CBD & Massage?

Cannabidiol, or CBD, has quickly become a wellness buzzword. Being used for everything from pain relief to anxiety reduction. But as it shows up in oils, capsules, creams, and even coffee, it’s important to move beyond marketing hype and explore what the science actually says.

In this article, we break down peer-reviewed research on CBD’s mechanisms, benefits, and potential risks, including how it may affect the liver. Whether you’re considering using CBD or just want a clearer understanding of how it works, this guide can help you make informed choices. First we are going to explore taking CBD orally and then we will explore topical uses. We’re excited to offer two targeted massage oil options that support your body where it needs it most. Our handcrafted CBD massage oil, made in collaboration with friends from Philadelphia and California, features full-spectrum CBD in a coconut oil base, along with arnica for pain support and wild mint for a subtle, cooling tingle. It’s non-intoxicating, non-sticky, and smells incredible.

What Is CBD and How Does It Work?

CBD is one of over 100 cannabinoids found in the cannabis plant. Unlike THC, CBD is not psychoactive and will not cause a “high.” Its effects are linked to its interaction with various receptors and enzymes in the body, especially those involved in inflammation, pain signaling, and nervous system regulation.

According to a review in The Journal of Medicinal Chemistry (2020), CBD acts on more than 65 molecular targets. These include serotonin receptors (5-HT1A), vanilloid receptors (TRPV1), and peroxisome proliferator-activated receptors (PPARs). Importantly, CBD does not directly bind to CB1 or CB2 receptors like THC, but it does influence how other compounds interact with them.

This diverse interaction profile may explain why CBD seems to affect so many systems at once, including mood, inflammation, and pain.

Potential Benefits of CBD

1. Pain Relief and Anti-Inflammatory Effects

One of the most researched and talked-about uses for CBD is pain management. Preclinical studies suggest CBD may reduce pain through several mechanisms, including modulation of TRPV1 (a receptor involved in pain and heat sensation) and inhibition of inflammatory signaling molecules.A 2015 paper in Bioorganic & Medicinal Chemistry explains how CBD alters how the body processes pain by regulating complex signaling pathways. These mechanisms don’t block pain entirely but may “dial down the volume,” especially in inflammatory or chronic pain conditions.

2. Neuroprotective and Anti-Anxiety Potential

While not all of your sources focus on this, it’s worth mentioning that the activation of serotonin receptors and regulation of oxidative stress pathways suggest possible benefits for anxiety and neurological conditions. However, more human trials are needed to fully support these outcomes.

Potential Risks and Drawbacks of CBD

1. Liver Enzyme Elevation

One of the most significant findings in recent years is that CBD may affect liver health, particularly at high doses or with prolonged use. A study published in Clinical Pharmacology and Therapeutics  found that even healthy individuals showed elevations in ALT (alanine aminotransferase), a marker of liver stress, after taking 1,500 mg of CBD daily.

Although these levels returned to normal and participants didn’t report severe symptoms, the study raises important concerns. If someone is using CBD regularly, especially alongside other medications that also require liver metabolism, it may be wise to monitor liver function through blood tests.

When CBD is present in the system, it can inhibit these enzymes, meaning it slows down how fast your liver breaks down other drugs. This can result in higher blood levels of those medications, which may lead to stronger or prolonged effects, increased side effects, or toxicity.

In The Essential Medicinal Chemistry of Cannabidiol (2020), the authors note:

“CBD is a potent inhibitor of multiple CYP isozymes, including CYP3A4, CYP2C19, CYP2C9, and CYP2D6. Given that over 60% of marketed drugs are metabolized via CYP3A4, this presents a significant potential for pharmacokinetic drug interactions.”
(Elmes et al., 2020, Journal of Medicinal Chemistry)

In addition, CBD may compete for metabolic capacity. For example, it can inhibit the metabolism of clobazam, a drug used to treat epilepsy, leading to increased levels of both clobazam and its active metabolite. This was significant enough that it influenced how Epidiolex (a prescription CBD medication) is dosed in clinical settings.

Why This Matters

What We Know vs. What We’re Still Learning

CBD is not a miracle cure, but it’s also not inherently dangerous. Its therapeutic potential is supported by meaningful molecular interactions and early human research, particularly in areas like inflammation and pain management. We know that CBD influences a wide range of receptors and signaling pathways, and it appears to offer measurable anti-inflammatory and analgesic effects. At the same time, studies have shown that it can impact liver enzymes and alter how the body metabolizes certain medications, which is important to consider, especially for anyone taking prescriptions.

Despite promising results, there’s still a lot we don’t know. Questions remain about the long-term effects of daily use, especially at moderate to high doses. We also need clearer guidance on safe and effective dosing for different individuals and conditions. While preclinical research has laid a strong foundation, more robust human trials are needed to fully understand the benefits and risks of CBD in everyday use.

Topical CBD

While most of the research covered in this article focuses on CBD taken orally or absorbed into the bloodstream, topical CBD works differently. Creams, balms, and massage oils applied directly to the skin offer localized support and are generally considered low risk in terms of systemic side effects. This is because topical CBD does not significantly enter the bloodstream, meaning it doesn’t interact with liver enzymes or interfere with medications the way oral CBD can.

Instead, topical CBD interacts with cannabinoid receptors in the skin and surrounding tissues—primarily CB1 and CB2 receptors—to influence pain signaling, inflammation, and immune response at the site of application. This makes it a valuable option for those seeking targeted relief without the need for internal absorption.

Emerging research supports the use of topical CBD for a variety of pain and skin-related conditions. A 2020 study in the Journal of Clinical and Aesthetic Dermatology found that CBD-infused transdermal treatments reduced itching, scaling, and irritation in individuals with inflammatory skin conditions like eczema and psoriasis, with minimal adverse effects. A 2021 review in Cannabis and Cannabinoid Research highlighted CBD’s anti-inflammatory, anti-itch, and oil-balancing effects, making it promising for conditions such as acne, dermatitis, and chronic itch. More recently, a 2023 study in The Journal of Dermatological Treatment suggested that topical CBD may help modulate immune responses in chronic inflammatory skin diseases.

For those dealing with pain, a pharmacological review in Current Pharmaceutical Design (2023) noted that topical and transdermal CBD formulations show promise for managing localized discomfort—including arthritis and peripheral neuropathy—without exposing the body to the systemic effects seen with oral use.

Oral vs. Topical

CBD can offer a range of benefits, from reducing pain and inflammation to calming irritated skin. However, the route of administration matters. Oral CBD enters the bloodstream, interacts with a wide variety of molecular targets, and has the potential to interfere with how the body processes medications. It may also strain liver function at higher doses.

Topical CBD, on the other hand, stays mostly at the site of application. It interacts with receptors in the skin, offering more localized support for inflammation, pain, or skin irritation with a significantly lower risk of systemic side effects.

For those new to CBD or those managing multiple prescriptions, topical application may be a gentle place to start. So, while topical CBD doesn’t carry the same systemic effects as oral CBD, it offers meaningful localized benefits. Whether you’re managing joint pain, skin irritation, or chronic inflammation in a specific area, topical CBD provides a low-risk option worth considering. Our CBD oil blend has added benefits of Arnica oil and is often paired with our peppermint oil.