By: Elements of Green
Arthritis is a painful and sometimes even debilitating condition which affects millions of people across the UK, Europe, and the world. CBD is known for its analgesic (pain-fighting) qualities, and it appears to assist the immune system. So can CBD help with arthritis pain? Plenty of people are using CBD already to help with arthritis. A survey last year in the United States by The Arthritis Foundation found that 79 percent of arthritis sufferers have used CBD, were using it at the time of the survey, or were considering CBD use. This article reviews the research into whether CBD can be a part of an arthritis treatment plan.
One important thing to know is that arthritis is not a disease itself. It is more of a general term for joint pains and diseases. There are over 100 different kinds of arthritis and conditions related to arthritis. Arthritis is often associated with aging, and it is more common among older people and it generally increases in severity with age. But more than two thirds of people with arthritis are under the age of 65, and there are some types of arthritis which primarily affect children.
The dozens of kinds of arthritis can be put into three main classes.
- Osteoarthritis: Also known as degenerative arthritis, osteoarthritis is the most common type of arthritis. In osteoarthritis, the cartilage which cushions the ends of our bones, wears away and leaves the bones to rub directly against each other. In turn, the rubbing causes pain, swelling, and joint stiffness.The risk factors for osteoarthritis include obesity, family history of osteoarthritis, age, and a previous injury which did not heal properly. People who have osteoarthritis or who are at risk of it are advised to get regular physical activity and lose weight if appropriate. For cases with more severe pain, often over the counter pain-killers such as paracetamol or ibuprofen are used. In some cases, a joint needs to be replaced surgically with an artificial joint.
- Inflammatory Arthritis: An inflammatory arthritis is one associated with an unhealthy immune system. Rheumatoid arthritis, gout, and psoriatic arthritis are all examples of inflammatory arthritis. Fibromyalgia is a disease closely associated with inflammatory arthritis. Many inflammatory arthritis diseases are genetic, and many can be triggered by environmental factors like cigarette smoking, alcohol overuse, and sweetened beverages. Pain reduction is a major goal of inflammatory arthritis just as with other forms of arthritis, but early diagnosis and aggressive treatment can cause remission of many forms of inflammatory arthritis, and a set of drugs called disease-modifying antirheumatic drugs (DMARDS) have been developed which can help.
- Infectious Arthritis: Some forms of arthritis are caused by a bacteria, virus, or fungus. In these cases, the invasive agent enters the joint and triggers inflammation. Treatment for pain is common when an infectious arthritis occurs, but more important is that in many cases an antibiotic, antifungal, or antiviral drug can often clear up a case of infectious arthritis permanently.
Treating arthritis depends on the kind of arthritis one has, but one treatment common to almost all forms of arthritis focuses on reducing pain.
What is CBD?
CBD, or cannabidiol, is a compound found in the hemp plant. For thousands of years, CBD was an “undiscovered” part of the plant. Most people interested in cannabis focused on THC, the psychoactive compound in cannabis. Unlike THC, CBD will not make the user high. More recently, people have been discovering that CBD could help them even with very little or no THC. People use CBD for stress and anxiety, for sleep regulation, for energy, and most importantly for arthritis sufferers, for pain.
CBD works by interacting with the endocannabinoid system, a recently discovered part of all our bodies which is associated with regulating inflammation, reducing the perception of pain, boosting the immune system, and more. All of us have a few naturally occurring endocannabinoids and CBD works with the same receptors which our own cannabinoids do. Specifically, many of the cells in our bodies have what are called the CB1 and CB2 receptors. CB2 receptors are mostly in the human immune system. CB1 receptors are in our nervous systems, especially in the brain. CBD is also believed to interact with the TRPV1 receptor in a different system. The CB1 and TRPV1 receptors are associated with pain and how we perceive it.
CBD and Arthritis
CBD-specific related research is in its infancy, as it only started becoming popular a few years ago. But because of all the reports from users about CBD and pain relief, scientists quickly seized on pain relief among arthritis sufferers as a research area. Some of the studies are looking at CBD in combination with its psychoactive cousin, THC. Others are looking at CBD alone.
An early (2015) study in rats indicated that CBD delivered by means of a topical CBD gel reduced pain, and joint swelling and improved immune response. A 2017 study backed that up and also found that CBD prevented nerve damage. In Denmark, researchers are currently recruiting for a study of CBD to treat osteoarthritis in the hand and in psoriatic arthritis. American scientists in New York State are planning a study using a CBD patch to alleviate pain in those with osteoarthritis of the knee. And in Canada, researchers are in the early stages of a study to see if CBD might help with pain associated with knee replacements among patients who had knee osteoarthritis.
While the studies will be important and may usher in new specific treatments, arthritis sufferers are not waiting around, and neither are arthritis groups. Treatment for pain is among the top reasons people choose to start using CBD and arthritis sufferers are no exception. As mentioned, nearly 80% of arthritis sufferers have used CBD or are thinking about it. That same survey also found that three quarters of current CBD users found it effective or very effective in helping to manage arthritis symptoms. Pain is by far the most common relief people seek and find, but survey respondents also reported that CBD helped reduce morning stiffness, improve sleep, and reduced fatigue.
One area of use that emerged from the study is that many arthritis sufferers use CBD because it is not addictive like opioids are. Opioids are not a good choice for most arthritis sufferers because they are supposed to be used only for short period because of the chance of addiction. However, for some patients, opioids were the only option when other pain relievers failed. CBD is a potential substitute for opioids. Additionally, opioids are sometimes prescribed to arthritis patients as a short-term pain relief following joint replacement surgery. Some of the people who had undergone that procedure reported that CBD helped them wean themselves from the opioids.
The Senior Faculty Editor of Harvard Health Publishing recommends that “if CBD can safely improve your symptoms, it may be worth considering.” The Arthritis Foundation lays out guidelines for buying CBD and shared that some, but not all, people report noticeable pain relief, a reduction in anxiety, and/or better sleep.
Another area for CBD research in the future will be on whether CBD’s effect on the immune system might be helpful for some forms of inflammatory arthritis. That effect would be more difficult to observe anecdotally, so we will have to wait for specific studies to see of CBD can help with that aspect of arthritis.
CBD is generally well-tolerated by adults and few people see any side effects. CBD’s interaction with drugs is something which has not been well studied, so if you are using CBD for arthritis pain or you are thinking of starting to use CBD, have a discussion with your physician about the drugs you are taking, whether they are simply over the counter pain relievers or more arthritis-specific drugs.
Using CBD for Arthritis Pain
If you decide to take CBD for your arthritis pain and have discussed any drug interactions with your doctor, one big decision you must make is how to get the CBD to the joints which are experiencing arthritis pain.
The most common way to take CBD is as an oil. CBD oil is introduced into the mouth but not swallowed. Instead, CBD oil users put the oil under the tongue and allow it to be absorbed by the mucosal membranes there.
There are two other ways which might be more appealing to many arthritis sufferers. Edibles are an increasingly popular way to take CBD. In the case of edibles, the CBD oil has been mixed into a food product instead of being combined with another oil. CBD Gummies are among the most popular edibles and are sometimes combined with other things which are good for you, such as vitamin A for bone strength and a boost to the immune system. Sometimes CBD is mixed into a tea blend or a protein powder, or even a chocolate cookie. You then eat or drink the CBD as part of the food or drink made from it. When consuming an edible, CBD is taken into the body by the liver. Some people find CBD to be metabolized that way to have different effects from CBD which is taken into the body by the mouth. And of course, it’s more fun to eat a sugary gummy or a rich chocolate cookie than it is to dissolve oil in the mouth, so some people find it easier to remember to use their CBD when it is in an edible product. Everyone’s experience is slightly different, just as people have differing reactions to a medication, for example.
The other way to take CBD which may be especially helpful to arthritis suffers is as a topical. These creams, balms, and gels are similar to other skin care products but they have CBD. The idea behind a topical is to apply the CBD right where it hurts. It is absorbed by the skin and makes its way to the joints, reducing pain and inflammation along the way. CBD topical products are often made with other ingredients which fight pain or otherwise make the skin feel better such as menthol, capsicum, and aloe vera.
Some arthritis sufferers use multiple methods to take CBD, such a lotion in combination with an edible or an oil. In those cases its helpful to be mindful that the UK Food Safety Agency recommends a maximum daily dose of 70 mg/day of CBD. All of the products on the Elements of Green website deliver CBD under the UK’s recommendation but of course someone using two product will want to make sure that the combined effect is under the recommendation.
As The Arthritis Foundation wrote, CBD works for some people and not for others. Sometimes if CBD is not working it is worth trying a few different products to see whether a different formulation or method of taking CBD works better for you than others. Some people benefit from a “broad-spectrum” CBD product, one which also has other non-psychoactive cannabinoids such as CBN or CBG. Others get a better effect from CBD alone. At Elements of Green, we have written a guide which takes you through some of the reasons why CBD might not be working for you and what to do about it.
As mentioned in the guide, one big reason CBD might not be working is that you might not be buying a very good CBD product. The Arthritis Foundation was clear on that point. There are a lot of suspect makers of CBD right now. A British study last year found that fully half of the CBD products it tested had less CBD than advertised and some had no CBD at all! Of course CBD is not going to work if you think you are taking it but in truth are not getting any CBD. At Elements of Green, we insist that all of the products we make available to you are lab tested for potency and purity.