In recent years, CBD has captured the attention of researchers for its potent anti-inflammatory properties. For this very reason, CBD has become a hugely popular supplement in the world of health and wellness, trumpeted by many as a therapeutic godsend for minor aches and pains.
Following countless anecdotal reports that cannabinoids can alleviate joint pain, researchers have now begun investigating CBD as a potential treatment for arthritis. Does it work? Here’s what the science says.
Arthritis: an overview
Arthritis is a long-term condition that causes chronic pain, inflammation, and stiffness of the joints. In the UK, over 10 million people are living with arthritis or other, similar inflammatory joint conditions.
There are two main types of arthritis. The first, rheumatoid arthritis, occurs when the immune system begins to attack the joints’ healthy tissue, in what is known as an autoimmune response. This causes a build-up of fluid and inflammation, resulting in pain and stiffness of the joints.
Osteoarthritis is another common form of arthritis. It also involves inflammation but is mainly characterised by thinning of the joint cartilage and bone. It commonly affects the hip, knee, and thumb joints.
Currently, arthritis is treated using medication, physiotherapy or surgery. Common medications for rheumatoid arthritis patients are disease-modifying anti-rheumatic drugs (DMARDs), which can have some pretty nasty side effects. These could include nausea, headaches, loss of appetite, and hair loss, as well as more serious risks such as liver damage and infections.
In addition to these disease-modifying drugs, many people with arthritis also take strong painkillers to manage the inflammatory joint pain. Since prescription painkillers often come with a risk of tolerance and addiction, many are reluctant to rely on these drugs. Instead, some people with arthritis are turning to more natural methods, such as CBD, to manage their pain.
What is CBD?
Cannabidiol, better known as CBD, is one of over 100 naturally occurring cannabinoids found in the Cannabis sativa plant. Unlike the plant’s mind-altering molecule, tetrahydrocannabinol (THC), CBD is non-psychoactive and cannot get you high.
For this very reason, CBD has become a hugely popular health and wellness supplement amongst those seeking some of the medicinal benefits of whole-plant cannabis but without the intoxicating effects.
How does it work?
CBD interacts with our body’s endocannabinoid system (ECS), a complex cell-signalling network that coordinates countless biological functions. By regulating our mood, appetite, sleep, pain levels, immune health, and much more, the ECS aims to maintain biological stability in the body.
Although its exact mechanisms of action are yet to be fully understood, several experimental studies have shown that CBD can indirectly modulate the activity of cannabinoid (CB) receptors, CB1 and CB2, and subsequently alter the signalling of our body’s naturally derived cannabinoids, termed endocannabinoids. By supporting the ECS, CBD can therefore assist the vast array of biological functions that this system coordinates.
Could CBD relieve joint pain?
Since the ECS is heavily involved in regulating our immune system, CBD can have a strong influence on immune cell activity. In both experimental and clinical settings, CBD has been shown to have potent anti-inflammatory action.
How does it do this? CBD is thought to increase levels of anandamide (a key endocannabinoid) which, in turn, can modulate the activity of CB2 receptors in the immune system and subsequently alter immune cell function. Since our immune cells are responsible for the production of molecules that mediate and exacerbate the inflammatory response, known as inflammatory cytokines, CBD can – in some conditions – inhibit the release of these cytokines and reduce the severity of inflammation.
Inflammation is a major driver of joint pain experienced by people with arthritis. This is why many patients are turning to CBD to help manage their symptoms. According to the Arthritis Foundation, “some people with arthritis who use CBD report noticeable pain relief, improved sleep, or reduced anxiety.”
CBD for arthritis: the evidence
Whilst there are many testimonials claiming that CBD can relieve arthritis pain, the only existing scientific evidence we have of this comes from animal model studies. In 2016, one study found that the topical application of CBD skin patches significantly reduced swelling, inflammatory pain, and inflammatory blood markers in rats after four days of application.
In 2017, another study found that CBD prevented the development of pain and nerve damage in rats with osteoarthritis. The authors concluded that CBD may be a safe, useful therapeutic for treating [osteoarthritis] joint neuropathic pain.”
A randomised controlled trial published in Pain in 2020 found daily CBD treatment “significantly decreased pain and increased mobility” in dogs with osteoarthritis. The effects seen were dependent on the dose administered, with higher doses resulting in a better clinical outcome.
Despite some experimental evidence to suggest that CBD can target synovial fibroblasts, the cells that drive inflammation and joint destruction in rheumatoid arthritis, there is currently a notable lack of data to support its use in treating arthritis in humans. Since these animal model findings have not yet been replicated in human cohorts, there is no evidence showing the optimum dosage for using CBD for arthritis, or if it even works at all.
There is, however, an abundance of anecdotal evidence in favour of using CBD to manage arthritis pain. In 2019, the Arthritis Foundation released survey data showing that 29% of 2,600 survey respondents confirmed they were currently taking CBD, approximately 3 out of 4 of whom reported that it was either effective or very effective in relieving several symptoms.
However, results from a 2022 randomised, double-blind, placebo-controlled trial seem to contradict this. The study, published in Pain, investigated the effects of CBD on hand osteoarthritis and psoriatic arthritis. Patients received 20 to 30 mg of CBD or placebo daily for 12 weeks. The researchers found “neither clinically nor statistically significant effects of CBD for pain intensity in patients with hand osteoarthritis and psoriatic arthritis when compared with placebo.”
Whilst these findings aren’t definitive, they show that low doses (20 to 30 mg) are likely to be ineffective at managing arthritis. Since other studies have found that could help to relieve chronic pain, future clinical trials are needed to assess the effects of higher doses on arthritis pain in humans.
Other benefits of using CBD
As many as 70% of those living with arthritis also experience trouble sleeping. CBD has also been shown to be an effective natural sleep aid. Although scientists aren’t entirely sure how it works, CBD may help to overcome the restless nights caused by joint pain.
Arthritis pain can be hugely taxing on a person’s mental wellbeing. Since the condition infringes on all aspects of daily life, it is not uncommon for people living with arthritis to experience anxiety, depression, and other mood disorders.
CBD, by interacting with serotonin receptors, may help to enhance the signalling of serotonin in our brain. Since our mood is hugely dependent on our serotonin levels, CBD may help to alleviate symptoms of anxiety and depression.
Although many of the underlying causes of arthritis cannot be controlled, some risk factors could be influenced by our lifestyle. Sleep deprivation and heightened levels of stress, for instance, can exacerbate inflammation and contribute to joint damage – and as we’ve just seen, CBD could help.
Smoking can also increase the risk of developing arthritis and there is even some evidence to suggest that CBD could help you to quit.
Is it safe?
The World Health Organisation (WHO) has declared that CBD is “generally well tolerated with a good safety profile,” but it has shown to cause mild side effects in some people. This could include nausea, appetite changes, and fatigue, but these side effects are typically remedied with the correct dosage and are mild in comparison to existing arthritis drugs.
If you are on other medication, it is important to consider the risk of drug interactions whilst using CBD. If you’re keen to try CBD to manage arthritis pain, do not replace your current medicines. Instead, you should consult a doctor or medical professional before adding CBD to your treatment plan.
It is also worth noting that CBD is biphasic, meaning that it can have opposing effects on the body, depending on the dosage administered or the conditions of our body. So, in some instances, CBD can boost the immune system, rather than suppress inflammation.
How to take CBD
Although CBD is not currently an approved treatment for arthritis, high-quality commercial products are widely available for those who think CBD could help. Unlike THC, which is only legally available on prescription in the UK, CBD is completely legal to buy and use, providing the product contains less than 1mg of THC per container.
There are countless ways to take CBD. For more information about each of the many ways to get your dose in, see our latest guide to navigating the different ways to take CBD.
Based on the existing anecdotal data, these are thought to be the best CBD options for those seeking relief from joint pain and inflammation:
Oils are the most popular way to take CBD. By dropping it under the tongue, CBD can enter the bloodstream quickly and provide near-immediate relief. The dropper also gives you control over your dosage, allowing you to take more on days that you need it most. To help decide which CBD is right for you, take a look at our guide to CBD oil.
If the strong taste of CBD oil isn’t your thing, why not give CBD capsules a try? Capsules are simply CBD oil in their encapsulated form. Instead of placing the oil under the tongue, capsules are swallowed and the CBD is absorbed by the digestive system. This does mean, however, that the effects take slightly upwards of 30 minutes to kick in.
For those seeking localised anti-inflammatory relief, CBD-infused balms, creams, and gels may be your best bet. When applied to the skin, CBD can penetrate the skin surface and get right to the source of inflammation. Topical CBD products tend to have lower doses, so be sure to seek out a product with a higher potency.
Vaping is another quick way to get CBD into the bloodstream. As a vape pen is easily transportable, it can be used on the move for immediate relief. But since the safety and long-term health effects of using vaping products are not yet known, it is wise to approach this method with caution.
In response to the growing popularity of using CBD to manage arthritis symptoms, the Arthritis Foundation has released their official CBD guidance where they detail the dos and don’ts for incorporating CBD into your arthritis treatment plan.
Whilst CBD may not be a viable alternative to current treatment for some people, the existing evidence suggests that it could help others. There is, therefore, an urgent need for further research into whether CBD could be an effective complementary therapy for people living with arthritis.