Hemp Flower Oil and Occupational Pain Management in Farming Communities: A Systematic Review.

Musculoskeletal pain is a major concern for agricultural workers worldwide. However, access to safe and non-opioid pain relief measures is limited in resource-scarce settings. Hemp flower oil, a rich source of cannabinoids and terpenes, has been recognised as a promising adjunct pain therapy due to its analgesic and anti-inflammatory activities through the activation of CB2 receptors, TRP channels, cytokine downregulation and antioxidant mechanisms. This study is a systematic scoping review with narrative synthesis conducted in accordance with PRISMA 2020 guidelines which aims at addressing this issue through a comprehensive analysis of available evidence using a phytochemical, mechanistic, genomic and sustainability approach. This review is guided by the PRISMA framework and incorporates a total of n = 44 studies conducted between 2000 and 2025. Preclinical research accounted for a significant proportion of the overall evidence (68%), indicating a strong mechanistic rationale for hemp flower oil as a pain reliever. Clinical trials accounted for a small proportion of the overall evidence (23%), while genomic research accounted for a small proportion of the overall evidence (9%), indicating associations between cytokine polymorphisms and ion channel variants and cannabinoid receptor genotypes. This review aims to bridge the gaps and address the knowledge gaps and research priorities through a comprehensive analysis of available evidence and a roadmap for future research using a novel interdisciplinary approach. Hemp flower oil shows preliminary potential, but current clinical evidence remains limited and of low certainty for managing musculoskeletal pain in agricultural workers.