Arthritis Treatment

Arthritis is a common chronic condition characterized by joint inflammation, pain, and stiffness. The two most prevalent forms are osteoarthritis (OA) and rheumatoid arthritis (RA).

Current treatments often provide inadequate symptom relief and can have side effects. This has led many patients to explore alternative therapies like cannabidiol (CBD), a non-intoxicating component of cannabis.

Several preclinical studies using animal models of arthritis have yielded promising results:

• Transdermal CBD gel significantly reduced joint swelling, spontaneous pain, immune cell infiltration and synovial membrane thickening in a rat model of Rheumatoid Arthritis.
• Oral CBD treatment decreased clinical signs of arthritis and cartilage degradation in a mouse model of Osteoarthritis. 
• CBD reduced inflammatory biomarkers in the spinal cord and dorsal root ganglia in a rat Osteoarthritis model, suggesting it may target central and peripheral pain pathways

To date, only a few small clinical studies have evaluated CBD for human arthritis:

• In a RCT of 97 Osteoarthritis and Rheumatoid Arthritis patients, a CBD/THC mouth spray (Sativex) improved pain and sleep quality compared to placebo over 5 weeks.
• A RCT found no significant benefit of oral CBD (20-30 mg/day) vs placebo for reducing pain and inflammation in 129 patients with hand Osteoarthritis or psoriatic arthritis over 12 weeks. Note, this is a lower dose than many patients use for their arthritis.
• An observational study of 428 patients with hip or knee Osteoarthritis found that 22% of those taking CBD products (oral or topical) reported clinically meaningful pain reductions.

While these initial findings are mixed, larger and longer trials are needed to fully assess CBD’s therapeutic potential for managing Osteoarthritis and Rheumatoid Arthritis Symptoms. 

‍Arthritis patients are increasingly using over-the-counter CBD products to self-manage their symptoms, despite limited clinical evidence. Common routes of administration include:

• Oral: oils, capsules, edibles 
• Topical: creams, balms, patches
• Inhaled: vaping

Topicals allow for localized application to painful joints, while oral products provide more systemic effects. Most patients start with low CBD doses (5-10 mg) 1-2 times daily and gradually increase as needed and tolerated. However, optimal dosing for arthritis remains unclear. 

‍Some potential side effects to monitor include fatigue, diarrhea, appetite and weight changes, and elevated liver enzymes [15]. CBD can also interact with certain medications. Patients should consult their doctor before using CBD, especially if taking other arthritis drugs.

The current evidence suggests CBD may help reduce arthritis-related inflammation and pain, but more research is needed to establish its efficacy and safety. Most supportive data come from preclinical animal studies, with mixed findings from the few small clinical trials conducted so far.

‍Despite the limited clinical evidence, many arthritis patients are experimenting with CBD products to manage their symptoms. A survey of 428 patients with hip or knee Osteoarthritis found that 54% were considering CBD use and 7% currently used it, primarily learning about CBD from friends or media rather than healthcare providers. 

This widespread interest in CBD highlights the unmet need for better arthritis treatments, as well as the importance of further clinical research and physician education on this topic. Patients should be aware that CBD products from markets, green fairies and the like, are not regulated like prescription drugs, so quality, cannabinoid quantities and labelling accuracy may vary considerably. 

‍While CBD shows therapeutic potential for easing arthritis symptoms based on preclinical evidence and patient anecdotes, more large-scale human studies are necessary to determine appropriate dosing, long-term safety, and interaction risks. Until then, patients interested in trying CBD for arthritis should discuss it with their doctor to weigh the potential benefits and risks for their individual situation.