Evidence based

CBD and Arthritis: Current Research & Understanding

Arthritis is an inflammatory disease affecting the joints. It can lead to loss of mobility and lowered quality of life. CBD and other cannabis extracts popular as an alternative or adjunctive treatment for arthritis. In this article we’ll discuss how this works, and how people are using CBD to alleviate symptoms.

Article By
Justin Cooke , posted 2 months ago

According to the Arthritis Foundation, 54 million adults have been diagnosed with arthritis. It’s the leading cause of disability among adults in the developed world.

Despite how common arthritis is, there aren’t many effective treatment options for the condition outside of pharmaceutical painkillers and anti-inflammatories — which often come with undesirable side-effects and fail to address the underlying cause of the condition.

Due to its broad spectrum of pain-relieving and anti-inflammatory effects, CBD has gained a lot of attention lately as a promising treatment for arthritis.

Here, we’ll discuss how CBD can benefit both rheumatoid arthritis and osteoarthritis. We’ll go over what the research says and how people are using CBD currently, and offer a guideline on dosing.

Let’s get right into it.

  • Table of Contents

Does CBD Improve Arthritis Symptoms?

Arthritis involves inflammation of the joints. The cause of the inflammation and tissue damage characterizes the condition as either rheumatoid arthritis (autoimmune) or osteoarthritis (other).

CBD offers different benefits to each form of arthritis.

Most of these benefits come from CBD’s anti-inflammatory properties.

Regarding osteoarthritis, CBD fights the source of the inflammation by blocking key inflammatory messengers such as TNF-a. It also blocks the pain caused by this inflammation.

Regarding rheumatoid arthritis, the inflammation is far more severe because the body’s immune system attacks and destroys joint tissue. CBD supports this form of arthritis on many levels by regulating the immune cells responsible for causing most of the damage to the joints.

Normally, immune cells called T-cells enter the joint tissue, become activated, and start attacking. CBD slows this process down by making it harder for the T-cells to become active in the joint — therefore, reducing the rate of joint damage.

A Few Tricks to Getting the Most out of CBD for Arthritis:

  1. Make sure you’re using the right dose (mid-high strength)
  2. Ensure the CBD you’re using is high-grade to avoid causing more inflammation
  3. Don’t rely solely on CBD as a treatment — it works best when combined with other diet and lifestyle modifications
  4. Take CBD frequently and give it enough time to start producing results (this can take several weeks)
  5. Use CBD both topically and internally for best results

What Does the Research Say?

In one study involving collagen-induced arthritis in mice, researchers found that CBD administration slowed the progression of both acute arthritis and chronic arthritis [1].

In this particular study, both CBD injections and oral CBD had the same effect. The dose used in this study was quite high — around 25 mg/kg per day.

How Does CBD Work for Arthritis?

CBD interacts with the endocannabinoid system, which is involved in several different processes throughout the body. Its broad effects give it a few different mechanisms to tackle arthritis symptoms.

The most important benefits of CBD in relation to arthritis are the anti-inflammatory and pain-killing effects.

Since both rheumatoid arthritis and osteoarthritis are caused by underlying inflammatory processes and involve symptoms of pain and swelling, CBD is an excellent treatment option for both these conditions.

The Benefits of CBD for Arthritis:

  • Lowers inflammation
  • Inhibits pain transmission
  • Modulates hyperactive immune activity (rheumatoid arthritis)

Researchers want to know how CBD and other cannabinoids are so beneficial to arthritis. They tested the effects of various synthetic cannabinoids and a cannabidiol analog (O-1918) and found that another receptor — known as GPR55 — is also involved in the processes behind the pain-relieving benefits of cannabinoids [9].

The Biochemical Mechanisms of CBD for Arthritis

  • Inhibits T-lymphocyte proliferation in damaged joint tissue [2]
  • Inhibits cytotoxic T-cell activity [3]
  • Suppresses macrophage function and antigen presentation [4]
  • Inhibits nitric oxide production by macrophages [5]
  • Modulates of tumor necrosis factor (TNF), IL-1, and IFN-g [6, 7]
  • Suppresses B cell chemokine production [8]

Ultimately, the most beneficial effects of CBD on arthritis revolve around its anti-inflammatory properties.

What Is Arthritis?

Arthritis is an inflammatory condition affecting the joints. It generally progresses slowly, with symptoms worsening over time. It’s most common in the elderly, overweight individuals, and athletes.

There are many different types of arthritis, depending on the cause — however, we normally classify them into one of two categories: rheumatoid arthritis and osteoarthritis.

1. Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease. Each one of our cells has a special protein “tag” attached to the outside of the cell. This tells the immune cells (T-cells and B-cells) that it’s meant to be there — just like someone having a hall pass. Without this “hall pass,” it will be attacked and destroyed by the immune cells on sight.

With autoimmune diseases, there’s a disruption in this system.

Here are a few things that can go wrong:

  • The tags on the outside of the cell are labeled incorrectly
  • The cells don’t have the tag on the outside of the cell
  • The immune cells ignore the tag and attack the cell

In all of these events, the results are virtually the same: the T-cells and B-cells begin attacking the body’s own cells. When this occurs in the joint tissue, we end up with rheumatoid arthritis.

The characteristics of this condition are redness and swelling of the joints. Usually, the affected joints appear equally inflamed on both sides of the body and are often described as feeling “hot.”

There’s no cure for rheumatoid arthritis — but there are medications that can help to keep symptoms at bay. Most of these medications are anti-inflammatory — since inflammation is the primary driver of the disease.

Symptoms of Rheumatoid Arthritis

  • Pain around the joints
  • Inflammation in the joints
  • Stiffness
  • Loss of range of motion
  • Fatigue
  • Loss of appetite
  • Anemia
  • Fever

2. Osteoarthritis

Osteoarthritis is also characterized by achy, sore joints — but it is not an autoimmune disease.

Osteoarthritis begins with low-grade inflammation of the joints, causing damage to the cartilage and cells that produce the slippery synovial fluid that reduces friction and aids in smooth movement within the joints. As a joint begins to deteriorate from the breakdown of cartilage, the inflammation increases.

This condition is self-perpetuating — the worse it gets, the faster it progresses.

The primary treatments for osteoarthritis involve using anti-inflammatories, reducing movement of the joint, and taking nutritional supplements to support synovial fluid and collagen production.

Unlike rheumatoid arthritis, osteoarthritis can be cured depending on the severity of the condition and willingness of the patient to change diet and lifestyle habits dramatically.

Symptoms of Osteoarthritis

  • Pain around the joints
  • Inflammation in the joints
  • Stiffness
  • Loss of range of motion

Conventional Treatments for Arthritis

  • Low-impact exercise
  • Corticosteroids (prednisone, cortisone)
  • Non-steroidal anti-inflammatories (NSAIDs)
  • Immunosuppressants (rheumatoid arthritis)
  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil)
  • Menthol
  • Hydrocodone (Vicodin)
  • Capsaicin
  • Surgery (joint replacements)

Lifestyle and Diet Changes to Support Arthritis

  • Weight loss
  • Regular low-impact exercise
  • High antioxidant diets
  • High fiber diets
  • Avoid dietary allergens

Using CBD for Arthritis

There are two ways you should consider using CBD when treating arthritis — topically and internally. Both have their own positives and negatives, but the best treatment will involve a combination of both.

Let’s explore each form of application in detail.

1. Taking CBD Internally

Taking CBD internally allows the cannabinoids to travel deep within the inflamed tissues. This is important with arthritis because the inflammatory processes occur deep within the joint itself — well below structures such as bones and ligaments that slow the absorption of topical cannabis.

Internal CBD is also necessary to achieve pain inhibition in the brain and spinal cord — something topical CBD simply can’t offer.

You can take CBD internally using one of the following products:

2. Applying CBD Topically

Topical CBD is very useful for arthritis. It delivers the anti-inflammatory cannabinoids directly to the source. This form of CBD offers pain-reducing benefits at the site of injury directly but doesn’t offer any inhibition on the pain pathway leading up the spine and into the brain — where much of CBD’s analgesic effects take place.

For this reason, it’s important that you use a combination of internal and topical CBD for arthritic pain — both rheumatoid and osteoarthritis.

When looking for topical CBD products to help manage symptoms, find a high-potency salve, ointment, or cream. Many of the products on the market don’t contain enough cannabinoids to realistically offer improvement for the condition.

How Much CBD Should I Take?

The dose of CBD for arthritis can vary depending on the severity of symptoms and the type of arthritis.

For low-grade osteoarthritis — characterized by mild joint pain — a low potency may be sufficient.

For rheumatoid arthritis or more severe osteoarthritis, a medium- or high-strength dose of CBD may be necessary.

When trying CBD for the first time, it’s recommended that you start with a low dose and build up gradually over time. Once you find relief from your symptoms, you’ve found the right dose.

Calculating CBD Dosage Strengths by Weight

Unit of MeasureLow StrengthMedium StrengthHigh Strength
Imperial (pounds)1 mg for every 10 lbs3 mg for every 10 lbs6 mg for every 10 lbs
Metric (kilograms)1 mg for every 4.5 kg6 mg for every 4.5 kg12 mg for every 4.5 kg

Daily Doses of CBD by Weight and Strength (in mg)

Weight (lbs)Low StrengthMedium StrengthHigh Strength

100 lbs

10 mg

30 mg

60 mg

125 lbs

13 mg

38 mg

75 mg

150 lbs

15 mg

45 mg

90 mg

175 lbs

17 mg

52 mg

105 mg

200 lbs

20 mg

60 mg

120 mg

225 lbs

22 mg

67 mg

135 mg

250 lbs

25 mg

75 mg

150 mg

Potential Side-Effects of CBD

Although CBD has been proven to be safe many times over, it’s important to know about the potential side-effects it may produce. Everybody is different, and what works for one person doesn’t always work the same way for another.

Here are some of the most common side-effects of CBD:

  • Appetite suppression
  • Diarrhea
  • Drowsiness
  • Dry mouth
  • Lightheadedness
  • Lower heart rate
  • Sedation

Final Verdict: Using CBD for Arthritis

CBD is an excellent option for people suffering from either type of arthritis — rheumatoid arthritis or osteoarthritis.

The potent anti-inflammatory benefits of CBD make it an excellent treatment for the underlying cause of rheumatoid arthritis — which is heavily reliant on autoimmunity. CBD stops the T-cells from proliferating and attacking the joint tissue and inhibits inflammation at several different levels.

Regarding osteoarthritis, CBD stops the low-grade inflammation taking place in the cartilage region of the joints.

Additionally, CBD effectively alleviates pain resulting from both types of arthritis.

For the best results, it’s recommended that you use both an internal form of CBD (such as an oil, tincture, capsule, or edible), as well as a topical form applied to the affected joints directly.


References

  1. Malfait, A. M., Gallily, R., Sumariwalla, P. F., Malik, A. S., Andreakos, E., Mechoulam, R., & Feldmann, M. (2000). The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis. Proceedings of the National Academy of Sciences, 97(17), 9561-9566.
  2. Specter, S., Lancz, G., & Hazelden, J. (1990). Marijuana and immunity: tetrahydrocannabinol mediated inhibition of lymphocyte blastogenesis. International journal of immunopharmacology, 12(3), 261-267.
  3. Klein, T. W., Kawakami, Y., Newton, C., & Friedman, H. (1991). Marijuana components suppress induction and cytolytic function of murine cytotoxic T cells in vitro and in vivo. Journal of Toxicology and Environmental Health, Part A Current Issues, 32(4), 465-477.
  4. McCoy, K. L., Gainey, D., & Cabral, G. A. (1995). delta 9-Tetrahydrocannabinol modulates antigen processing by macrophages. Journal of Pharmacology and Experimental Therapeutics, 273(3), 1216-1223.
  5. Coffey, R. G., Yamamoto, Y., Snella, E., & Pross, S. (1996). Tetrahydrocannabinol inhibition of macrophage nitric oxide production. Biochemical pharmacology, 52(5), 743-751.
  6. Formukong, E. A., Evans, A. T., & Evans, F. J. (1988). Analgesic and antiinflammatory activity of constituents of cannabis sativa L. Inflammation, 12(4), 361-371.
  7. Watzl, B., Scuderi, P., & Watson, R. R. (1991). Marijuana components stimulate human peripheral blood mononuclear cell secretion of interferon-gamma and suppress interleukin-1 alpha in vitro. International journal of immunopharmacology, 13(8), 1091-1097.
  8. Srivastava, M. D., Srivastava, B. I. S., & Brouhard, B. (1998). Δ9 tetrahydrocannabinol and cannabidiol alter cytokine production by human immune cells. Immunopharmacology, 40(3), 179-185.
  9. Schuelert, N., & McDougall, J. J. (2011). The abnormal cannabidiol analogue O-1602 reduces nociception in a rat model of acute arthritis via the putative cannabinoid receptor GPR55. Neuroscience letters, 500(1), 72-76.

Conditions that May Respond to Cannabidiol