CBD and Chronic Pain: What Massage Therapists Need to Know
Written by Maggy Troup, owner of Ascend Massage Studio. As always, this article is not meant to replace medical care from your primary physician. This article is simply meant to inform and provide education for individuals who are interested in learning about this topic. Maggy shares her wisdom regarding the benefits and considerations for using CBD for managing chronic pain. If you want to learn more about why she found interest in integrating CBD into her massage therapy session and how she became so knowledgable in the topic, read our Q&A with Maggy entitled “Integrating CBD into Massage Therapy.”
Our Clients with “Mystery Pain” Seek Validation
As a massage therapist, we see it every day—clients coming through our doors in search of relief from chronic pain. Whether it’s aching joints, persistent sciatica, migraines, fibromyalgia, or that elusive “mystery pain” doctors can’t quite diagnose, pain is often the driving force behind someone seeking bodywork. Many of these clients feel overlooked or dismissed by traditional medical systems, so they are coming to us for answers. They have often been prescribed narcotics that merely mask symptoms rather than address the root cause - but what they really want is a long-term solution—not a quick fix.
While massage therapy is already one of the most sought-after, non-invasive options for managing pain, therapists are increasingly exploring ways to deepen their results and support lasting relief. One of the most promising and often overlooked tools therapists can add to our practice might not be a new modality—it might be a bottle of CBD.
Pain Is Personal—and It’s Everywhere
Pain is incredibly complex and deeply personal. The International Association for the Study of Pain (IASP) defines it as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.” Translation? Pain isn’t always something we can see—or even explain—but it’s very real to the person experiencing it.
According to the CDC, over 51 million Americans live with chronic pain, and it’s one of the top reasons people turn to complementary care like massage therapy. Read more on how to support your clients who have chronic illness in this article. As therapists, we often become the first line of defense for these clients, especially when medications have failed or produced undesirable side effects. This is why it is important for massage therapists to be up to date on the latest pain management research and be striving to improve the results in the treatment room.
https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm/?utm_source=chatgpt.com
The Opioid Crisis Changed Everything
Let’s be honest—opioids are often used as the default solution for chronic pain. But with a growing awareness of the risks and dependency issues, clients are hungry for natural, sustainable alternatives. That’s where CBD (cannabidiol) enters the conversation and can be the solution our clients are seeking.
Since the 2018 Farm Bill legalized hemp-derived CBD, it has become a go-to remedy for pain relief—and for good reason. One study published in The Journal of Cannabis Research (2020) found that over 60% of CBD users were turning to it specifically for pain, inflammation, and joint issues. And when paired with therapeutic touch? That’s where the magic happens.
CBD and Massage: A Powerful Combination
CBD is not “just” a wellness trend—it’s a compound with growing scientific support. Research shows that CBD interacts with the body’s endocannabinoid system (ECS), a system that plays a key role in regulating pain, inflammation, mood, and immune response.
Here’s what we know so far:
CBD helps modulate pain signals by increasing the availability of endocannabinoids (your bodies own “bliss” molecule) like anandamide
It reduces inflammation by interacting with CB2 receptors in the immune system (Xu & Chen, Journal of Clinical Investigation, 2021).
CBD enhances tissue recovery, making it an ideal coupling with massage therapy focused on sports recovery or injury rehab.
Whether applied topically during massage or used sublingually by the client, CBD works synergistically with our own bodies healing system. When applied topically during massage, it can decrease the pain response and calm the client's nervous system. Learn more about integrating CBD into your massage therapy sessions in this great Q&A with Maggy Troup.
Why the ECS Should Be Required Learning for Massage Therapists
If you’re unfamiliar with the endocannabinoid system (ECS), you are not alone. Discovered in the early 1990’s it is a recent discovery and a system that is still being explored to this day. The ECS is a regulatory network in the body that helps maintain balance—or homeostasis—across all major systems. Think of it as our body's control tower; it is often referred to as the mother of all systems, helping our body regulate vital physiological processes. When our body experiences a dysregulation, such as pain, the ECS plays a critical role in how pain is perceived, processed, and resolved. Its main role is to make sure our body is working optimally and maintaining a healthy balance.
Massage already stimulates the ECS by increasing anandamide levels (our body’s own endocannabinoid molecule). When we add CBD into the mix, we’re giving the system an extra boost to reduce inflammation, relax the body, and rewire the way pain is being experienced by our client.
Dr. Ethan Russo, a leading researcher in cannabinoid science, has even proposed the theory of Clinical Endocannabinoid Deficiency (CED), linking dysfunction in the ECS to conditions like migraines, IBS, and fibromyalgia—all common complaints in our treatment rooms. Wouldn’t it be wonderful if we could help our clients and loved ones be free of these icky ailments? As massage therapists, we have an opportunity—and maybe even a responsibility—to understand this system. Since the discovery was so recent, many medical textbooks are missing the education about this crucial system of our body. The truth is— the more we know, the better we can support our clients.
Topical CBD vs. Ingested CBD: What Massage Therapists Should Know
Topical CBD, such as oils or balms, are ideal for massage therapy. When applied to the skin:
It interacts directly with local cannabinoid receptors and pain-sensing neurons, offering fast, localized relief.
It doesn’t enter the bloodstream, which makes it safe and non-intoxicating.
Many topicals combine CBD with anti-inflammatory botanicals, making them even more effective for joint, muscle, and nerve pain.
Ingested CBD (like tinctures or capsules) works systemically and is great for clients dealing with more widespread or internal pain conditions. It activates the ECS from within, helping balance the body’s overall pain response and nervous system regulation.
Our clients are already reading about CBD, some are already using it and others are curious. They are looking to us as a trusted wellness provider for guidance. By understanding how CBD works with the Endocannabinoid system, we position ourselves as an informed professional who can integrate science-backed, plant-based strategies into our treatments. Whether that means offering CBD-enhanced massages or simply educating clients on how they can support their healing between sessions, this knowledge makes our work more impactful.
The Takeaway
Pain management is evolving, and our clients are looking for more personalized care. Massage therapy is at the forefront of that shift. As research continues to explore the role of CBD and the endocannabinoid system in addressing chronic pain, massage therapists have a unique opportunity to amplify the body’s natural healing systems—offering our clients not just temporary relief, but real progress. If you are serious about helping clients with chronic pain, now is the time to:
Learn more about CBD’s role in inflammation and pain signaling.
Explore safe, effective ways to integrate CBD into your sessions.
Become a trusted and educated resource for our clients questions
All of these are covered the the CBD Integrated: Understanding the Endocannabinoid System Continuing Education class that Maggy Troup teaches. Let’s come together so we can give our clients every advantage in their healing journey—and let’s do it with confidence, knowledge, and care.
References:
Xu, D.H. & Chen, J. (2021). Cannabinoid modulation of pain and inflammation. Journal of Clinical Investigation, 131(4).
MacCallum, C.A., & Russo, E.B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12-19.
Baron, E.P. (2015). Comprehensive review of medicinal marijuana, cannabinoids, and therapeutic implications in medicine and headache: What a long strange trip it’s been. Headache: The Journal of Head and Face Pain, 55(6), 885-916.