CBD as a Treatment Option for Osteoarthritis?
With Roger Clemens DrPH
CBD, the non-psychotropic cannabinol of marijuana, is becoming an increasingly popular treatment option and may offer unique benefits for osteoarthritis. It has been shown to attenuate symptoms of pain and inflammation. Considering CBD for osteoarthritis pain? We asked the experts for their advice to help you make an informed decision.
What is osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis, affecting more than twenty million Americans. OA is a degenerative joint disease, defined by loss of joint smoothness and range of motion due to increased bone density and bone growths (osteophytes). OA is further defined by:
- Join degeneration
- Intermittent inflammation
- Peripheral neuropathy
What are the symptoms of osteoarthritis?
- Decreased movement within the joint
What is CBD?
Cannabidiol (CBD) is a compound that is found in the cannabis plant. Unlike THC, which is another compound from the same plant, CBD is not psychotropic, and therefore does not create the “high” that the plant is more typically known for.
CBD has been shown to be:
Can CBD help relieve symptoms of osteoarthritis?
The symptoms experienced with OA encompass inflammatory, nociceptive, and neuropathic pain. CBD is an exogenous (out of the body) cannabinoid that acts on our endogenous (in the body) cannabinoid system to function in an antioxidant capacity, decrease inflammation and act as an analgesic.
Historically, osteoarthritis has been thought of as a non-inflammatory arthritis, however, recent evidence showcases the role of inflammation in the symptoms of OA, as well as in the condition’s progression. Intervention with CBD may offer an opportunity to slow the progression of OA by decreasing inflammation, both systematically and locally. The interaction of CBD with your immune system and its potential antioxidant affect may help to decrease symptoms associated with OA and improve quality of life.
What research is there about CBD and pain relief?
- Ingested CBD has been shown to block pain signals from reaching your brain by binding to specific pain receptors.
- Ingested CBD has been shown to attenuate central sensation and neuropathic pain development.
- Applied topically, CBD has been shown to decrease pain sensations locally by reducing mechanosensitivity of your joint nociceptors.
- Applied topically, CBD has been shown to reduce joint swelling and decrease immune cell infiltration, inflammation, and thickening of the connective tissue that lines your joints.
- Applied topically, CBD has been shown to reduce acute, inflammatory changes.
- Ingested CBD has been shown to reduce production of inflammatory cytokines.
- CBD has been shown to help relieve anxiety and sleep disturbances associated with chronic pain conditions.
CBD is not addictive and has minimal known side effects. Extracted from cannabis satvia, CBD belongs to a family of plants that have long been used for their medicinal properties. According to Roger Clemens DrPH, professor of pharmaceutical sciences and Associate Director of the Regulatory Science Program at the University of Southern California School of Pharmacy, more research is needed to prove the efficacy of CBD as a treatment for arthritis. However, he says: “Studies among humans indicate CBD, when administered by injection or in topical transdermal forms, may have antiarthritic effects independent of cannabinoid receptors. In addition to helping to control inflammation, cannabinoids reduce pain by activating central and peripheral CB1, peripheral CB2 receptors, and CBD-sensitive non-cannabinoid receptor targets.”
How do you use CBD for pain relief?
- Topicals are best used for immediate pain relief and seem to be particularly helpful for people with OA. They don’t enter your bloodstream, so they’ll only affect the site where they’re applied. Topicals come in creams and oils that are absorbed by your skin and can have anti-inflammatory and antinociceptive (pain inhibiting) effects.
- Ingestibles do enter your bloodstream and cross your blood-brain barrier, inducing more whole-body systemic effects. Ingestibles also pass through your digestive system, which means it will take longer for you to feel their effects, but they are also likely to last longer.
The American Arthritis Foundation recommends administration of CBD using topical application, tinctures, oral sprays, or capsules. They do not recommend edibles, because the dosage is a bit unpredictable. Vaping is also not advised because of the possible negative affects to your respiratory system, as well as potential inflammation.
- Oral Sprays and tinctures are taken under your tongue, where they are quickly absorbed into your bloodstream.
- Capsules are a pill form of CBD.
If you’re interested in trying CBD for the first time, start at a low dose, such as 5 milligrams, and go from there. It’s important to remember that you will not feel the effects of ingestibles immediately. Even if you don’t notice anything in the first few hours, don’t consume more on the first try, as you can always increase your dosage later, but not reduce it once you have already ingested it.
Is CBD legal?
The legality of CBD in the United States has caused some confusion regarding CBD’s relation to marijuana. Let’s break it down:
- Hemp is the male version of the cannabis plant that must contain .3% or less THC, and was officially legalized nationally in 2018 thanks to the Farm Bill, although it had not been illegal before that, and has long been found in innocuous products such as towels, necklaces, clothing, and sheets.
- CBD can be extracted from both hemp (the male version of the cannabis plant which cannot make you “high”), and from marijuana (the female version which is known for just the opposite).
- CBD extracted from marijuana is federally legal, however it is not legal in every state. CBD extracted from hemp is legal in every state, the same as the hemp that it is sourced from.
Lord Jones is a reputable supplier of CBD that ships different products depending on your zip code to ensure that the CBD you are receiving is legal in your state, whether marijuana is legal there or not.
Should you take CBD for osteoarthritis?
Your health is personal, and how you choose to manage osteoarthritis will depend on several lifestyle factors. The American Arthritis Foundation reports that CBD may be a beneficial option for people with arthritis and recommends discussing all treatments with your healthcare provider. For many people, this non-psychotropic, mild cannabinoid can offer relief from the chronic pain of osteoarthritis with minimal side effects. If you think it might be helpful for you in dealing with your OA, remember to start at a low dose to evaluate if it is something you want to use to supplement your individualized treatment plan.
With Roger Clemens DrPH [[wysiwyg_imageupload:2304:]] CBD, the non-psychotropic cannabinol of marijuana, is becoming an increasingly popular treatment option and may offer unique benefits for osteoarthritis. It has been shown to attenuate symptoms of pain and inflammation. Considering CBD for osteoarthritis pain?
Complementary treatments and arthritis – from turmeric to cannabis oil
Why do people use complementary medicines?
People use complementary medicine for many different reasons, including:
- wanting to use more natural treatments
- their symptoms aren’t fully controlled by conventional medicine.
Read more about practical complementary therapies which can help to ease the symptoms of arthritis, from yoga to meditation.
Are they right for me?
As with all complementary treatments, different things work for different people and it isn’t possible to predict which might be the most useful or effective.
There are some key points to consider if you’re thinking about using any complementary treatments.
- What are you hoping to achieve? Pain relief? More energy? Better sleep? Reduction in medication?
- What are the financial costs?
- Is there any evidence for their effectiveness?
Are complementary medicines safe?
Complementary medicines are relatively safe, although you should always talk to your doctor before you start any new treatment.
In specific cases they may not be recommended, for example, if you are pregnant or breastfeeding, or they may interact with certain medication.
A starter for five
Here we share a spotlight on the most popular complementary medicines that people call our helpline about.
It’s thought that turmeric can possibly reduce inflammation, which could help people with arthritis.
People with knee osteoarthritis who took part in a research trial (2009) reported improvements to their pain levels after taking turmeric. The evidence is limited however, as it is from just one trial. What evidence there is suggested that people only had minor side-effects after taking turmeric.
Turmeric can be bought from health food shops, pharmacies and supermarkets in the form of powder.
Glucosamine sulphate and glucosamine hydrochloride are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage.
The results for the use of glucosamine for osteoarthritis are mixed and the size of the effect is modest. There’s some evidence that more recent trials and those using higher-quality methods are less likely to show a benefit.
Capsaicin is taken from chilli peppers. It works mainly by reducing Substance P, a pain transmitter in your nerves. Results from randomised controlled trials assessing its role in treating osteoarthritis suggest that it can be effective in reducing pain and tenderness in affected joints, and it has no major safety problems. Evidence for its effectiveness for fibromyalgia is related to a single trial.
Other names: Axsain®, Zacin®, chilli, pepper gel, cayenne
Capsaicin is licensed in the UK for osteoarthritis and you can get it on prescription in the form of gels, creams and plasters.
There are no major safety concerns in applying capsaicin gel/cream. A review of capsaicin applied to the skin to treat chronic pain (not specifically related to osteoarthritis, rheumatoid arthritis or fibromyalgia) concluded that around one third of people experience a reaction around the area where the treatment is applied. It’s important to keep capsaicin away from your eyes, mouth and open wounds because it will cause irritation. There have been no reported drug interactions.
Fish oils are rich in omega-3 essential fatty acids, which have strong anti-inflammatory properties. Fish liver oil is also a rich source of vitamin A (a strong antioxidant) and vitamin D (which is important for maintaining healthy joints).
Evidence suggests that fish body oil can improve the symptoms of rheumatoid arthritis. Unconfirmed evidence also suggests a combination of fish body and liver oils might also be useful in the long term, particularly in reducing the use of non-steroidal anti-inflammatory drugs (NSAIDs). There isn’t enough evidence for the use of fish liver oil for osteoarthritis.
Omega-3 fatty acids also play a role in lowering cholesterol and triglyceride levels in your blood, so they can reduce the risk of heart disease and stroke in people with inflammatory arthritis.
In the UK, dietary guidelines recommend eating two portions of fish a week, including one oily. Fish oil is considered to be well tolerated at this dose.
At the correct doses, side-effects are usually minor and uncommon.
Cannabis oil (CBD)
CBD is type of cannabinoid – a natural substance extracted from the cannabis plant and often mixed with an oil (such as coconut or hemp) to create CBD oil. It does not contain the psychoactive compound called tetrahydrocannabidiol (THC) which is associated with the feeling of being ‘high’.
Research in cannabinoids over the years suggests that they can be effective in treating certain types of chronic pain such as pain from nerve injury, but there is currently not enough evidence to support using cannabinoids in reducing musculoskeletal pain. We welcome further research to better understand its impact and are intently following developments internationally.
CBD oil can be legally bought as a food supplement in the UK from heath food shops and some pharmacies. However, CBD products are not licensed as a medicine for use in arthritis by MHRA (Medicines and Healthcare products Regulatory Authority) or approved by NICE (National Institute for Health and Care Excellence) or the SMC (Scottish Medicines consortium).
We know anecdotally from some people with arthritis, that CBD has reduced their symptoms. If you’re considering using CBD to manage the pain of your arthritis, it’s important to remember it cannot replace your current medicines, and it may interact with them, so please do not stop/start taking anything without speaking to a healthcare professional.
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Find out more about complementary medicines and the top five that people contact us about.