Living the kind of life that I have, I’m amazed by the degree to which it’s been a pain-free existence. (I’m talking physical pain only—you don’t want to hear me talk about the rest.)

This doesn’t make me the best test subject for cannabis-made topical pain relievers. And while I have considered imparting tremendous bodily harm upon myself for the sake of journalism, it’s actually not necessary. As a caregiver in the Oregon Medical Marijuana Program (OMMP) system, I have a number of patients who are unfortunately in near-constant pain from myriad ailments, from chronic to terminal.

The upside is that I sometimes get to share free samples with my patients, and that helps me get a sense of what product works for which condition. Such was the case with Nightingale Remedies.

Nightingale’s owner and CEO, Patrick Brennan, had worked in the Oregon cannabis industry back in a different era, the pre-Measure 91, OMMP-only days. (Were we ever so young?) Brennan used cannabis to treat a variety of injuries from years of intense snowboarding and skateboarding, resulting in a “chronically out-of-whack back” and four knee surgeries.

“This came from necessity,” says Brennan. “I tried all the other patches, salves, and oils, none which brought me consistent relief and comfort. So I chose to make a product that I believe delivers on the promise of true pain relief.”

Brennan started by purchasing dozens of cannabis-infused topicals from Oregon and other states with cannabis programs, both recreational and medical. He then deconstructed each product by its ingredient list, drafted a lengthy spreadsheet, and reviewed each one’s effectiveness with the help of a doctor and a pharmacist. “It allowed me to toss out a number of ingredients that, while commonly used, had no true pain-relieving value,” he says.

The product’s long label lists more than 50 ingredients, which Brennan and his team chose to create a true “entourage effect.” That includes turmeric curcumin, Boswellia serrata, glucosamine hydrochloride, methylsulfonylmethane (MSM), and the cannabinoid CBD. Brennan says the lengthy list serves to address pain in two ways. (Warning: science ahead.)

“Studies have shown that CBD regulates the release of neurotransmitters and central nervous system immune cells to manage both nociceptive and neuropathic pain levels in the body. Nociceptive pain is the most common type of pain, and is caused by the detection of noxious, or potentially harmful, stimuli by the nociceptors around the body. Nociceptors are receptors that are specifically designed to detect stimuli that may cause harm to the body, which may be mechanical, chemical or thermal in nature.

“For example,” Brennan continues, “they may sense when there is physical damage to the skin, muscles, bones, or connective tissue in the body, or when they are exposed to toxic chemicals or extreme temperatures. They usually have a high threshold, but when they are activated, they send electrical signals of pain to the central nervous system and the brain to deliver the perception of pain.”

(This goes against what Patrick Swayze taught me in Road House—“pain don’t hurt”—but I’m going to take Brennan at his word.)

How well did Nightingale Remedies’ formula work? To be honest, I was skeptical. I’ve had mixed results using CBD-based topicals, with some patients responding very well, and others receiving next to no relief. It’s a frustrating exercise for caregiver and patient alike.

So I was floored when I got reports back from users with a near-universal thumbs up. Better still, the cream didn’t simply address one or two conditions, but offered pain relief for those with osteoporosis, rheumatoid arthritis, Parkinson’s, neuropathy from diabetes, and severe muscle and joint pain. One patient was able to swap out the opioid pain pills being used to treat a back injury.

Bonus: The absence of THC allows the product to be used by those concerned about “getting high” from a cannabis, including children. It also allows the cream to be shipped in all 50 states.

Anything that moves those in pain to forgo traditional pharmaceutical offerings is a win for wellbeing, and products with THC and CBD in them are a great start. Because—sorry, Patrick Swayze—pain actually does hurt.