A recent scientific review article got clever with its title that begins “Joints for joints.” Apparently, science writers can be funny, too! But this is an important article, especially with all the questions people have about using CBD for arthritis and joint pain.
The importance of the article is two-fold. First, it’s a large-scale review of the current research on the use of cannabinoids for rheumatoid arthritis. Secondly, it was published in the journal Current Opinion in Rheumatology. In the world of medicine, that’s a big deal—cannabinoids are definitely going mainstream.
The pain of arthritis is due in large part to the inflammatory response. The pain, swelling, tenderness, and redness in a joint are classic signs of inflammation—and anything we can do to reduce the inflammation will reduce the pain and stiffness and help improve motion around the joint.
The key points in the article include:
- CBD acts as an anti-inflammatory substance by:
- Dampening the response by the immune system, which directly reduces inflammation
- Decreasing the levels of inflammatory substances around the joint
- “CBD is effective in reducing inflammation and pain and might enhance the efficacy of therapeutic drugs.”
Does CBD oil work for all forms of arthritis? Does CBD work for all forms of joint pain? Well, the quick answer is yes—because all forms of arthritis and joint pain are due to inflammation in some part of the joint.
Types of Arthritis
The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.Osteoarthritis (OA) is a type of degenerative disease—that means that age or overuse of a joint results in damage over time. Rheumatoid arthritis (RA) is an autoimmune disease—where the immune system gets a misplaced signal and begins to attack your own body. In OA, cartilage begins to break down because of injury, overuse, or aging; in RA, the immune system attacks the thin tissue that lines the joints.
There are over 100 different types of arthritis—some of the more common forms are Carpel Tunnel Syndrome, degenerative disc disease (which is a common cause of low back pain), fibromyalgia, gout, lupus, and the arthritis associated with psoriasis.
All these types of arthritis have at least one thing in common—inflammation. The inflammation irritates nerves and causes pain. Inflammation is such a central part of any form of arthritis that the Arthritis Foundation recommends an anti-inflammatory diet that has been proven to help reduce pain and inflammation.
Since CBD has anti-inflammatory properties, it seems reasonable that CBD can be useful for arthritis pain.
A Bit of History of Cannabis and the Endocannabinoid System
Cannabis has been used as a medicinal plant for thousands of years, but THC (and then, later, CBD) were only “discovered” in the 1960s. In the late ‘80s, the endocannabinoid system, which is found in humans and animals, was described. It turned out that cannabis produces natural substances (think of them as keys) that could “fit” into receptors found on the surface of cells (think of the receptors as locks).
But what was this endocannabinoid system good for? What did it do?
It turns out that the endocannabinoid system is active in quite a few roles: it has a part to play in mood (you probably guessed that one), memory, the brain’s “reward” system (the feel-good-about-yourself system), how cells respond to insulin, the body’s response to stress, energy production, and inflammation—and pain. In general, the main endocannabinoids, Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG) can bind to receptors on the surface of cells—there are two known receptors, CB1 and CB2.
AEA and 2-AG are made “on demand” and act in the same area they were made. On top of that, they are pretty quickly degraded, meaning that these endocannabinoids only act for a short time.
Evidence that CBD Can Reduce Arthritis Pain
CBD for Osteoarthritis
Osteoarthritis is the most common form of arthritis. It is related to aging, injury, and being overweight. The most common symptom is pain in the joint—this is worse after using the joint, worse later in the day, and after long periods of not using the joint. OA can occur in any joint, with the most common being the knee, spine (causing low back pain or neck pain), fingers, hips, and toes.
Animal studies clearly show that CBD can reduce the pain, inflammation, and damage associated with osteoarthritis. There have only been a few human studies completed, but these have produced promising results:
- A synthetic form of CBD was applied as a topical gel to treat knee pain in osteoarthritis. The results indicated that pain reduction was significant using the synthetic CBD gel.
- A recent study using an online survey of chronic pain patients indicated that use of CBD for osteoarthritis could reduce the use of opioids.
CBD for Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease. Essentially, the immune system gets confused about what is a normal part of the body and what isn’t. Because of this confusion, the immune system begins to damage various targets—in the case of rheumatoid arthritis, the target is the thin tissue lining the joints. Damage to the joints is due to both the direct damage from immune cells and from inflammation.
RA usually starts in the small joints of the hands and feet—leaving them tender, warm, red, and swollen. The pain is usually worse in the morning and after a period of rest. RA can then move to wrists, knees, ankles, elbows, hips, and shoulders, usually affecting both sides of the body. RA can also damage the skin, eyes, lungs, heart, and other organs.
As it turns out, CBD is not only an anti-inflammatory substance that reduces pain, but it can also act as an immunosuppressive agent and reduce the immune response.
Just as with osteoarthritis, the human studies on RA are just beginning.
- A preliminary study on Sativex, which contains CBD and THC in a 1:1 ratio (in an oral spray form), concluded that “a significant analgesic effect was observed and disease activity was significantly suppressed following Sativex treatment.”
- A recent review pointed out that the cannabinoids, including CBD, have significant potential in treating diseases with both an immune and an inflammatory component, and the review specifically mentioned RA as potentially benefiting from CDB.
The conclusions were that using CBD for arthritis and joint pain is a promising approach to pain relief.
How CBD Works on Arthritis Pain and Inflammation
We are still learning, and there are lots of details and lots of possibilities. Pain is a complicated problem—there are at least three different mechanisms for pain and at least four major theories describing how pain is felt.
CBD appears to reduce pain in both direct and indirect ways—a good thing, because that likely means that CBD can reduce different types of pain in arthritis and other diseases where joint pain is an issue.
- CBD can delay the degradation and reuptake of the naturally produced endocannabinoids AEA and 2-AG.
- Antidepressants like SSRIs (selective serotonin reuptake inhibitors) work by increasing the levels of serotonin by decreasing the amounts sucked back into a nerve cell. CBD appears to work in the same way. The end result is that the endocannabinoids stay in the system longer—so the conclusion is that using CBD for arthritis should be effective.
- Anxiety is often a component of pain, and CBD can help reduce the anxiety associated with pain by activating serotonin (sometimes known as the “happy hormone) pathways.
- CBD can interact with several different surface receptors (about 70 have been identified so far). Overall, these interactions reduce inflammation and pain.
- CBD can affect the function of some receptors associated with pain by changing the shape of the receptor just a bit—it’s a bit like jamming a lock. When it does that, the real key won’t work as well. In this case, that means the sensation of pain isn’t transmitted to the brain as well.
In summary, there seems to be a great deal of promise in using CBD for arthritis and joint pain, due to the way it decreases the inflammation associated with the joints.
Summary of Results on CBD for Arthritis and Joint Pain
Animal studies have been convincing, and we are beginning to see the results of the first well-controlled and well-done human studies. Animal studies are also great to determine possible side effects of CBD on animal models of arthritis. At the doses used, there appear to be very few adverse effects—and the ones that were seen were very mild (nausea and fatigue for the most part, and these tend to decrease with time). We have known for a long time from many people’s experience with cannabis, that cannabinoids can be useful for reducing the pain and inflammation of arthritis. It’s nice to know that the scientific world is catching up now!
Overall, using CBD for arthritis and other joint pain is a promising approach and may be worth a try.