CBD Improved Walking Speed in MS Patients but Did Not Reduce Spasticity

A randomized trial in 49 MS patients found that 4 weeks of escalating CBD doses improved walking test times and reduced maximum pain, but did not significantly reduce spasticity.

Mousavi, Pegah et al.·Naunyn-Schmiedeberg's archives of pharmacology·2025·Moderate EvidenceRandomized Controlled Trial
RTHC-07198Randomized Controlled TrialModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=49

What This Study Found

CBD treatment (escalating from 5 to 80 mg/day over 4 weeks) significantly improved walking speed on the T25-FW test (p=0.031) and reduced maximum pain (p=0.033) compared to placebo, but did not significantly reduce spasticity severity at 4 or 8 weeks.

Key Numbers

49 patients (24 CBD, 25 placebo). CBD escalated from 5 to 80 mg/day. T25-FW improvement: p=0.031. Maximum pain reduction: p=0.033. No significant spasticity reduction at 4 or 8 weeks.

How They Did This

Double-blind randomized controlled trial of 49 MS patients with spasticity-related walking difficulties, comparing escalating-dose sublingual pure CBD to placebo over 4 weeks at Ghaem Hospital, Iran.

Why This Research Matters

MS spasticity affects millions and current treatments have significant side effects. While CBD did not reduce spasticity per se, the functional improvement in walking speed is clinically meaningful.

The Bigger Picture

The disconnect between spasticity scores and walking improvement suggests CBD may help MS patients through pathways other than direct spasticity reduction, possibly through pain reduction, anxiety relief, or other mechanisms.

What This Study Doesn't Tell Us

Small sample size. Short 4-week treatment. Relatively low CBD doses. Single-center study in Iran. High dropout (9 of 49). Does not address long-term effects.

Questions This Raises

  • ?Would higher CBD doses reduce spasticity directly?
  • ?Why did walking improve without spasticity changes?
  • ?How does pure CBD compare to THC/CBD combinations already approved for MS spasticity?

Trust & Context

Key Stat:
CBD improved MS walking speed (p=0.031) without reducing spasticity itself
Evidence Grade:
Double-blind RCT provides good internal validity, but small sample and short duration limit conclusions.
Study Age:
2025 RCT from Iran, the first of its kind in that country.
Original Title:
A randomized trial on efficacy of purified cannabidiol on spasticity in multiple sclerosis patients with gait problems: first report in Iran.
Published In:
Naunyn-Schmiedeberg's archives of pharmacology, 398(12), 17435-17444 (2025)
Database ID:
RTHC-07198

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

Does CBD help with MS spasticity?

This trial found CBD did not directly reduce spasticity severity, but it did improve walking speed and reduce pain in MS patients with spasticity-related gait problems. The benefit may come through pain or other pathways rather than spasticity itself.

How much CBD was used in this MS study?

Patients started at 5 mg/day and escalated to 80 mg/day over 4 weeks. This is relatively low compared to some CBD studies, and higher doses might show different results.

Read More on RethinkTHC

Cite This Study

RTHC-07198·https://rethinkthc.com/research/RTHC-07198

APA

Mousavi, Pegah; Emadzadeh, Maryam; Karimikhoshnoudian, Bahar; Sahraian, Mohammad Ali; Ghaffari, Mehran; Shaygannejad, Vahid; Payere, Maryam; Baghaei, Ava; Zabeti, Aram; Nahayati, Mohammadali. (2025). A randomized trial on efficacy of purified cannabidiol on spasticity in multiple sclerosis patients with gait problems: first report in Iran.. Naunyn-Schmiedeberg's archives of pharmacology, 398(12), 17435-17444. https://doi.org/10.1007/s00210-025-04347-w

MLA

Mousavi, Pegah, et al. "A randomized trial on efficacy of purified cannabidiol on spasticity in multiple sclerosis patients with gait problems: first report in Iran.." Naunyn-Schmiedeberg's archives of pharmacology, 2025. https://doi.org/10.1007/s00210-025-04347-w

RethinkTHC

RethinkTHC Research Database. "A randomized trial on efficacy of purified cannabidiol on sp..." RTHC-07198. Retrieved from https://rethinkthc.com/research/mousavi-2025-a-randomized-trial-on

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.