CBD for arthritis: What the research shows

CBD has shown benefits for many health conditions, including arthritis. Here’s what the research shows

CBD shows promise in reducing the side effects of arthritis, but more long-term studies are needed to examine whether it can prevent and fully treat the condition.

CBD is short for cannabidiol (CBD), a popular cannabinoid found in the cannabis plant. Cannabis is an incredibly unique and complex plant, full of compounds that give it its characteristic effects, taste, and smell. Compounds include cannabinoids like CBD and THC, terpenes, flavonoids, lipids, and other plant compounds. CBD is popular and widely appreciated for its well-tolerated nature and its vast range of therapeutic effects that can benefit our physical and mental wellbeing.

Arthritis is a common condition that affects individuals of all ages and causes inflammation and joint pain. The individual symptoms experienced will depend on the type of arthritis. Still, they generally include joint pain, tenderness, stiffness, high inflammation levels, weakness, and restricted movement around the joint (1). Two of the most common types of arthritis are rheumatoid arthritis and osteoarthritis. While there is currently no cure for arthritis, treatments including surgery, physiotherapy, and medication have been successful in slowing down arthritis for many patients.

Arthritis and CBD

CBD has already been utilised to ease and assist many health conditions, including insomnia, anxiety and depression, nausea and chronic pain. Under the umbrella of chronic pain conditions is arthritis. While studies are still in their infancy, the results are promising.

Traditional medication for arthritis varies, but usually includes a mix of different options (2):

• Painkillers to reduce pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation.
• Counterirritants to interfere with the transmission of pain signals.
• Corticosteroids to reduce inflammation and suppress the immune system.
• Biologic response modifiers to target various proteins involved in immune response.
• Disease-modifying antirheumatic drugs (DMARDs) to restrict your immune system from attacking the joint.

While these medications are effective, safety from long-term use is often questioned. Repeated use of these drugs has been shown to damage the arthritis patient’s heart, liver, stomach and kidneys. When doses are too high or taken for a prolonged period, this can also cause liver damage in some instances (3).

More patients are becoming aware of alternative treatment methods like lifestyle changes or physical therapy. In addition, natural medication alternatives like CBD have risen in popularity as an option with fewer adverse side effects.

The Endocannabinoid system CBD can lower inflammation and pain by its interaction with the endocannabinoid system (ECS). The ECS is a complex cell-signaling system responsible for regulating body processes, including our mood, metabolism, energy levels and pain output. The ECS consists of endocannabinoids, cannabinoid receptors and receptor proteins. Cannabinoids like CBD can interact with receptors in our brain and nervous system and cause an uptake of certain compounds and hormones (4).

CBD can influence how our brain perceives pain and increases the level of serotonin by interacting with serotonin receptors (5). This creates feelings of relaxation in our brain and body, which can help reduce the intensity of arthritis side effects.

Cannabinoids can also block specific receptors that influence inflammation and pain within the body. In particular, CBD can block receptors that allow for levels of anandamide, an endocannabinoid, to increase in the body (6). This affects the way receptors respond to signals that they receive, reducing both inflammation and pain.

Studies on arthritis and CBD

The relationship between CBD and common health conditions like chronic pain has long been a topic of interest. Researchers have begun to branch out to similar conditions like arthritis, in particular, rheumatoid arthritis. This autoimmune and inflammatory disease causes the immune system to attack healthy cells, usually resulting in one of several joints being attacked.

One of the first trials that investigated the effectiveness of cannabis-based medication to treat rheumatoid arthritis involved patients who used Sativex, a spray containing cannabis extract, over five weeks. Participants found the drug was effective in reducing inflammation and pain while also contributing to improved sleep quality. Any reported side effects were mild and did not affect the patient’s quality of life (7).

Another study involving rats looked at the topical application of CBD gels for joint pain and inflammation. Researchers found that the transdermal absorption from the CBD was sufficient enough to reduce joint swelling and reduce pro-inflammatory biomarkers. They concluded that topical CBD application has strong therapeutic potential for relief from arthritis and inflammation-related conditions without extreme adverse side effects (8).

While preliminary research is highly promising, more long-term and large-scale studies involving human participants are still required for researchers to comprehend the effects of CBD on arthritis symptoms fully.

CBD as a preventative treatment

Arthritis is incredibly common and affects individuals from all walks of life. With the rise in the prevalence of different types of arthritis, significant attention has been given to preventing this disease.

The causes of arthritis are complex and can result from several risk factors that create a compounding effect (9). These include:

• Your family history and genes. This makes you more susceptible to environmental factors, and because of this, you may be more likely to develop arthritis if an immediate family member has the disorder.
• Your age. Risk factors generally increase with age.
• Your gender will affect what type of arthritis you develop. For example, women are more likely to develop rheumatoid arthritis.
• A previous joint injury can increase the probability of that joint developing arthritis.
• Being obese and carrying extra weight can stress joints, mainly your knees, hips and spine.

While patients cannot control most of these risk factors, one that can be monitored is obesity. It is well acknowledged that obesity is highly influenced by lifestyle choices like diet, exercise, sleep and even stress levels (10). This means incorporating a healthy and well-balanced diet with lots of fresh fruits and vegetables, increasing the frequency of exercise, practising mindfulness, and getting good quality sleep.

CBD can help reduce stress and improve your quality of sleep by its interaction with the ECS. When it interacts with cannabinoid and serotonin receptors in your brain and nervous system, it can improve your mood, promote relaxation, and reduce feelings of anxiety (11).

CBD as a treatment for arthritis side effects

Arthritis is a complex autoimmune disease that can cause your body to attack joints, and over time, it destroys bone and cartilage that leads to the loss of joint function and stability. While symptoms of arthritis can vary, depending on the individual and how severe the disease progression is, some common side effects are often experienced across the board.

Chronic pain

Chronic pain can result from an injury or illness like arthritis and is classified as high levels of pain that last over a few months and remain persistent even after full recovery. While the level of chronic pain can vary, depending on the individual, it can be severe and drastically affect the arthritis patient’s quality of life (12).

Pain is one of the most reported side effects of arthritis, and while painkillers can manage it, the side effects of these medications on top of what is already taken to treat arthritis can be detrimental to the patient’s health long-term. Because of this, more individuals are seeking natural and more gentle pain-relief options, like CBD. CBD oil remains a popular choice for many patients as studies have shown its effectiveness in reducing the severity of chronic pain output.

A 2017 review investigated CBD use for general chronic pain and summarised the key findings from various studies. After analysing the results of dozens of trials and reviews, researchers concluded that substantial evidence pointed at cannabis being a suitable treatment option for adults who experience chronic pain (13).

Another study supported these findings, with researchers noting that CBD and other cannabinoids could offer a new and effective treatment option for chronic pain patients by reducing inflammation and pain. They also concluded that patients were unlikely to build up a tolerance to the potent effects of CBD, which was beneficial, as this meant the dosage did not need to be increased over time (14).

CBD is a popular cannabinoid, but it doesn’t create euphoric “high” and psychoactive effects like THC, another cannabinoid found in cannabis. Researchers in a 2015 study suggested that when CBD worked in conjunction with other cannabinoids, it can influence receptor systems within our body and the ECS. Anandamide is a compound that has been associated with reducing pain perception and improving mood in individuals, and CBD can increase the levels of anandamide in our body (15).

Swelling and inflammation

Another commonly expressed side effect of arthritis is joint swelling and widespread inflammation. Most but not all types of arthritis are the results of inflammation from the immune system. In a healthy individual, the body produces white blood cells and compounds to protect from infection (16). However, in inflammatory conditions like arthritis, the immune system will trigger a response that causes damage to its own tissues.

Cannabinoids like CBD have been seen to suppress inflammatory responses, which can reduce arthritis symptoms. Cannabinoids have potent properties that regulate pathways involving the suppression of cytokines in inflammatory sites and activating apoptosis within immune cells. Due to this, researchers believe CBD could be a beneficial preventative treatment for diseases that involve chronic inflammation within the body, like arthritis. However, more research is still required (17).

Joint pain experienced by the arthritis patient can also exacerbate inflammation levels as pain and inflammation have a close relationship and often walk hand-in-hand in many diseases. Inflammation can be chronic or acute. Arthritis patients have chronic inflammation due to a prolonged inflammatory response which can increase oxidative stress, directly affecting healthy organs and tissues (18).

Reduced appetite

Another common side effect of arthritis is reduced appetite or weight loss due to the extreme pain and stiffness that can directly affect the patient’s quality of life, mood, metabolism, and affinity for food or eating. Some arthritis medications can also affect appetite, resulting in unintentional weight loss.

A 2016 study found that the medication leflunomide, commonly prescribed to patients with rheumatoid arthritis, was associated with weight loss. This is because leflunomide can cause nausea, diarrhoea, and changes in bowel habits, all of which can influence weight management (19).

Long-term appetite loss can adversely affect the patient, as this could lead to insufficient nutrient intake and fatigue due to extreme muscle loss. Most studies that research the relationship between CBD and appetite have shown variable data, with some showing weight gain and others showing distinct weight loss (20). Despite the inconclusive research, researchers conclude CBD has a potent effect on hunger and appetite.

Another study investigated the relationship between CBD and nausea and found noticeable results. Research from 2011 suggests CBD and its interaction with the endocannabinoid system lead to the regulation and reduction of vomiting and nausea in both animals and humans (21).

As a common cause of arthritis can be excess weight or obesity, a reduced appetite or weight loss can prove beneficial in improving their health and reducing their symptoms. However, for patients at a healthy weight or who are already underweight, unintended weight loss and a decreased appetite can be harmful to their health.

The bottom line

CBD shows promise in reducing the common side effects and symptoms of arthritis by interacting with the ECS to lower inflammation and reduce the perception of pain.

Because of this, many arthritis patients are beginning to use CBD in conjunction with traditional medication. While current research is promising, more studies are required to increase the global therapeutic use of CBD.

References

1. https://www.ncbi.nlm.nih.gov/books/NBK518992/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422329/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681678/
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877694/
5. https://pubmed.ncbi.nlm.nih.gov/30157131/
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3316151/
7. https://pubmed.ncbi.nlm.nih.gov/16282192/
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4851925/
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5920070/
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859313/
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552517/
13. https://www.ncbi.nlm.nih.gov/books/NBK425767/
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371734/
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604191/
16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5091071/
17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/
18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147972/
19. https://onlinelibrary.wiley.com/doi/full/10.1002/art.39647
20. https://pubmed.ncbi.nlm.nih.gov/25935511/
21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3165951/

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