Better, faster, higher, stronger! Arthritis treatment with CBD
Psychologists all over the world state that the first minutes of our awakening determine our mood for the whole day ahead. They say we should think about moments when we were happy, the beautiful places we saw, and remember the faces of our closest people. But how to tune to the good mood if the first thought after awakening is how to get off the bed with minimal pain and not to curse the whole world? For millions of Americans suffering from different forms of arthritis, morning can quickly transform from the beautiful beginning of a new day to the demo version of hell.
According to statistics provided by the Arthritis Foundation, today, almost 54 million adults and 300 thousand children have heard the “arthritis” diagnosis from their physicians. If we add all people who have arthritis but haven’t been officially diagnosed to these numbers, the count will rise to more than 91 million. Prognoses for the future are also far from positive - by 2040, the number of arthritis cases is expected to grow by more than forty-nine per cent.
Daily life changes immediately for people with arthritis or another type of rheumatic disease, causing joint pain. Among the most debilitating and common symptoms of arthritis are stiffness, pain, and decreased movement within the joints. All of these symptoms can be severe and worsen over time. Moreover, these “physical” symptoms of rheumatoid arthritis are often accompanied by psychological symptoms such as depression and anxiety. In addition to this, people with arthritis may also contend with other medical problems that tend to coexist with arthritis, like diabetes, heart disease, and obesity.
To date, there are over 100 different types of arthritis. Among its most common forms are:
- Rheumatoid arthritis. Rheumatoid arthritis refers to the category of autoimmune disorders and usually affects hands and feet.
- Osteoarthritis. Osteoarthritis is a degenerative joint disease and in most cases occurs with age. This type of arthritis often affects the knees, fingers, and hips.
Other arthritis types also include fibromyalgia, gout, septic arthritis, and lupus. Osteoarthritis is more common and affects over 3.8% of people, while rheumatoid arthritis affects around 0.24% of people. According to statistics, in Australia, about 15% of people are affected, while in the United States, this index increases to more than 20%. Overall, the arthritis disease becomes more common with age and in many cases is a reason that people miss work and can result in a decreased quality of life.
Pain can vary in severity and remains the most common symptom in all types of arthritis. Other arthritis disorders as rheumatoid arthritis and lupus can also affect other organs of the body, leading to such symptoms as:
- Fatigue and malaise;
- Poor sleep;
- Weight loss;
- Inability to walk or use hands;
- Stiffness (usually worse in the morning);
- Muscle aches;
- Difficulty moving the joints.
Advanced arthritis is often followed by significant secondary changes. Arthritic symptoms make it difficult for a person to exercise or move around, thereby causing a significant impact on the quality of life. Secondary effects include:
- Loss of flexibility;
- Decreased aerobic fitness;
- Muscle weakness.
Decreased mobility, in combination with the symptoms listed above, can make it quite difficult for an individual to remain physically active. All this may contribute to high cholesterol, increased risk of obesity, and vulnerability to heart diseases. Also, as it was mentioned above, people with arthritis diagnosis are at increased risk of depression, which may be a result of numerous factors, such as fear of worsening symptoms.
The outcome of any disease directly depends on how and when it was diagnosed. The faster you note the first “alarm bells” and visit the doctor - the less damages the disease will cause to your health. In the case of arthritis, diagnosis is usually made by clinical examination from a health professional, and in many cases, is supported by blood tests and radiology. As a rule, additional tests are assigned depending on the type of suspected arthritis. The first call to action is pain that always accompanies arthritis. It may differ depending on the arthritis type and its location. In the case of the two most common arthritis types - osteoarthritis and rheumatoid arthritis, pain patterns are similar and different at the same time. In the case of rheumatoid arthritis, pain is generally worse in the morning and is often associated with stiffness lasting around half an hour. At the same time, in the case of osteoarthritis, morning pain is usually replaced by stiffness, which in most cases eases relatively quickly with movement and exercise. Among the children and aged people, the pain might not be the main presenting feature as the elderly simply move less, while children often refuse to use the affected limb.
Among the most critical features are speed and time of onset, the symmetry of symptoms, pattern of joints involvements, early morning stiffness, aggravating and relieving factors, and tenderness. In the majority of cases, a physical examination may either confirm the diagnosis or indicate systematic disease. To follow the disease progression and assess its severity, doctors often use radiographs, prescribe the blood tests and X-rays of the affected joints. Today there are various treatments for alleviating the arthritis symptoms but no cure. Treatment options can include steroid injections into affected joints and joint replacement surgery for people with an advanced form of osteoarthritis, where the cartilage in the knees, hips or other joints has worn away. For patients with the autoimmune disorder rheumatoid arthritis, antirheumatic drugs may also be prescribed to slow the disease progression that also causes severe joint pain.
A choice that we have today. Modern treatments for arthritis
In the modern world, medicine doesn’t stand still, and there is a choice of different treatments for arthritis available today. The modern arthritis treatments include disease modifiers, biologics block cytokine, joint replacement, hydroxylapatite, and arthroplasty. Let’s evaluate the main pros and cons of each of these options.
- Disease modifiers. Drugs that are called disease modifiers are usually used in rheumatoid arthritis patients who have had the arthritis symptoms for at least half a year and for whom NSAIDs (nonsteroidal anti-inflammatory drugs) can no longer help with the joints swelling. One of the methods of disease modifiers use is injecting gold into a joint. This method helps about fifty per cent of patients but remains effective in only 5-15 per cent of them after the five-years use period. Such treatment is not an anti-inflammatory, and for today no one still knows exactly how it works. Specialists assume that the physical presence of gold in the joint may reduce swelling. Another well-known disease modifier is Methotrexate. Methotrexate is an anti-cancer drug that tempers the runaway cell division in the affected joint. If these disease modifiers do not provide the desired effect, agents that suppress the immune response, such as cyclophosphamide, may be prescribed.
- Joint replacement. In the case of advanced arthritis, affected joints may be replaced with synthetic materials. These materials usually include polymers (long-chained molecules) such as silicone in the fingers and other small joints and metals like cobalt-chrome and titanium alloys in the larger joints. The devices that replace patient joints must be durable enough. In addition to this, they must not stimulate attack by the overactive immune system, push surrounding structures out of their normal position, and interfere with healing.
Before the advent of synthetic implants, surgeons removed the joints surfaces. They assumed that the scar tissue filling in the area would allow more mobility than the arthritic joint. This type of surgery is often failed. The first implants were developed by an army surgeon Alfred Swanson, M.D from Grand Rapids, Mich. He created the first devices in the late 1950s out of silicone elastomers, polymers made from the element silicon, which is found in quartz.
In comparison to surgery, these implants proved far more successful. After pioneering the first implants, research continued in the 1960s to create better options that would become more flexible. In 1969, the first silicone-based joint implants appeared on the market. The improved implants provided a flexible hinge for the joints of the wrists, fingers, and toes. Since then, more than twenty different models have been developed. More than a million people have already received joint replacements, and they are still based on silicone.
- Biologics blocks cytokine. It was proven that the immune imbalance underlies some forms of arthritis. Unravelling this imbalance together with an investigation of the mechanism drugs influence the immune function to reduce inflammation have become an entirely new approach to treating arthritis - the use of "biologics," or body chemicals. These new arthritic drugs are aimed at blocking cytokine production. Such a mechanism represents a different approach to halting prostaglandin synthesis, which is the prime target of most existing arthritis drugs. Studies and innovative approaches are still continuing. At Nova Pharmaceuticals in Baltimore, new amino acids are currently studying in animal tests. These unusual amino acids are able to block the release of inflammation-provoking cytokines from activated T cells (a specialised type of white blood cell). Several laboratories are also focused on using interleukin-1 to prevent inflammation. It is an immune system chemical that must bind to the lining inside joints to start the inflammatory process.
- Arthroplasty. During the implant resection of arthroplasty or implant surgery as we used to call it, the surgeon removes the surface of the joint bones and the excess cartilage. After this, the centres of the tips of abutting bones are hollowed out, and the stems of the implant are inserted there. The hinge part of the implant lies between the bones, which both align the bones and allows them to bend at the joint. In most cases, the implant is "fixed," or held in place, with special bone cement. Then, the tendons, muscles, and ligaments are repaired. After this, the patient must exercise to achieve the maximal flexibility of the new joint, but it can take a year or more of physical therapy to get maximum rehabilitation.
- Hydroxylapatite. The new step in the joint replacements is the use of special materials that resemble the body components. The latest body implants are coated with calcium phosphate materials, like hydroxylapatite, which interacts with the bone. The main goal of using such biologically active materials is to enhance the attachment of the implant to the bone. Instead of filling in the spaces with cement, scientists are testing a variety of new porous coatings that will allow a "biological fixation," in which bone can grow into the implant area.
CBD as a new term in the arthritis disease treatment
Even with a choice of available modern treatments and medications for arthritis, people are still searching for more natural and effective pain relief options. Often, current therapies are not enough to relieve the discomfort. Recently, a new word appeared on the horizon of modern arthritis treatment giving the hope and perspectives for all the people who have heard the “arthritis” diagnosis from their physician one day. This word is cannabidiol.
Cannabidiol (or CBD) is one of the numerous chemical cannabinoids found in the Cannabis Sativa plants. Lately, this cannabinoid has got great popularity all over the world due to the range of benefits to our health. The one thing that we all should keep in mind when hearing the word cannabis is that cannabidiol is not a psychoactive chemical even despite the fact that it occurs naturally in cannabis plants. The main psychoactive cannabis component is called delta-9-tetrahydrocannabinol or THC. This chemical changes our mental state and is famous for its ability to provide so well-known “high” feeling.
As for rheumatoid arthritis, researchers still don’t know the exact way marijuana affects our organism. The substantial primary evidence for today is that it can help relieve long-term pain. As pain is the primary symptom of all the arthritis types, this is where the CBD oil comes into play.
Among more than one hundred chemicals found in Cannabis Sativa plants that can affect our mind and body, the oil form of CBD is preferred for medical uses. This component doesn’t affect our brain the way THC does and can boast of minimal side effects when using. Many trials and studies have already been conducted on CBD and found that this cannabinoid may offer several significant benefits for people diagnosed with arthritis. CBD studies are still going on, and it will take quite a lot of time to prove the cannabidiol benefits for our health and create FDA-approved medications. Nevertheless, results obtained for today are promising, and CBD has all the chances to overtake the existing arthritis medications one day. Let’s see what research we have nowadays and what are the main CBD benefits for people with arthritis know to date.
One of the primary benefits of cannabidiol for RA treatment is its positive effect on pain. According to the study published in 2017 in the journal Pain, CBD can prevent osteoarthritis pain and joint neuropathy. Based on the obtained results, researchers affirmed that CBD could decrease joint inflammation as well as serve as a protectant to the nerves. In addition to this, cannabidiol can also be used to relieve other chronic pains as well. A study published in Therapeutic and Clinical Risks Management states that CBD can also be helpful as an easing pain agent for people diagnosed with conditions such as cancer and multiple sclerosis. According to several other studies, cannabidiol can also cause a highly positive effect for people with fibromyalgia pain. Moreover, all the people taking CBD to ease their pain experienced only mild side effects such as dizziness, drowsiness, and dry mouth that is significantly less in comparison to effects from other medications for this condition.
We have already mentioned that besides the physical symptoms of rheumatoid and other types of arthritis, people also face psychological symptoms such as anxiety and depression. While working together, these symptoms can significantly worsen the quality of people’s lives and even degrade the course of the disease itself. Even before discovering CBD for rheumatoid arthritis, this cannabinoid has been linked to a variety of mental health benefits. Cannabidiol is well-known for its ability to noticeably reduce anxiety and decrease the depression condition. According to one of the studies, cannabidiol has shown such effective results in this field of research, that it can be used as a potential treatment for multiple anxiety disorders. Also, according to research published in The Permanente Journal, CBD oil can be effective in reducing anxiety among young children as well. Due to its benefits for overcoming depression, CBD can become an excellent choice for people suffering from arthritis symptoms as, according to Arthritis Foundation, depression rates among patients with RA can be up to ten times higher in comparison to the rates of the general population.
The CBD benefits sound promising and clear, what about the mechanism of work? How does this cannabinoid influence our organism without any severe side effects, unlike other modern medications? Cannabidiol affects our brain activity, but in a different way than THC does. The mechanism of CBD action on our health is based on its interaction with the receptors of our internal endocannabinoid system. CBD oil interacts with two types of these receptors - CB1 and CB2 to reduce inflammation and provide noticeable pain relief. CBD2 receptors play a significant role in our immune system. As rheumatoid arthritis involves our immune system to attack the tissue in our joints, a CBD relationship with these receptors could explain why cannabidiol works well for the main symptoms of rheumatoid arthritis. Besides this, the anti-inflammatory effects of CBD could help either slow down or completely stop the RA progression, which can cause permanent damage to the joints over time. Moreover, these cannabidiol effects could reduce such inflammation-related rheumatoid arthritis symptoms as fever and fatigue.
What to note when choosing CBD for arthritis? Tips for beginners
It is always challenging to try something new instead of good old options. In the case of CBD for arthritis, it is twice more complicated because this treatment isn’t approved yet and, in general, any cannabis-related products are usually associated with legality problems and psychoactive influence on our mind. We have collected the main things to note prior to starting your treatment with cannabidiol. Today’s realities claim that more and more people with arthritis are turning to CBD products to reduce pain and manage other RA symptoms to be able to live and work normally. For today, little research has been done on cannabidiol in humans.
Furthermore, according to the Arthritis Foundation, none of the studies were done on people with arthritis. Nevertheless, people don’t wait for more research - they are using CBD now because of its increasing popularity and proof from animal tests. To help people to be safe and not to fall prey to aggressive marketing and inaccurate claims, the Arthritis Foundation has even released a special guide to better understand this hyped cannabinoid and all the risks associated with it.
These are the main tips for beginners and answers to the most frequently asked questions to get the expected beneficial results from CBD and without causing harm to your health.
- Why so popular? Secrets of the CBD hype. We have already mentioned that CBD is a chemical compound of the cannabis plant. Most of the CBD products available today online and in stores are made from hemp - a plant that doesn’t contain much THC. It doesn’t affect our brain in a way THC does; neither does it make us “high”. The consumers’ attention to cannabidiol has blown up in recent years, causing a worldwide hype around this compound and become the main driver of hundreds of studies. While a few years ago, the majority of people didn’t have any idea what CBD is, today the cannabidiol market is expected to reach the $22 billion position by 2022, according to the Brightfield Group data. There are several decisive reasons for such rapid growth. First of all, the latest Farm Bill finally removed the illegal stigma from hemp, making it legal in the United States, excluding it from the prohibited Schedule 1 category of drugs that includes ecstasy and marijuana. In addition to this, in states where recreational or medical marijuana is now legal, cannabidiol can be purchased in dispensaries. All this together has given a significant push to CBD development and growth, increasing the cannabidiol business value and opening new horizons in the possible medicinal use of this compound.
- To date, CBD is widely used by people with arthritis. Despite the lack of studies confirming the beneficial effects of CBD on people with arthritis, it is still widely used by people with this diagnosis. According to a survey held in California, which involved 2500 respondents, chronic pain and joint pain are the two main medical conditions when people choose CBD instead of all other available medications. Among the next three conditions for which people take cannabidiol are depression, anxiety, and insomnia - conditions that often accompany arthritis disease. The next online survey was held by the Arthritis Foundation, interviewing 2600 people. The results of the survey showed that almost eighty per cent of all respondents had already tried CBD or were considering trying it to relieve pain - the most debilitating arthritis symptom. Nearly thirty per cent of respondents stated they were currently using cannabidiol, while three out of four of them reported about getting noticeable relief. Many of the respondents claimed that CBD not only improved their physical function and morning stiffness, but also helped them to sleep better, be less fatigued, and reduced symptoms of depression and anxiety.
- CBD studies are still limited. It is probably the primary thing you should keep in mind when choosing CBD instead of all other options for arthritis treatment. Even after releasing the guidelines, the Arthritis Foundation recommends not to perceive it as an endorsement for CBD taking. There aren’t still any officially confirmed studies about cannabidiol safety and effectiveness. Nevertheless, for the moment, there are several important rules and things to note when you decide to choose CBD for your treatment. Animal studies have shown that CBD has anti-inflammatory and pain-relieving properties, but none of these effects has been validated in human studies.
To help people navigate the modern marketplace without any negative consequences, the guidelines of the Arthritis Foundation includes the following tips:
- Start low and go slow. For the moment, there are no adequate recommendations on how much CBD you should take to get the desired effect. Thus, it is advised to start with a low dose (a few milligrams) of CBD product and then add a few more after a week. If this dose isn’t enough to get the effect, it is recommended to go up in small increments in the next several weeks. If you decide on the dosage that brings relief, continue taking this dose twice a day in a daily regime to maintain the stable level of cannabidiol in your blood. Today, you can find cannabidiol in various lotions, food, edibles, vaping, suppositories, and other means available online and in shops. The Arthritis Foundation recommends to avoid such forms of CBD products and substitute them with CBD in tinctures, capsules, or sprays.
- Don’t give up on DMARDs. According to the guidelines released by the Arthritis Foundation, it is highly recommended not to replace the disease-modifying drugs with CBD. Especially if these are drugs that help prevent permanent joint damage in the case of the inflammatory types of arthritis. Cannabidiol might help with the arthritis symptoms, but there is no evidence of how it can influence the course of the disease. In addition to this, you should discuss any chosen CBD product with your doctor to find out whether it is safe to take it together with your other medications. Follow-up evaluations every three months as with any new treatment are also required.
- Beware of drug interactions. Discussing the introduction of new CBD products into your treatment program with your doctor is obligatory because scientists have identified many classes of medications that might interact with cannabidiol, significantly impacting the drug’s effectiveness. For people with arthritis, medications that should be taken cautiously are corticosteroids (Prednisone, Aleve, Celebrex, tramadol, Xeljanz), certain antidepressants (Celexa, Elavil, Remeron, Prozac, Zoloft, Paxil), and medications that are often prescribed for fibromyalgia (Lyrica, Neurontin). It doesn’t mean you should avoid CBD taking in case you take any of the above-listed medications. It just means that it is highly important to pay closer attention to these drugs when discussing cannabidiol taking with your doctor. Thus, you will be able to protect yourself from any surprising side effects and symptoms during the treatment.
- Shop carefully. CBD products are widely unregulated in the United States and are available in all kinds of shops, not only in dispensaries. Today you can buy CBD capsules, edibles, sprays, and tinctures in restaurants, hair salons, and health-food stores. It is obvious that the quality of these products varies significantly from one place to another. In many cases, CBD products are unlabeled or even falsified. A study held in 2017 showed that 43% of the 82 CBD products purchased online had more CBD in its composition than it was indicated, while 26% had less. Besides this, eighteen of the eighty-two products contained unexpected THC that wasn’t labelled. Aside from mislabeled products, specialists also worry about the possible contaminant in CBD products made from hemp, because hemp is a plant that absorbs heavy metals, pesticides, and other harmful for our health substances. The Arthritis Foundation highly recommends purchasing CBD products from proven companies that care about the quality of their products and have all the necessary confirmation certificates.
- Be sure that CBD products are for you. It’s not a surprise that the good-quality CBD products are expensive, especially if you take them on a regular basis. To avoid wasting money, you should be completely sure that the chosen product will have a beneficial impact on your symptoms. Specialists recommend starting a diary where you will be able to note whether and how your symptoms changed. If after six to eight weeks of CBD products taking you will not note any effects, it is recommended to review your treatment. If you are not experiencing any benefits, there is no reason to continue spending money for cannabidiol products.
What remains behind the scenes? Legality, right dosage, and side effects of CBD
All the CBD’s benefits and perspectives sound promising and exciting, but of course, there is another side of this coin. First of all, the most controversial issue for today regarding cannabidiol is its legality question. Some countries have already allowed CBD taking both for medical and recreational purposes, some only permitted its medicinal use, while others still consider it as prohibited by the law substance. Currently, cannabis and CBD products, such as CBD oil, are legal for medicinal or recreational use in certain parts of the United States. If marijuana is only permitted for medical use in your state, then all you need before you can purchase CBD oil is a recommendation from your doctor. At the same time, if cannabis is legal for recreational use as well, then you will be able to purchase CBD oil or other CBD products in dispensaries or online shops.
What you should understand with regards to the question of CBD legality is the main difference between all the components of the marijuana plant. The primary compound that is a source of all the legality problems with marijuana worldwide is THC. It is a chemical that is responsible for that unique “high” feeling that we all associate with this plant. Unlike THC, cannabidiol can’t boast of the psychoactive properties, and this is probably its main trump card. Due to the absence of the high effect on our brain, CBD is one of the main perspective medications for today, showing promising results for the whole range of diseases. Thus, CBD does not create the same effect that one typically gets when smoking, inhaling, or otherwise ingesting marijuana. According to the U.S. Drug Enforcement Administration (DEA), THC remains the primary component that makes marijuana illegal in several states, so most probably the question of its legality worldwide is only the question of time.
What situation do we have today? In 2016, the DEA issued a final rule regarding cannabis that created a new code number. This new code was designed to cover “any material, compound, mixture, or preparation” regarding the marijuana plant. Based on this new code, the DEA stated that CBD extracts that contain other cannabinoids (even small amounts) would still fall under the previous old code, making the substance illegal under federal rule. Nevertheless, cannabidiol pure extracts that contain no other cannabinoids would fall under the new code and could potentially be legal to use.
Summing up all the legality niceties covering cannabidiol, the question of whether it is legal or not still doesn’t have a clear answer. The legality of CBD products directly depends on your geographical location, local laws, and the presence of other cannabinoids in the CBD extract. All these factors should be carefully considered prior to purchase CBD for arthritis and other conditions treatment.
The rapid popularity of CBD products together with their renewed legal status for medical purposes has triggered the rise of various CBD products available on the market today. Nowadays, a person decided to choose CBD for pain relief, or other conditions improvement will face with a wide choice of different CBD forms available. They include edibles, tinctures, vaporisers, topicals, sublingual drops. These are only the most commonly used CBD forms. All of them differ by way of taking them and affect your body at different rates. For example, if you want the effect “here and now”, the most suitable products for you will be vaporisers and topicals. These CBD products can provide you with a noticeable effect in two and ten minutes, respectively. Also, if you want to take CBD in the most fun and unusual form, you can choose CBD chocolates, baked goods, sodas, and even CBD gummies.
Regardless of the product you choose, the right dosage is still the main factor. First of all, to get the desired relief and to take the maximum from all CBD benefits, you should stick to the recommended dosage. The golden rule regarding CBD dosage is “start low and go slow.” It means that you should start with a low dose (from 5 to 10 mg), and slowly increase it over a few weeks until you notice the effects. Such an approach enables you to see how well your body responds to the active substance without giving it more than necessary. According to the statistics, people usually find pain relief when they take 20 to 35 mg of CBD daily. You can either take the full dose at once or break it up throughout the day. Usually, people notice improvements shortly after starting supplementing with CBD, with more significant effects appearing after two weeks.
Another crucial moment regarding CBD oil taking for arthritis is its compatibility with other medications you take. It is recommended to consult with your doctor before including CBD into your treatment program. For example, your physician can let you know if cannabidiol might interact with any drugs you currently take or potentially worsen a chronic condition. To date, there is a list of potential drug interactions with CBD created by the U.S. National Library of Medicine. Anyway, you should always consult with your doctor about your case. One of the main CBD benefits is that it comes without any potential severe side effects. Those who use cannabidiol for the first time might experience some mild side effects like fatigue, nausea, appetite changes, and diarrhoea.
Summing up all the information we have regarding CBD for arthritis treatment, the conclusion is short - it gives hope. Cannabidiol gives hope for people who already put up with their disease and used to live a new life with certain limitations. It also gives hope for scientists who are “creating” the modern science history, and for doctors who can substitute regular medications with a better natural equivalent. A range of cannabidiol benefits has already been proved, while a lot of them are still on the horizon waiting for the final verdict. Anyway, the results of the studies existing today are promising, and this gives an excellent chance for CBD to become a worth substitution for many medications prescribed today for people with arthritis to relieve their pain. A lot of studies and human trials are still needed. Anecdotal reports from people currently using CBD for pain relief are positive, and many of us choose not to wait for the official approval of these cannabidiol benefits. In such a case, to get the desired effects, the most critical moments are:
- to pick the most suitable CBD formulation for your needs based on their use and time of CBD products to kick in;
- to choose only high-quality CBD products without lots of extra ingredients;
- to pick the right dose;
- to discuss including CBD into your treatment with your doctor to avoid possible interactions with other drugs you take.
Cannabidiol is only at the start position of this race, but in case of getting the green light, it will rush forward, leaving the majority of modern medications behind. Medicine doesn’t stand still and, keeping pace with the science one day it will rise to the heights never known before.