If you’re one of the 10 million people in the UK currently suffering from arthritis, you’ve probably experienced your fair share of arthralgia. Simply referring to ‘joint pain,’ arthralgia tends to flare up first thing in the morning, or after a joint is subjected to a lot of use, and it normally intensifies as the condition matures. Alongside swelling and stiffness, this achy or burning type of pain is the most common symptom of arthritis, and, due to the unpleasant nature of the disorder, an increasing number of people are turning to an unlikely remedy to seek relief – CBD.
Otherwise known as cannabidiol, CBD is a chemical compound found in the cannabis plant. Due to a growing body of research into its potential benefits, and public endorsements from an array of well-known celebrities, the cannabinoid has shot into the mainstream in recent years. In a report released by The Arthritis Foundation in 2019, out of the 2,600 people surveyed, 79% reported using CBD to try and alleviate their arthralgia. This is seemingly for good reason, because out of those respondents who used the compound, a majority of them anecdotally reported a notable decrease in levels of pain and an improvement in physical function and wellbeing.
However, aside from anecdotal reports, you might be wondering – what is currently known about CBD and its relationship to arthralgia? Is CBD actually effective in reducing pain? Does it help to affect any other arthritic symptoms? And, if CBD is likely to be effective, how do I know which cannabidiol products to use, and the best way to apply them? But rest assured, in this article, we’ll be answering all these questions and more, to help you understand more about this unique herbal remedy and its influence on arthritis. But before we explore CBD’s potential in subduing arthralgia, let’s first understand more about this cannabinoid and its unique impact on the human body.
What is CBD?
Short for cannabidiol, CBD is one of over one hundred other chemical cannabinoids that are native to the cannabis Sativa plant. Often extracted from industrial hemp (a variety of cannabis Sativa), CBD was first isolated in 1942, but due to cannabis’ complicated legislative history, CBD has only reached commercial success in the past few years. Unlike its fellow cannabinoid tetrahydrocannabinol (THC), cannabidiol doesn’t make the user feel intoxicated, and with no overdoses from the substance ever being reported, the use of the substance is widely considered as safe. This is supported by a report from the World Health Organization which states, ‘To date, there is no evidence of public health-related problems associated with the use of pure CBD.’
CBD is understood to potentially relax the body and mind in a number of ways, likely because of its principal function in counteracting the psychoactive effects of THC. In addition to reducing feelings of paranoia, anxiety, and brain fog, due to the compound’s purported anti-inflammatory and antioxidant properties, CBD has also been shown to have the potential to reduce symptoms of insomnia, to soothe a variety of skin conditions such as eczema and psoriasis, and, crucially, to reduce levels of pain. Due to the relative infancy of the compound, however, much about CBD and its purported benefits are still yet to be extensively researched.
If you’ve ever browsed CBD products, you might have noticed that the herbal agent comes in a number of different forms. CBD can be extracted in full-spectrum, broad-spectrum, and isolated varieties, and knowing the difference between these three types of CBD is crucial in making sure you get the most out of your cannabinoid experience. So, to clarify, full-spectrum CBD contains extracts from the whole of the hemp plant – from flower to seed and everything in between. This means that it features terpenes, nature’s aromatic molecules, and in most cases, also THC. In comparison, broad-spectrum CBD contains all the goodness of full-spectrum products, only without the risks of THC; while CBD isolate contains cannabidiol and cannabidiol only.
How does CBD work in our bodies?
Even though much about CBD and its relationship with our body is still to be explored, the main reason why the cannabinoid is understood to have therapeutic potential is because of the unique way it may interact with our endocannabinoid system (ECS).
Discovered as late as 1992, our endocannabinoid system is located throughout the human body and brain, and it is composed of a network of receptors (CB1 and CB2), enzymes, and endocannabinoids. Its complex actions influence a range of functions in our body, including our immune, inflammatory, stress, and pain response, and its overall function is to bring balance to these vital processes. This system functions regardless of whether someone uses CBD or not, but if the system is not producing enough endocannabinoids the system can become out of whack, and this can result in the body feeling unbalanced.
Therefore, when CBD is consumed, it has the potential to mimic the natural cannabinoids in our body and influences the function of the CB1 and CB2 receptors. Since these receptors are located in our central nervous system, our peripheral nervous system, and our immune system, by improving their receptiveness, CBD is understood to have the potential to possibly reduce anxiety levels, influence sleep quality, and crucially in supplementing the treatment of arthritis, also lower levels of inflammation and pain.
It is important to note that CBD products are only able to possibly elicit a whole-body response when they are ingested, because this is how they enter our bloodstream. In contrast to this, since the topical application of CBD prevents the substance from reaching our bloodstream, its effects aren’t relayed across the brain and body. However, rubbing CBD products into our skin may still generate valuable therapeutic benefits, because cannabinoids may still be able to interact with our ECS in the localised zone due to the wealth of cannabinoid receptors that exist in our skin.
What is arthritis?
Arthritis is a very common (and often poorly-understood) condition that causes pain and inflammation to take place within our joints. The main symptoms of arthritis include stiffness, redness, and tenderness of the joints, joint pain, and swelling, and even though these traits often appear over time, in some cases they can also occur suddenly. The disorder can affect people of all ages, but typically sets in when people are in their later stages of life, and even though there are more than 100 types of arthritis out there, the most common varieties of the condition are osteoarthritis and rheumatoid arthritis.
This is by far the most common form of arthritis, with around 8.5 million people living with this condition in the UK alone. The primary cause of osteoarthritis is the breakdown of cartilage, (a material which eases friction) in the lining of joints. The thinning of the cartilage makes tendons and muscles have to work harder, which contributes to stiff and painful joints and (in more extreme cases) reduced mobility levels.
Currently affecting around 400,000 people in the UK, rheumatoid arthritis is the second most commonly occurring form of arthritis, with women three times more likely to suffer from this condition than men. This variety of arthritis results from the body’s immune system targeting affected joints, and this contributes to higher levels of pain and swelling. This categorises rheumatoid arthritis as an autoimmune disease, and this means that people suffering from this condition are also at risk of developing problems with other organs and tissues in their bodies.
Although there are no current cures for arthritis, there are established ways to reduce its severity and slow down its progression. Surgery and lifestyle changes like exercising regularly and maintaining a healthy weight can reduce the risk of joint damage, and medicines like NSAIDs are often prescribed to lower levels of pain and decrease inflammation in the affected areas. However, many people are also turning to less conventional supplements- like CBD.
What does the research into CBD and arthritis currently say?
So, with so much speculation surrounding CBD and its ability to relieve symptoms of arthritis, what does the preliminary evidence actually say? Well, in a 2017 study published in Pain, rats, who were first injected with a substance that modelled osteoarthritis, were then administered doses of CBD into an artery in their knee joint. After the substance took effect, the rats purportedly displayed significantly fewer symptoms of inflammation in the joint and exhibited far fewer pain-related symptoms, such as shaking.
Similarly, in a 2016 study published in the European Journal of Pain, rats showcasing arthritic symptoms had CBD gel topically administered to the affected areas. After the CBD made it into the subject’s bloodstream, the rats who were given the highest doses of CBD purportedly showed considerably lower levels of pain and inflammation symptoms compared to the control group.
These two studies clearly indicate that the intravenous and topical application of CBD has the potential to be able to lower levels of inflammation and pain symptoms in rats who are experiencing arthritis-like symptoms. Additionally, since rats share much of our physiology and also have endocannabinoid systems that contain CB1 and CB2 receptors, it’s likely that these results may be transferable to humans. However, since few studies into cannabidiol’s influence on humans with the condition have been conducted, the exact impact on our complicated anatomical system remains clear.
How might CBD be able to soothe arthritic symptoms?
So, as we went over when explaining how CBD works in our bodies, CBD-infused products are understood to possibly impact symptoms of joint swelling and arthralgia in affected areas, because of its purported ability to impact endocannabinoid receptor activity. As clinical studies have found, if CBD activates CB2 receptors, it may trigger a response which lowers inflammation and oxidative stress. CBD is also understood to potentially reduce the levels of cytokines, which are signalling molecules that regulate inflammation, so this may further affect the cannabinoid’s purported anti-inflammatory response. Since arthritic symptoms (such as joint swelling, pain and tenderness) often result from the body’s inflammatory response, by limiting this reaction it is the most effective way to reduce the severity of the disorder.
CBD is also understood to potentially alleviate the pain that is often associated with cases of arthritis, by binding to the CB1 receptors in our endocannabinoid system. By binding to this endocannabinoid receptor, cannabidiol may also be able to increase levels of anandamide, which is an essential omega-6 fatty acid responsible for boosting levels of pleasure in the mind. Anandamide also is understood to elicit analgesic qualities, which is recognised to help alleviate arthralgia pain.
Finally, another way CBD is also likely to potentially soothe arthritic symptoms, is by improving anxiety and sleeping habits. As this 2019 study details, when patients suffering from insomnia were administered with consistent doses of CBD, 79.2% of them saw their anxiety symptom levels decrease, and 66.7% were able to achieve a better night’s sleep. This is relevant to those suffering from arthritis, because anxiety and issues with sleeping are two factors that often contribute to higher levels of pain. So, by generating a positive knock-on effect on our mental health and sleeping habits, CBD may be recognised to potentially aid us as we achieve a more holistic approach to pain relief.
How do I use CBD for arthritis?
So, if you’re interested in using cannabidiol products to try and address your arthritic symptoms, you might be wondering – where do I start? With the massive rise of the compound’s popularity and a subsequently huge variety of ways to sample the products, the CBD market can seem a little overwhelming at times. But don’t worry, we’re here to help. So, to help ensure you make the most out of your cannabinoid experience, here’s a couple of things to bear in mind when you’re looking to use CBD for arthritis.
Choose a method
Before you work out anything else, it’s wise to decide on a method to consume your CBD. Here’s a rundown on the most popular techniques, and how effective they’re likely to be when it comes to addressing arthritis.
Referring to any type of food product that is infused with CBD, edibles are a great introductory way to take CBD because they’re fuss-free and they come in a wide variety of different forms. Popular CBD edibles include cannabinoid-infused gummies, mints, chocolates, and baked goods, but depending on your individual preference, you can get edibles in virtually any form imaginable. They’re all pre-measured with even amounts of CBD, meaning there’s no need to measure out doses manually, and due to their versatility, they’re a lot more novel than many other methods of consuming CBD.
Once edibles are ingested, their potential effects are delivered throughout the whole body, which makes this method suitable if you’re looking to possibly address general pain, or alleviate more mental symptoms like those associated with anxiety or stress. However, when you consume cannabidiol using this method, due to the route it takes within our bodies, it enters the digestive system before being absorbed into the bloodstream. This means that this method often has much lower rates of bioavailability than other forms because some of the CBD is eliminated before it is able to take effect. So, to try and address this problem, it’s wise to try and choose CBD edibles with higher fat contents, as, because cannabidiol is fat-soluble, when it attaches to other fatty compounds it may disperse more effectively into our system.
Furthermore, due to the indirect route, CBD edibles travel around our system, it also means that it takes longer for the substance to potentially take effect. To be specific, from the time CBD edibles are consumed, it takes the compound about two hours to kick in, which is typically longer than it takes with other products. However, due to the delayed speed in which it travels around our system, it also means that its effects can last for around four to six hours, which make edibles useful in addressing pain in comparison to other methods, because you don’t need to repeat your dose as frequently.
The sublingual method simply refers to dropping a few drops of CBD oil under your tongue and leaving it there for around 20-30 seconds before swallowing it. It’s one of the most popular methods of cannabidiol ingestion, and you can administer a variety of products sublingually, such as oils, tinctures, lozenges, and sprays.
The method is named after the sublingual gland that is located under your tongue; because when you ingest a substance using this method, it gets absorbed by gland and delivered directly into your bloodstream. Due to this unique mode of delivery, when you consume CBD through this method, you’ll be able to feel the effects within 15-20 minutes, which is much faster than most other types of administration.
This method also features one of the highest rates of bioavailability, because much less of the substance is lost throughout its journey into the bloodstream. Both of these factors make it a potentially effective method for those suffering from arthritis-like pain, because it may be able to deliver much faster and more effective relief in comparison to other techniques.
As the name suggests, vaping CBD refers to the inhalation of cannabidiol vapour into the lungs through a vaporizer, also called a ‘vape’ or ‘e-cigarette.’ This method transports the CBD into your lungs, where it is absorbed by the mucosal membranes that line the organs before being diffused into your system. The speed of this process means that the CBD is transported to the bloodstream in around two minutes, and, due to the method’s incredibly direct mode of delivery, vaping has a bioavailability of around 50-60% (which is around four times more than edibles).
Due to the speed and efficiency of vaping, it’s often used as a popular way to potentially relieve pain symptoms. However, since most clinical trials on CBD investigate the effectiveness of oral, topical, and sublingual solutions, research on the possible benefits of vaping cannabidiol remains scarce. Also, as some studies into vaping have outlined, lots of e-liquids can contain potentially harmful chemicals, which can pose a risk to the health of our lungs. Therefore, compared to other methods of consuming CBD, vaping is generally considered one of the less safe options.
If you’re experiencing localised pain symptoms, like those associated with arthralgia, or if you’re looking to decrease other arthritic symptoms, such as stiffness and swelling, applying CBD topically might be the right option for you. Also referred to as a transdermal application, the topical administration of CBD products simply refers to you rubbing them into the surface of your skin. Topical products include anything you can rub into our skin, such as creams, lotions, conditioners, salves, and most types of oils.
This method is good at relieving localised arthritis symptoms, because the CBD gets picked up by endocannabinoid receptors in your skin. This may help the possible anti-inflammatory properties of CBD to be much more potentially effective at lowering pain and swelling in joints, because the purported benefits of the cannabinoid are much more condensed in comparison to oral and sublingual methods.
When you apply CBD products topically, the possible effects normally take around an hour to kick in, and after they’re in your system they last for up to 5 hours. However, since the topical application of CBD prevents the substance from entering your bloodstream, if you’re looking to also receive its potential benefits throughout your whole body and mind, this technique will not be for you.
Find high-quality CBD
After you’ve decided on a method that works best for you, it’s important to only consider products that feature high-quality CBD. If you just go for the cheapest product on the shelf, there’s a large possibility that the cannabidiol extract will be of a poor quality, will be less potent than advertised, or, in extreme cases, will even contain unsafe toxins or chemicals.
An easy way to avoid these risks is by searching for CBD products that have been third-party tested, which is when CBD samples get analysed by laboratories with no affiliation to the company. These third-party tests determine whether the cannabidiol contains any heavy metals, pesticides, or other toxins, and they also calculate the cannabinoid and terpene profile of the sample. When a CBD company tests their products using third-party laboratories, they are able to provide Certificates of Analysis (COA) for everything they sell. So, to make sure you’re always getting the creme of the crop, it’s important to make sure that your CBD products come with COA’s before purchasing them.
Work out your dose
Before you choose to use CBD products for arthritis or any for any other purpose, it’s best to work out your desired dose first. However, this isn’t always as simple as it sounds, because an individual’s ideal CBD dose depends on a number of variables, including a person’s weight, their cannabinoid tolerance, their individual body chemistry, their chosen method of consumption, reasons for taking CBD, and any medical conditions they may have.
As a general rule of thumb, it makes more sense to begin slow and low, by starting with a smaller dose and gradually working your way up until the CBD reaches its desired potential effect. If you are using CBD sublingually to try and tackle arthritic symptoms, the Arthritis Foundation recommends starting out by taking a few milligrams of CBD twice a day, and then increasing the dose if you are not experiencing adequate relief. However, depending on the severity of your symptoms, and the type of CBD product you are using, this individual dosage is subject to change.
Look out for complementary ingredients
While CBD by itself has been shown to have the potential to affect arthritis symptoms, it’s not the only natural compound on the market with purported anti-inflammatory properties. In addition to CBD, there are countless natural supplements out there that provide promise in lowering the pain and swelling associated with arthritis. So, before you make any final purchases, it’s worth shopping around for CBD products that contain other complementary ingredients.
For example, aloe vera is renowned for its potential properties, and may feature robust possible anti-inflammatory properties. The herb extract comes in a variety of different forms, and doesn’t have any known nasty gastrointestinal side effects.
Not too dissimilar from aloe vera, eucalyptus extract is also commonly used to supplement mainstream treatments of arthritic pain. This is because the leaves of the plant contain tannins, which are thought to be potentially able to lower levels of inflammation symptoms associated with arthritis.
Finally, turmeric, a vibrant yellow spice, also has a purported potential in assisting people with arthritic conditions. This is predominantly because curcumin, the spice’s main ingredient, has powerful possible anti-inflammatory properties.
So, if you’re looking to buy CBD products to address arthritic symptoms, finding one with complementary natural ingredients may further the compound’s potential.
With all things considered, there is reasonable evidence to suggest that CBD may be able to possibly impact features that are associated with arthritis. Due to the unique way cannabinoids interact with our bodies’ innate endocannabinoid system, the compound does hold potential in lowering our inflammatory response, and subsequently reducing the pain and swelling that comes alongside it.
However, it is important to note that, while early research into the matter has taken place on animals, nothing conclusive can yet be drawn about CBD’s effect on humans suffering from the condition. CBD should also not be used in replacement of any mainstream drugs that aim at preventing joint damage in inflammatory types of arthritis, and if you are considering using CBD products for arthritis, it is extremely important to talk with your doctor beforehand. This is so they can let you know how it’s likely to interact with your current medication, and possibly warn you against its use if they believe it’s not an appropriate course of action.
Verified by a Healthcare Professional
Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.