Can CBD oil help arthritis?
CBD, also known as cannabidiol, is a compound found in cannabis and hemp plants that is becoming increasingly popular as a natural remedy for a range of ailments. Unlike THC, the psychoactive compound in cannabis, CBD won’t get you high.
CBD is sold as a bottled oil that can be taken directly by mouth or added to food and drink, as well as in vaping liquids, edible gummies, capsules and creams.
Arthritis symptoms and pain are the two conditions CBD is most commonly used to treat and there is plenty of anecdotal evidence to suggest positive results. Scientific research shows that CBD can be helpful for chronic pain, although human studies focusing specifically on arthritis are currently scarce.
How does CBD work for arthritis?
CBD is one of numerous cannabis compounds, known as cannabinoids, that interact with a system in the body called the Endocannabinoid System (ECS). The ECS consists of cannabinoid receptors, found mostly in the central and peripheral nervous systems, and molecules called endocannabinoids, which are produced by the body as required, binding to the receptors and signalling cells to take action.
Among other things, the ECS is responsible for stabilising immune system responses such as inflammation and pain and it is possible that CBD may slow the breakdown of the endocannabinoids which trigger this, meaning their effects last longer.
CBD also interacts with a number of other receptors, including opioid receptors which are involved in pain relief, receptors (5-HT) for serotonin, which can increase a sense of wellbeing, and a receptor known as TRVP1, which is responsible for producing heat sensations.
What arthritis patients think of CBD
There’s a great deal of interest in the benefits of CBD among people with arthritis.
A recent survey by the arthritis Foundation asked 2,600 arthritis patients for their thoughts on the subject. The majority were osteoarthritis and rheumatoid arthritis sufferers who had been living with symptoms for over a decade.
The study found that 79% of patients were either using CBD, had used it in the past or were considering using it, with 29% saying they currently took it to manage their symptoms.
Pain relief was the main reason cited for using CBD – by 94% of respondents – but three quarters of those who took it said it was either ‘very effective’ or ‘effective’ in relieving a range of symptoms. Sixty-seven percent reported improvements in their ‘physical function’, more than 30% said it helped with morning stiffness, 71% that it aided sleep and over 30% said it made them feel less fatigued.
Evidence that CBD can help with arthritis
There is good medical evidence that CBD can help with the most significant symptom of arthritis in humans, chronic pain. A 2011 review of studies into the use of cannabinoids including CBD on chronic pain showed them to have significant success in reducing symptoms, and concluded that they were a safe alternative to existing medications. A follow-up study in 2015 reported the same findings.
A study on rats looking specifically at arthritis concluded that the CBD gel used to treat them demonstrated “therapeutic potential for relief of arthritis pain‐related behaviours and inflammation without evident side‐effects”.
Beyond general studies on pain in humans and animal research into arthritis itself, what's currently missing is a significant number of trials focused on human arthritis patients.
One study of osteoarthritis patients given a CBD gel to treat knee pain was inconclusive, although it did appear to suggest a more beneficial effect on men than women.
How to use CBD for arthritis
CBD products come in a variety of formats, including e-liquids for vaping, chewable ‘gummy’ sweets and capsules – but according to the Arthritis Foundation study, the vast majority of arthritis sufferers use CBD in one of two forms, with 62% taking it as a liquid and 55% as a topical product applied to the joints.
Here’s what to be aware of when it comes to these two methods of application.
CBD oil usually consists of the active ingredient dissolved in a carrier oil such as hemp, olive or coconut. It comes in small bottles generally fitted with a built-in dropper so the oil can be measured directly into the mouth or added to food and drinks.
The best way to take CBD oil is sublingually – that is, under the tongue. Placing a few droplets there and leaving it for a minute or two before swallowing allows it to be absorbed more directly into the bloodstream via the membrane beneath the tongue.
You can also swallow CBD oil directly, or add it to food or drinks, but bear in mind that it will take longer to work and more of the CBD will be lost to digestive processes. There’s also evidence that the type of food you eat with your CBD oil can make a difference to how well it’s absorbed, and that liquids above 71F may start to destroy CBD, meaning you could lose out if adding it to a hot coffee.
However you decide to take CBD oil, it’s important to choose a trustworthy brand. A recent report by the Centre for Medical Cannabis, showed that the quality of CBD products in the UK can vary hugely and that many contain far less CBD than claimed, so look for a brand that can demonstrate the provenance of its ingredients and that displays independent lab reports showing the amount of CBD in its products.
Jersey Hemp was granted the first licence for the harvesting of its own hemp for CBD production in the British Isles. Every batch of CBD oil undergoes rigorous quality control by its team of scientists and agricultural experts and is tested by an independent laboratory, with results available to view on the website.
The Centre for Medical Cannabis called Jersey Hemp “one of the most compliant, high quality and accurately labelled products that we tested.”
CBD creams and gels
CBD can also be administered via creams and gels applied to the skin. These are split into two types, topical and transdermal.
Although cannabinoid receptors are most commonly found in the nervous system, they do also exist in the skin and there is initial evidence that topical CBD creams, which penetrate the surface of the skin, may help with localised complaints such as arthritis.
Transdermal delivery, meanwhile, allows active ingredients to reach the bloodstream and thereby affect the entire system. There are transdermal CBD creams and patches on the market and early animal research suggests transdermal CBD gel can help reduce pain and inflammation.
Other things to consider
If you’re considering trying CBD to relieve arthritis symptoms, it’s important to remember that different forms of arthritis act in different ways, so that what may work for one may not work for another. In the case of rheumatoid arthritis, the Arthritis Foundation strongly recommends that conventional prescription medicines are not discontinued since they are known to help prevent permanent damage to the joints.
Whichever form of arthritis you have, it’s best to consult the heath care professional responsible for administering your treatment before using CBD.
According to the Arthritis Foundation’s wide-ranging survey, 63% of patients who said they were currently using CBD took it daily and another 26% used it several times per week.
However, the appropriate timing, frequency and dosage of CBD can depend on a number of factors, including the type of arthritis, the severity of symptoms, whether prescribed medications are being taken and individual factors such as age, weight and personal body chemistry.
The best way to determine dosage is to start small – perhaps 5-10mg – and work up in similar increments. Try a certain dosage for a day or two and record any effects, before adding more if needed. Stop at the dosage that achieves optimum benefits without adverse side-effects.
If you notice a beneficial effect after taking CBD but it wears off too quickly, you may want to try taking smaller amounts throughout the day.
For reference, the Jersey Hemp CBD oil dosage calculator can give you an idea of the sort of daily dosage that might be right for you based on your weight.
The UK’s Food Standards Agency advises as a precaution that healthy adults take no more than 70mg of CBD per day.
The speed with which CBD oil enters the bloodstream depends on exactly how it is taken. The fastest method is inhalation of CBD e-liquids from a vaping device, with any effects potentially being felt in a matter of minutes. However, the safety of vaping itself is unclear and it may not be for everyone.
The next most efficient method is to apply drops of CBD oil 'sublingually' – under the tongue – holding them there for a minute or two before swallowing. The CBD is absorbed via the blood vessel-rich membrane and effects may be felt in around 15-20 minutes.
Swallowing CBD directly will take longer – most likely a matter of hours – and the exact time and degree of absorption can vary depending on a number of factors including the contents of your stomach.
Chewing CBD gummies may provide a small amount of sublingual absorption but most of the CBD will pass through the digestive system before being absorbed.
The Arthritis Foundation says the effects of topical creams may be felt within 15 to 45 mins and there is evidence that they may peak after around 90 mins.
One of the reasons that CBD is seen as an interesting avenue for further research by scientists, and as an appealing natural remedy by CBD users, is its relatively low-level of serious side-effects and the fact that it appears not to induce dependency like some pharmacological treatments. CBD is generally considered medically ‘well tolerated’, meaning that only small numbers of patients drop out of clinical trials due to adverse effects.
However, CBD can have side-effects in a small proportion of people. Among the most common is dry mouth, experienced by 11% of those involved in a 2018 study of over 2,400 CBD users. Tiredness / fatigue is also regularly reported, while some sources suggest CBD can sometimes cause nausea, diarrhoea, appetite changes or irritability.
CBD can interact with a wide range of drugs in ways that are potentially unsafe. These include some statins and blood pressure medicines and those that come with a grapefruit warning. However, many drugs that can be adversely affected by CBD do not carry warnings. Therefore, if you are on any medication or supplements, you should consult your doctor before using CBD.
The author of this article is not a medical expert and nothing in this article constitutes medical advice or gives rise to a medical practitioner/patient relationship. You should seek specialist medical advice where required. Never disregard professional medical advice or refrain from seeking it because of something you have read here.