®) in patients with multiple sclerosis: a study with quantitative sensory testing and laser-evoked potentials.” Medicines 5.3 (2018): 59.
- Alhazzani, A. A., et al. “Insomnia among non-depressed multiple sclerosis patients: a cross-sectional study.” The Egyptian journal of neurology, psychiatry and neurosurgery 54 (2018): 1-5.
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- Al-Ghezi, Zinah Zamil, et al. “Combination of cannabinoids, Δ9-tetrahydrocannabinol and cannabidiol, ameliorates experimental multiple sclerosis by suppressing neuroinflammation through regulation of miRNA-mediated signaling pathways.” Frontiers in immunology 10 (2019): 1921.
- Furgiuele, Alessia, et al. “Immunomodulatory potential of cannabidiol in multiple sclerosis: A systematic review.” Journal of Neuroimmune Pharmacology 16 (2021): 251-269.
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Gleb is a freelance writer from Vancouver, Canada specializing in CBD and cannabis. He’s read thousands of studies on CBD and other supplements, helping him translate complex science into plain language. Gleb has tried and reviewed dozens of CBD brands and products, written third-party testing reports, and knows the CBD industry inside and out. When not writing, he likes to kickbox, travel, and tell everyone how awesome intermittent fasting is.