Cannabis and Arthritis. How can medicinal cannabis contribute to treat the symptoms of arthritis and arthrosis ?
Cannabinoids are only one of the multiple compounds that constitute cannabis and, among them, THC and CBD are the most notorious. These compounds can act in our organisms through what is known as the endocannabinoid system. The endocannabinoid system is related to relaxation and the inhibition of pain signaling (additional information can be found at “The endocannabinoid system”).
Among the best-known cannabinoids, CBD is characterized by not having a direct psychotropic effect (does not affect consciousness) and has several medicinal properties.
The ability of CDB to ease pain through different mechanisms of action including prevention and resolution of inflammation has been researched for over a decade now. More recently, a beneficial effect has also been shown in patients that have used creams and ointments containing CBD to treat rheumatoid arthritis. Overall, the administration of CBD using creams is preferred to treat joint disorders, since CBD can be topically applied directly to the affected area, but sublingual oils and capsules have also been shown to be effective.
However, an unlike the well-documented and published beneficial effects of CBD on neuropathic pain and cancer, the treatment of rheumatoid arthritis still requires systematic studies to corroborate its effectiveness.
Previous studies on this matter lacked experimental design and, therefore, many patients use CBD at their own risk, since there is no recommended dosage or proper monitoring of its administration (for instance, 65% of approved Canadian users for medicinal cannabis have been diagnosed with arthritis).
In addition to the well-documented anti-inflammatory effects of CBD, some studies suggest that it could also help regenerate damaged joints, therefore contributing to the positive resolution of such pathology. It has also been shown that CBD plays a role during bone fracture repair.
A recent publication from 2016 showed that the topic administration of CBD (oils or creams) to the area affected with arthritis alleviates pain and inflammation without causing any adverse effects.
Additional studies from 2006 regarding the effect of Sativex (a pharmacological preparation derived from cannabinoids) for the treatment of rheumatoid arthritis showed that it had an analgesic effect and eased pain.
Adapted from https://swcarizona.com/medical-cannabis-arthritis/
It has been shown that THC is 20 times stronger than aspirin and twice as strong as hydrocortisone at reducing inflammation.
In 2000 it was shown that CBD was also able to block the progression of arthritis, whether it was administered orally or by injection. It was also shown that CBD could have a positive effect against osteoarthritis, although more studies are still needed to corroborate these results.
The mechanism of action of cannabinoids is usually through the CB1 and CB2 endocannabinoid receptors, but the binding to non-typical receptors such as GPR55, involved in the response to painful stimuli and hence reducing nociception (sensing of painful stimuli), has also been described.
The beneficial effects of CBD on arthritis result from the combination of blocking nociception, inhibiting inflammation and preventing the development and onset of this cartilage pathology. Therefore, the use of cannabis not only could help to reduce pain but also to prevent the onset of arthritis or even the development of a more acute arthritis.
What is arthritis?
The symptomatology of arthritis involves joint pain due to inflammation. This occurs because the cartilage wears out and no longer cushions the bones, so any movement of the joint causes friction since the bones rub each other, which produces the characteristic pain associated with this pathology (osteoarthritis or arthrosis).
Arthritis includes many different disorders: rheumatoid arthritis, lupus, osteoarthritis or arthrosis, fibromyalgia and gout.
Image from: https://medlineplus.gov/ency/article/001243.htm
Arthritis can also be due to the inflammation of the synovial membrane, which wears out the cartilage causing great pain and can even cause problems with the synovial fluid (the fluid that can be found inside the joint; this is the case of rheumatoid arthritis). Sometimes joint stiffness and even swelling, along with the obvious impairment of movement, accompany this pain. For instance, people with arthritis cannot apply the same force as people that do not suffer from it which makes them avoid certain movements that are no longer possible to them, such as opening a jar.
Arthritis usually occurs in elderly patients (some forms of arthritis caused by autoimmune diseases may appear during childhood), which reflects the wearing out of our joints over time. At this stage, the only way to solve this pathology is by using a prosthesis that replaces the damaged cartilage as well as the administration of anti-inflammatory treatment.
Analyzed and discussed by Paula Pifarré, PhD. Cannabity Healthcare Scientific Collaborator.