Arthritis is a rheumatic disease involving the swelling and pain of at least one joint and its surrounding tissues.1 The term “arthritis” actually refers to over 100 types of diseases and conditions.
Symptoms of rheumatoid arthritis are thought to have been first described in the year 1800, but Hippocrates and other ancient Greeks may have written about similar symptoms thousands of years earlier.2
Arthritis is the leading cause of disability in the United States, affecting about 1 in 4 adults and 300,000 children.3 With osteoarthritis (OA), the most common form of arthritis, the cartilage of the joint breaks down and the bone underneath it weakens.
Many types of arthritis involve inflammation. A recent study determined that exercise can reduce arthritis-related inflammation by promoting production of endocannabinoids, the naturally occurring compounds within the body that work with the endocannabinoid system.4 Which begs the question: can the cannabinoids found in medical marijuana help alleviate arthritis symptoms? And if so, which is better for arthritis pain: THC or CBD?
What Causes Arthritis?
Although many types of arthritis have specific causes and risk factors, others – like rheumatoid arthritis – are less clear. While some uncertainty remains around what triggers certain forms of arthritis, the most causes and risk factors include:
- Family history: If someone in your family has arthritis you are more at risk.
- Age: With certain types of arthritis, like OA, your risk grows as you age.
- Sex: Arthritis is more common in women, although gout is three times more prevalent in men.
- Post-traumatic injury: You are more likely to develop arthritis in a previously injured joint.
- Weight: People who are overweight or obese have a higher risk of developing arthritis due to the extra stress put on joints.
- Repeated Strain: Playing a sport or having an occupation that involves repeated stress on joints can lead to arthritis.
- Unhealthy habits: Smoking tobacco or a lack of regular physical movement can also increase your risk.
- Pre-existing conditions: Certain bacteria, viruses, and autoimmune diseases can cause you to develop arthritis.
Arthritis Signs & Symptoms
Signs of arthritis are typically most prevalent in the joints. If you have arthritis, you may experience one or more of the following symptoms:
- Pain
- Redness
- Swelling
- Stiffness
- Difficulty flexing the joint
- Warmth
- Tenderness
Sometimes arthritis can develop as a complication of certain conditions, such as:
- Autoimmune disease
- Psoriasis
- Inflammation
- Lupus
- Previous back strain or other injury
The various types of arthritis can have different rates of progression, but typically symptoms gradually worsen over time. If medication and physical therapy do not help, doctors will sometimes recommend surgery to repair, replace, or fuse the affected joint.
How Cannabis Can Help Alleviate Arthritis
As medical marijuana programs are implemented in more and more states, an increasing number of patients are turning to marijuana for their rheumatic diseases.5 Although early results are promising, much of the current research around marijuana for arthritis is either contradictory or not clinically significant, and experts continue to study its potential to address arthritis symptoms.6
- A 2018 animal study examined pain in dogs with osteoarthritis. After eight weeks of treatment with oral CBD oil, researchers observed a decrease in pain and an increase in comfort of the dogs, attributed to the CBD.7 A similar study later reinforced these results, suggesting that further research in humans is warranted.8
- Fibromyalgia sometimes develops in people with certain forms of arthritis. In 2011, researchers compared the cannabis use of 28 people with fibromyalgia to a control group of non-users. The results showed an association between cannabis use and relief of some symptoms of fibromyalgia.9
- A randomized study of 320 people with OA focused on dosage using a synthetic, topical CBD gel. Although knee pain did decrease, it was not a significant difference from the placebo group.10
- A recent study followed 40 patients using opioids for pain associated with OA. When they examined patients 6 months before and after a prescription for medical marijuana, researchers found that marijuana usage resulted in less opioid use and a decrease in daily pain.11
- A 2011 study by the American College of Rheumatology found that people with arthritis have a higher likelihood of experiencing depression, anxiety, and sleep disturbances.12
The results of these studies are hard to compare because they involve different conditions, methods, and participants.
A decrease of OA-related pain was associated with the use of cannabis but depended on the user and method of use. Marijuana may have the potential to address certain complications of arthritis, but larger human trials are needed to determine what cannabinoids are best for arthritis pain. There may also be some peripheral benefits to cannabis use for rheumatic pain, like a reduction of opioid use, but the reason for this needs to be studied further.
With an eager population and results that can be widely interpreted, it is of the utmost importance that research continues into whether (and how) medical cannabis can benefit people with arthritis. Even while noting the shortage of data on the safety and efficacy of medical marijuana, the Arthritis Foundation issued guidance about using CBD for arthritis pain.
Although there are no clinical guidelines for using cannabis for arthritis, CBD has shown promise in helping with related symptoms like pain, depression, and sleep. THC may also help with sleep and – in small doses – anxiety. With inconclusive scientific evidence, it is important to manage expectations about the outcome of using medical marijuana for these symptoms, while also noting that there can still be adverse effects (especially if using too strong a dose).
The side effects of cannabis can include disorientation, fatigue, and impaired coordination, which can exacerbate pain, mobility issues, or arthritis-related depression. Additionally, cannabis can interact with some medications that you may be taking while experiencing symptoms of arthritis. Make sure to consult with your healthcare provider before adding marijuana to your treatment plan.
Medical cannabis products containing only CBD – or CBD and lower amounts of THC – are most commonly recommended for someone with arthritis. Look for strains with terpenes like myrcene, caryophyllene, and limonene for their anti-inflammatory properties and potential to slow the progression of OA.13 Precise dosage with oral cannabis methods like tinctures, capsules, or teas and localized application of CBD or THC topicals for arthritis is recommended.
Legality and Doctor’s Recommendation
To determine if your state considers anxiety to be a qualifying condition for medical marijuana, check out our Laws & Regulations section for the medical cannabis rules for your state.
If you find that your state recognizes anxiety or its symptoms as a qualifying medical condition, you can seek a doctor’s recommendation to get your medical cannabis card in your state.
How NuggMD Can Help
NuggMD is the nation's leading medical marijuana technology platform, serving patients in 21 states and growing. We’ve connected over 1,000,000 patients with their new medical marijuana doctors face-to-face via our state-of-the-art telemedicine platform.
We believe that every human being has the right to explore the benefits of medical cannabis and are fully committed to helping each patient explore all of their options in their journey to wellness. For further information on whether you qualify for medical cannabis, select your state.
Frequently Asked Questions About Cannabis & Arthritis
Does CBD work for arthritis?
Although there is not a large amount of data around safety and efficacy, the Arthritis Foundation has issued guidance on the use of CBD for arthritis and research is ongoing.
Can marijuana help symptoms of arthritis?
Current research into the benefits of marijuana for symptoms of arthritis is not clinically significant, and most studies focus on the cannabinoid CBD. Preliminary evidence shows that CBD may have potential to improve certain symptoms of arthritis, and THC may be beneficial in small doses.
What is better for arthritis pain - CBD or THC?
Although there are no clinical guidelines around these cannabinoids for arthritis, there is more data on CBD, which shows potential to improve joint-related pain.
Sources:
1. “Rheumatic Diseases.” Mayo Clinic Health System, www.google.com/url?q=www.mayoclinichealthsystem.org/locations/mankato/services-and-treatments/rheumatology/rheumatic-diseases&sa=D&source=docs&ust=1672102900181783&usg=AOvVaw1IJLPgeT9WiSnYdqvTTlRp. Accessed 27 Dec. 2022.
2. Entezami, Pouya, David A. Fox, Philip J. Clapham, and Kevin C. Chung. 2011. “Historical Perspective on the Etiology of Rheumatoid Arthritis.” Hand Clinics 27 (1): 1–10. https://doi.org/10.1016/j.hcl.2010.09.006.
3. “Arthritis.” Centers for Disease Control and Prevention, 2019, www.cdc.gov/chronicdisease/resources/publications/factsheets/arthritis.htm.
4. MD, Peter Grinspoon. “The Endocannabinoid System: Essential and Mysterious.” Harvard Health, 11 Aug. 2021, www.health.harvard.edu/blog/the-endocannabinoid-system-essential-and-mysterious-202108112569.
5. Fitzcharles, Mary‐Ann, Emmanouil Rampakakis, John Sampalis, Yoram Shir, Martin Cohen, Michael Starr, and Winfried Häuser. 2020. “Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada.” ACR Open Rheumatology 2 (5): 286–93. https://doi.org/10.1002/acr2.11138.
6. MS, Veena Ranganath, MD, and University of California, Los Angeles. “Randomized, Double Blind, Placebo-Controlled Trial to Evaluate the Safety and Tolerability of Cannabidiol (CBD) in Moderate to Severe Rheumatoid Arthritis.” Clinicaltrials.gov, 5 Oct. 2021, clinicaltrials.gov/ct2/show/NCT04911127?term=cannabis&cond=Rheumatoid+Arthritis&draw=2&rank=3.
7. Gamble, Lauri-Jo, Jordyn M. Boesch, Christopher W. Frye, Wayne S. Schwark, Sabine Mann, Lisa Wolfe, Holly Brown, Erin S. Berthelsen, and Joseph J. Wakshlag. 2018. “Pharmacokinetics, Safety, and Clinical Efficacy of Cannabidiol Treatment in Osteoarthritic Dogs.” Frontiers in Veterinary Science 5 (July). https://doi.org/10.3389/fvets.2018.00165.
8. Verrico, Chris D., Shonda Wesson, Vanaja Konduri, Colby J. Hofferek, Jonathan Vazquez-Perez, Emek Blair, Kenneth Dunner, Pedram Salimpour, William K. Decker, and Matthew M. Halpert. 2020. “A Randomized, Double-Blind, Placebo-Controlled Study of Daily Cannabidiol for the Treatment of Canine Osteoarthritis Pain.” Pain 161 (9): 2191–2202. https://doi.org/10.1097/j.pain.0000000000001896.
9. Fiz, Jimena, Marta Durán, Dolors Capellà, Jordi Carbonell, and Magí Farré. 2011. “Cannabis Use in Patients with Fibromyalgia: Effect on Symptoms Relief and Health-Related Quality of Life.” Edited by Antonio Verdejo García. PLoS ONE 6 (4): e18440. https://doi.org/10.1371/journal.pone.0018440.
10. Hunter, D., G. Oldfield, N. Tich, J. Messenheimer, and T. Sebree. 2018. “Synthetic Transdermal Cannabidiol for the Treatment of Knee Pain due to Osteoarthritis.” Osteoarthritis and Cartilage 26 (April): S26. https://doi.org/10.1016/j.joca.2018.02.067.
11. Renslo, Bryan, Ari Greis, Conan S Liu, Anjithaa Radakrishnan, and Asif M Ilyas. 2022. “Medical Cannabis Use Reduces Opioid Prescriptions in Patients with Osteoarthritis.” Cureus, January. https://doi.org/10.7759/cureus.21564.
12. Louie, Grant H., Maria G. Tektonidou, Alberto J. Caban‐Martinez, and Michael M. Ward. 2011. “Sleep Disturbances in Adults with Arthritis: Prevalence, Mediators, and Subgroups at Greatest Risk. Data from the 2007 National Health Interview Survey.” Arthritis Care & Research 63 (2): 247–60. https://doi.org/10.1002/acr.20362.
13. Rufino, Ana Teresa, Madalena Ribeiro, Cátia Sousa, Fernando Judas, Lígia Salgueiro, Carlos Cavaleiro, and Alexandrina Ferreira Mendes. 2015. “Evaluation of the Anti-Inflammatory, Anti-Catabolic and Pro-Anabolic Effects of E-Caryophyllene, Myrcene and Limonene in a Cell Model of Osteoarthritis.” European Journal of Pharmacology 750 (March): 141–50. https://doi.org/10.1016/j.ejphar.2015.01.018.
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