CBD Oil for Arthritis Pain: Does It Relieve Symptoms?
Cannabidiol oil, known as CBD oil or hemp oil, is all the rage these days, touted as a panacea for everything from cancer pain to depression and anxiety. Some research has indicated that it can relieve the pain of various forms of arthritis as well. CBD oil contains extracts from cannabis plants, which is the same plant family that marijuana (pot) comes from.
But let’s get this out of the way: CBD is not the same thing as pot and it will not get you high. The only thing the two have in common is that they are both derived from members of the cannabis family. Marijuana is the plant that contains tetrahydrocannabinol (THC), the psychoactive substance that induces the “high.”
CBD is not the same thing as pot and it will not get you high.
While marijuana contains some CBD, it is grown for its THC content. The hemp plant is the one that provides the source for the majority of the CBD oil products on the market today. Hemp contains an insignificant amount of THC (less than 0.3 percent); in contrast, marijuana can contain anywhere from 5 percent to 35 percent.
Some people have started using CBD oil to help relieve pain and lower inflammation, but the jury’s still out on whether or to what degree using it can help people with arthritis. Here’s what we know so far:
CBD Oil and Arthritis Pain Relief
The mechanism responsible for CBD’s positive health effects is not entirely understood, but researchers believe that the compound attaches to receptors in the body known as cannabinoid receptors; these may, in turn, cause the body to produce natural cannabinoids.
CBD oil doesn’t affect your brain the same way that THC does. THC interacts with different receptors in the brain than does CBD. According to Healthline, CBD oil interacts with two receptors, called CB1 and CB2, which can help reduce pain and the effects of inflammation.
“These receptors are primarily involved with coordination, movement, pain, emotional output, and the immune system,” explains Faye Rim, MDD, a physiatrist and pain management specialist at the Hospital for Special Surgery in New York City.
CB2’s involvement in immune system could help explain why CBD oil may be helpful in people with inflammatory autoimmune forms of arthritis, like rheumatoid arthritis (RA).
Dr. Rim says some of her arthritis patients have found relief, but she points out that CBD oil is only intended for use as an adjunct to medications, not as a first-line treatment.
How Do You Use CBD for Arthritis Pain?
CBD can be taken as a liquid, a tincture, in capsules, or applied topically. You can take the capsules orally, add the liquid to foods or drinks, or apply creams with CBD to affected joints. Read more about to start using CBD products for arthritis pain.
Mild side effects of using CBD may include sleep problems or nausea. The topical CBD arthritis cream occasionally causes an allergic reaction, so test it on a small area of skin first.
Most studies on CBD and arthritis have been done on rodents, including one published in a 2017 issue of the journal Pain that suggests CBD oil may relieve joint pain in osteoarthritis. A study in a 2016 issue of Arthritis Care and Research found that CBD oil may improve pain relief, sleep, and quality of life in some rheumatoid arthritis (RA) patients, but the sample size was extremely small, making the study mostly insignificant.
As Medical News Today reports, “there a lack of scientific evidence to prove conclusively that CBD is an effective arthritis treatment for humans.” More research, especially on bigger groups of human participants, will need to be conducted to better understand how CBD oil affects arthritis symptoms like pain, inflammation, and fatigue.
“I find it’s hit or miss,” says Dr. Rim. “[CBD] helps some people and has no effect on others, but I recommend that my patients try it, as there don’t seem to be any problematic drug interactions or major side effects.”
Currently, the FDA has approved CBD oil only for use in people with two rare and severe forms of epilepsy. It is not approved for the treatment of arthritis or chronic pain.
What to Know Before You Buy CBD
Because CBD products are currently unregulated — and often imported — it is very difficult to know exactly what you’re getting, and how much of it, in any given formulation.
This lack of regulation can result in products that vary widely in quality, Marcel Bonn-Miller, PhD, an adjunct assistant professor of psychology in psychiatry at the University of Pennsylvania School of Medicine, told HealthDay News.
Furthermore, CBD is legal in most states, but not all. Make sure you understand your state’s laws before purchasing or taking CBD oil.
When recommending CBD oil to her patients, Dr. Rim says she has no specific dosages or brands in mind. “I generally refer them to a health food store and encourage them to try a small amount at first and to increase if it’s well-tolerated.”
The hope, she says, is that we will have more definitive data on dosages and quality products over time.
You should check with your doctor before trying CBD oil to make sure it’s safe for you and won’t negatively interact with any medications you take.
CBD oil and joint pain
Joint pain affects millions of people around the world and is associated with a wide range of conditions and ailments. Some of the most common reasons for joint pain are musculoskeletal conditions and inflammatory diseases, yet few studies have addressed these.
Currently, treatment typically consists of drug therapy, including the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and weak opioids. Non-pharmacologic treatment plans include cognitive behavioral therapy, stress management, and patient education in self-management programs.
Based on the ways in which CBD oil impacts key brain receptors, it shows promise for those seeking an alternative treatment option in the hopes of reducing pain and inflammation. It may also address conditions related to chronic pain, including anxiety and sleep disorders.
Research overview
While studies are limited in regards to the effect of CBD oil on joint pain, researchers have identified a clear relationship between the two. Scientists have found that CBD appears to inhibit or activate key compounds which influence the ECS, including anandamide. This compound is associated with pain reduction, and CBD helps reduce its absorption. As CBD levels increase in the bloodstream, the amount of perceived pain may lesson. This means that CBD may help the body use the ECS more effectively.
In animal studies, CBD has been shown to reduce inflammation and relieve joint pain without inducing significant side effects. However, human studies are limited, and the results are mixed. More comprehensive studies are required.
The studies
A 2016 study, published in the European Journal of Pain, examined the efficacy of topical CBD in rats. It was found that the application of CBD significantly reduced joint swelling, as well as limb posture scores as a rating of pain. It was concluded that topical CBD offers therapeutic potential for pain-related inflammation and behaviors associated with arthritis.
Another study, published in the journal Pain, focused on CBD pain prevention in relation to rat osteoarthritis. Upon studying osteoarthritis in rats, it was found that CBD blocked joint pain in a dose-dependent manner. In addition, prophylactic CBD administration prevented the future development of nerve damage and associated pain in the arthritic joints. The researchers concluded that CBD may be a safe treatment option in mammals, targeting pain while blocking the inflammatory responses that drive disease progression.
Patient perspectives
Billy Evans, 34, has been using CBD oil, as well as CBD creams and salves, in order to address his joint pain and muscle spasms. “I currently live in the United States and am in need of a shoulder replacement,” Evans told Weedmaps News. “Upon using CBD oil, I was able to get off of three different muscle relaxers, as well as some of my pain medications.”
Kayleigh Shanna, 31, is both a patient and industry expert, working as a cannabis sommelier, consultant, and master grower. “I originally began taking CBD oil in order to better treat my symptoms of depression and anxiety,” Shanna said. “However, I also suffered from pain and sleep disturbances as a direct result of my mood disorder, both of which significantly improved after I began taking CBD oil daily.”
Brendon James, 30, first became a medical patient in 2010 following a major car crash. After severely damaging his foot, he was living in constant pain. “I was given everything from pain medications to nerve suppressants and opioids, but the side effects made me seek alternatives,” James said.
He continued, “Today, I have been taking high-CBD strain cannabis and oil derivatives for nearly a decade. This treatment option has helped considerably with the pain, as well as my ability to cope with life alterations associated with nearly losing my foot. The pain will never fully go away, but CBD has helped reduce the associated inflammation. There have been no notable side effects and I am in no way addicted to it. I am now in control of my pain — not the other way around.”
What the experts say
Dr. Bonni Goldstein is a medical adviser to Weedmaps.com, author of Cannabis Revealed, and Medical Director of Canna-Centers in California. She says CBD can help reduce inflammatory discomfort. “CBD is a potent anti-inflammatory and can decrease joint pain in patients with arthritis and other conditions that cause joint inflammation. Patients often report better mobility and an ability to decrease the use of NSAIDs with CBD use.
“An elderly woman was brought to my office by her adult daughter. The elderly lady was experiencing pain from osteoarthritis in her knees that began to affect her mobility. The patient began taking a 25:1 CBD:THC ratio edible, resulting in almost complete resolution of pain and improved mobility,” Goldstein said.
“Plants all over the world have evolved thousands of their own chemicals that just by coincidence are useful in treating human illnesses,” says Dr. Paula Williams, a physician at Apollo Cannabis Clinics, a medical cannabis care center in the Toronto area. “It turns out that the nervous system has neural pathways that use the body’s own cannabinoid receptors. Cannabinoids interact with the CB1 and CB2 receptors in various ways to increase natural pain relief. These are not the same as opioid receptors, which is one reason why cannabis does not tend to be addicting when used for pain relief.”
Williams recommends using CBD and THC in tandem for joint pain relief.
“I’ve been prescribing medical cannabis to patients in my pain practice, hundreds of them, for about 10 years,” Williams says.
“There are many kinds of joint pain, but one of the most common sources of pain is arthritis,” states Adie Rae, Ph.D., a subject matter expert for Weedmaps who has extensively studied the endocannabinoid system. “Both rheumatoid and osteoarthritis patients report using topical CBD oil to manage their symptoms. The true efficacy of these products has not been studied in clinical trials, but in animal models of arthritis, topical CBD effectively reduces pain and inflammation.”
Bottom line
Many patients report using CBD to relieve symptoms of joint pain. Animal models have shown positive effects, especially in relation to arthritis. However, at this time, more scientific research is required in humans to determine dosing and overall safety guidelines.
Rae added, “An important consideration for patients choosing to explore topical CBD for joint pain is the formula or makeup of the product. Some CBD oils are diluted in carrier oils that are not very compatible with the skin, whereas other plant-derived oils can enhance skin penetration (jojoba oil, for example). Also, eucalyptus, rosemary, and citrus oils have been shown to increase the skin penetration of other medications, so topical CBD products that also contain these ingredients could yield better results.”
