Arthritis and Medical Cannabis
Arthritis is an umbrella term describing any disorder that affects joints and bones. The two main types are osteoarthritis (aka degenerative bone disease) and rheumatoid arthritis. Osteoarthritis (degenerative bone disease) is the most common form of arthritis.
Potential Efficacy / Quality of Evidence (Low, Average, High) of Arthritis for Medical Marijuana
Average – potentially high, especially for autoimmune-related forms of arthritis.
Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help
CBD may help fight inflammation and keep joints lubricated.
CBDA and THCA may also be useful.
A small amount of THC may help beat pain and inflammation.
CBD:THC 20:1; CBD:THC 3:1; CBD:THC 1:1.
Medical Cannabis Pros
May help treat arthritic pain, which is associated with inflammatory, nociceptive and neuropathic pain.
Could be an anti-arthritic and help repair old bones.
Medical Cannabis Cons
No definitive proof of efficacy as of yet; or cannabinoids may be effective for some arthritic patients, but not all.
More research is needed in order to look at what types of arthritis can be treated with cannabis – there are some indications that osteoarthritis requires a different treatment to rheumatoid arthritis.
More About the Condition
Osteoarthritis (degenerative bone disease) is the most common form of arthritis. Osteoarthritis usually forms as a result of age and/or the use of other medications, especially corticosteroids. Rheumatoid arthritis is an autoimmune disorder mostly affecting the hands and/or feet. Symptoms or any type of arthritis include joint pain, stiffness, swelling, warmth & redness, a decreased range of motion and sometimes even affecting muscles and other organs.
A study by Dr. Sheng-Ming Dai of China’s Second Military Medical University found that there are unusually high concentrations of CB2 receptors in the joint tissue of arthritic patients. CBD may help activate the pathway of these CB2 receptors and decrease inflammation. Other studies, like those undertaken by Dr. Jason McDougall and Melissa O’Brien, show that cannabinoids may help repair joint tissue. Different cannabinoid ratios may be needed for different types of arthritis.
Arthritis sufferers are usually given a mixture of antibiotics, NSAIDs such as ibuprofen, steroids such as prednisone, and disease-modifying anti-rheumatic drugs (DMARDs) such as azathioprine (purine synthesis inhibitor) and chloroquine (IL-1 receptor suppressor an anti-malarial). Steroids may actually thin the bones with long-term use, so some of the current treatment methods are certainly a double-edged sword.
Quotes from Experts
“Natural phytocannabinoids and synthetic derivatives have produced clear activity in a variety of models of joint pain in animals. These effects are the result of both inhibition of pain pathway signalling (mostly CB1) and anti-inflammatory effects (mostly CB2). There are also numerous anecdotal reports of the effectiveness of smoking cannabis for joint pain. Indeed, it is the largest medical request for the use of the drug. However, these reports generally do not extend to regulated clinical trials for rheumatic diseases. Nevertheless, the preclinical and human data that do exist indicate that the use of cannabis should be taken seriously as a potential treatment of joint pain.” Source: Miller RJ, Miller RE. ‘Is cannabis an effective treatment for joint pain?‘ Clin. Exp. Rheumatol. 2017 Sep-Oct;35 Suppl 107(5):59-67. Epub 2017 Sep 28. PMID: 28967368.
“For people living with chronic pain, the options for medication to assist with pain management are limited, and each has its drawbacks. For these people, medical cannabis offers a potential alternative to traditional pharmaceuticals such as NSAIDs, acetaminophen and opioids.” ‘Medical Cannabis‘, The Arthritis Society.
Case Studies – Patient Stories