Should You Offer Massage with CBD Oil and CBD Cream?
Massage therapists are always looking for new ways to provide their clients with a better massage experience. Perhaps this quest has led you to consider offering massage with cannabidiol oil or cream for your clients. If so, there are a number of factors you’ll want to consider, ranging from potential benefits and risks, to questions of legality.
Let’s begin with the basics.
What Is Cannabidiol?
Cannabidiol—more commonly known as CBD—is one of the many chemical compounds found in the cannabis plant family, the scientific name of which is Cannabis sativa and includes both hemp and marijuana plants (1, 2). A variety of products containing CBD are now available, including topical oils, creams, sprays, and lotions, as well as oils, gummies, and capsules made specifically to be ingested.
The topical products are, of course, those of greatest interest to massage therapists.
2 Types of CBD
But not all CBD products are the same. All CBD that is sold over the counter is derived from the hemp plant.
There are two types of CBD:
- CBD Isolate is pure CBD and does not contain any terpenes or THC (tetrahydrocannabinol), the psychotropic compound that gets you high.
- Full Spectrum CBD contains CBD and low levels of THC (less than .3%) and terpenes. The THC and terpenes combine to create what is known as “the entourage effect,” which can provide a false feeling of enhanced well-being. This type of CBD can cause you to fail some drug tests.
Since the goal of massage is not to get the client high, any oils, creams, or so forth should be of the CBD Isolate which is THC free.
CBD Massage Oil Benefits
Benefits of CBD oil, according to proponents, range from reducing pain and inflammation to fighting stress, promoting deeper sleep, improving heart health, and protecting against cancer (3). Experts, however, say the evidence to support these claims is scant (4).
Further complicating the picture, as Massage Magazine’s editor-in-chief Karen Menehan points out, most of the cannabis research to be found in the U.S. National Library of Medicine’s database “is on the ingestion of CBD products for medical conditions including chemotherapy and AIDS-related nausea; epilepsy; and multiple sclerosis” (2).
In other words, the research that does exist on CBD oil does not address its topical use for massage.
That being said, massage therapists have long been keen observers of the positive effects of various aspects of the massage experience in the absence of research, only to have researchers come along later and verify what we’d perceived all along.
There is an array of reported side effects (e.g., tiredness, diarrhea, changes in appetite or mood), but as most aren’t serious or long lasting, the possible benefits may outweigh any potential risks.
Relief from Pain and Inflammation
The endocannabinoid system—a specialized system in the human body involved in regulating, for example, pain, appetite, and sleep—produces neurotransmitters called endocannabinoids. There is some research that suggests that endocannabinoid receptor activity is positively affected by CBD, reducing pain and inflammation (1).
One such study, in the Journal of Experimental Medicine, “found that CBD significantly reduced chronic inflammation and pain in some mice and rats” (5, 6). The Dutch Association for Legal Cannabis (NCSM) has stated that the safest way to use CBD oil for back pain is to apply it topically, where “it is expected to absorb through the skin, have an anti-inflammatory effect right at the site of application, then also block pain as it enters the blood stream and affects the nervous system” (7).
CBD massage cream for pain is another option.
Touted for its “highly-targeted approach to pain relief because of the way it works as a lock and key system with the human body” (8), CBD massage cream provides relief from joint and musculoskeletal pain.
An added benefit is that, because CBD cream contains hemp oil, it is an exceptional moisturizer (8).
Numerous retailers go so far as to claim CBD cream helps prevent skin cancer (e.g., 8, 9), but none of them provide references to support this claim.
Although people with chronic anxiety disorders are often advised by physicians to avoid cannabis owing to the propensity for THC to amplify feelings of paranoia and anxiety (5), the authors of a review study found strong evidence to support the use of “CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder” (11).
Because of CBD massage oil effects on pain and inflammation—with CBD oils and creams working directly on the sites of irritated nerve receptors (8)—it’s easier for the client to relax.
Alleviating Cancer Symptoms
There is research to suggest that CBD may alleviate side effects of cancer treatments, such as nausea and vomiting, as well as pain associated with the cancer itself and its treatment (1). To date, the studies done have mostly been done regarding ingested CBD, but the stress reduction provided by CBD is a valuable outcome for cancer patients. One study has even pointed to the potential of CBD as a treatment for cancer itself (12).
Due to CBD’s ability to reduce the production of the oily secretions in sebaceous glands and because of its anti-inflammatory properties, CBD may be helpful in treating acne, based on recent research (13, 14).
Sensory Stimulation Heightened
Because CBD has a positive effect on the receptors in the body that control serotonin levels, CBD not only lowers anxiety levels, as previously mentioned, it also heightens one’s mood and alertness (8).
Though the research is still relatively new, CBD has shown great promise in treating such neurological disorders as epilepsy and multiple sclerosis (1). Treatment with CBD may even prevent the cognitive decline associated with Alzheimer’s disease (15).
A Few Caveats
The positive effects of CBD in the treatment of a variety of issues and illnesses promise a bright future for CBD massage and wellness, and offer the possibility of providing even greater comfort and care to our clients.
However, as with any massage modality or tool—especially those without a long history—it’s important to proceed with caution.
There are several areas that deserve particular consideration:
- Possible drug interaction. There are several types of medications, including some anti-epilepsy drugs, with which CBD oil may interact negatively (3). In the epilepsy study there was one incident of side effect, but the researchers themselves said they could not determine if it was the drug or the CBD that caused the issue. In the second epilepsy study, the side effect mentioned above did not occur. The point being, as with any oil or cream you apply to your client, if you have any concerns, you should discuss with your client and maybe ask your client to get clearance from the client’s physician before applying.
- Labeling. If you are going to use CBD, I would recommend you buy it from a company you trust.* Many CBD product labels are misleading and intentionally deceiving, with many even containing THC or other compounds that aren’t correctly identified on the label (3). Be sure the label states the amount of CBD in the container. A 2017 study in the Journal of American Medicine, in fact, found that nearly 70% of all CBD products sold online are incorrectly labeled (16).
- Legality. The Agriculture Improvement Act of 2018, also known as “The Farm Bill, was passed by Congress and signed by the President, stating that hemp-derived products, like CBD, are not classified as a drug and are legal to sell in all 50 states.
Why Should Your Clients Get All The Benefit?
As massage therapists, using your hands all day and standing on your feet too long can create aches and pains. In addition to the aches and pains you may endure on the job, running your own massage practice or simply dealing with the normal day-to-day in your life can cause unwelcome stress. CBD could be an alternative option for you as well.
1. https://www.healthline.com/nutrition/cbd-oil-benefits, HealthLine, “7 Benefits and Uses of CBD Oil (Plus Side Effects),” by Jillian Kubala, Published February 26, 2018, Retrieved January 7, 2019.
2. https://www.massagemag.com/marijuana-massage-5-questions-answered-32929/, Massage Magazine, “The MT’s Guide to Marijuana and Massage,” By Karen Menehan, Published April 18, 2018, Retrieved January 7, 2019.
3. https://www.verywellhealth.com/cbd-oil-benefits-uses-side-effects-4174562, VeryWellHealth, “CBD Oil: Benefits, Uses, Side Effects, and Safety,” By Cathy Wong, Updated September 29, 2018, Retrieved January 7, 2019.
4. https://www.webmd.com/pain-management/news/20180507/cbd-oil-all-the-rage-but-is-it-safe-effective#1, WebMD, “CBD Oil: All the Rage, But Is It Safe & Effective?,” By Dennis Thompson, Published May 7, 2018, Retrieved January 7, 2019.
5. https://www.medicalnewstoday.com/articles/317221.php, MedicalNewsToday, “Everything You Need to Know about CBD Oil,” By Jon Johnson, Last Updated July 27, 2018, Retrieved January 7, 2019.
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371734/, Journal of Experimental Medicine 209, no. 6 (2012): 1121–34, “Cannabinoids Suppress Inflammatory and Neuropathic Pain by Targeting α3 Glycine Receptors,” By Wei Xiong et al., Retrieved January 7, 2019.
8. https://www.sagelynaturals.com/blogs/news/5-surprising-benefits-of-cbd-massage, Sagely Naturals, “5 Surprising Benefits of CBD Massage,” By Kerrigan Behrens, Published September 4, 2018, Retrieved January 7, 2019.
9. https://farma.health/cbd-cream-benefits/, Farm Health, “CBD Cream Benefits,” By Monique LeGrow, Retrieved January 7, 2019.
10. https://drethernet.com/product/cbd-cream/, DrEthernet, “CBD Cream,” Retrieved January 7, 2019.
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/, Neurotherapeutics 12, no. 4 (2015), 825–36, “Cannabidiol as a Potential Treatment for Anxiety Disorders,” By Esther M. Blessing, Maria M. Steenkamp, Jorge Manzanares, and Charles R. Marmar, Retrieved January 7, 2019.
12. https://bpspubs.onlinelibrary.wiley.com/doi/abs/10.1111/bph.14426, British Journal of Pharmacology, “Anti-Tumour Actions of Cannabinoids,” By Burkhard Hinz and Robert Ramer, Published July 17, 2018, Retrieved January 8, 2019.
13. https://www.ncbi.nlm.nih.gov/pubmed/25061872, Journal of Clinical Investigation 124, no. 9 (2014): 3713–24, “Cannabidiol Exerts Sebostatic and Antiinflammatory Effects on Human Sebocytes,” By A. Oláh et al., Retrieved January 8, 2019.
14. https://www.ncbi.nlm.nih.gov/pubmed/27094344, Experimental Dermatology 25, no. 9 (2016): 701–7, “Differential Effectiveness of Selected Non-Psychotropic Phytocannabinoids on Human Sebocyte Functions Implicates Their Introduction in Dry/Seborrhoeic Skin and Acne Treatment,” By A. Oláh et al., Retrieved January 8, 2019.
15. https://www.ncbi.nlm.nih.gov/pubmed/25024347, Journal of Alzheimer’s Disease 42, no. 4 (2014): 1383-96, “Long-Term Cannabidiol Treatment Prevents the Development of Social Recognition Memory Deficits in Alzheimer’s Disease Transgenic Mice,” By D. Cheng et al., Retrieved January 8, 2019.
16. https://www.sciencedaily.com/releases/2017/11/171107112244.htm, ScienceDaily, “Nearly 70 Percent of Cannabidiol Extracts Sold Online Are Mislabeled, Study Shows: Mislabeling May Lead to Adverse Effects for Patients, Including Children with Epilepsy,” By University of Pennsylvania School of Medicine, Published November 7, 2017, Retrieved January 8, 2019.
17. https://www.forbes.com/sites/monazhang/2018/04/05/no-cbd-is-not-legal-in-all-50-states/#3e81402b762c, Forbes, “No, CBD Is Not ‘Legal in All 50 States,’” Mona Zhang, Published April 5, 2018, Retrieved January 8, 2019.
18. https://chicago.suntimes.com/cannabis/cannabis-cdb-oil-medical-marijuana-guide/, Chicago Sun-Times, “Cannabis 101: A Guide to CBD Oil, What It Is, How It Works, Who Can Use It,” By Tom Schuba, September 19, 2018, Retrieved, January 8, 2019.
19. https://qz.com/quartzy/1457260/whats-the-legal-status-of-cbd-after-the-midterms/, Quartzy, “What’s the Legal Status of CBD after the Midterms?,” By Jenni Avins, Published November 11, 2018, Retrieved on January 8, 2019.
20. https://www.forbes.com/sites/mikeadams/2018/09/28/no-the-dea-did-not-reschedule-the-cbd-compound/#6404d56d1bef, Forbes, “No, the DEA Did Not Reschedule the CBD Compound,” By Mike Adams, Published September 28, 2018, Retrieved January 8, 2019.
21. https://www.vice.com/en_us/article/pawdz9/cbd-products-are-everywhere-but-is-cbd-legal-not-exactly, Vice, “CBD Products Are Everywhere, but Is CBD Legal? Not Exactly,” By Cole Kazdin, Published July 11, 2018, Retrieved January 8. 2019.
About the Author
Yvonne Zipter, LMT, BCTMB
Yvonne completed her massage therapy training at the Cortiva Institute in Chicago in 2007. Following graduation, she earned certifications in prenatal and geriatric massage and became Board Certified with the NCBTMB in 2014. Early in her career, she worked primarily with amateur athletes—triathletes and runners, mostly—but now works mainly with issues related to disability. Yvonne has never gotten over the thrill of being able to help people feel better and loves exploring the many ways massage can improve our health.