CBD for Arthritis. Arthritis is understood to mean various inflammatory joint diseases with different causes. It is important to first differentiate arthritis from arthrosis because they are often confused because both affect the joints. Arthrosis is excessive joint wear due to articular cartilage degradation. Arthritis is a chronic inflammation of the joints, which in rare cases can also affect internal organs.
The term arthritis summarizes inflammatory joint diseases. They may have different causes, distinguishing between infectious arthritis (for example, by bacteria) and non-infectious arthritis. The most common form of arthritis is rheumatoid arthritis. It affects around one to two percent of all adults, depending on their age. It is one of the non-infectious-related arthritis: In this, the body’s defense (immune system) is disturbed and attacks the joints and endogenous tissue. The cause for this is not yet clear.
CBD, also known as cannabidiol plays a role in immune system modulation which means, it can help in autoimmune conditions like rheumatoid arthritis. But also the strong anti-inflammatory properties of CBD and the interaction and inhibition of certain receptors make CBD a potential form of treatment. Cannabidiol (CBD), Tetrahydrocannabidiol (THC) and the by-product of its metabolism have anti-inflammatory and pain-killing (analgesic) properties. However, there are other properties of cannabinoids, and especially CBD, such as the ability to suppress T-cells, affect the immune system and how cannabinoids affect the so-called GPR55 receptors associated with the development of arthritis. In this article we look at the currently known properties and studies that make CBD and other cannabinoids a potential treatment for arthritis. So stay tuned!
Arthritis: Causes and symptoms
When rheumatoid arthritis affects a person, it attacks normal tissue components as invading pathogens cause inflammation. The inflammation attacks the lining of the joints and then spreads to cartilage and bone while causing destruction therein and making joints immobile and deformed. There are environmental and genetic factors involved in this reaction.
Symptoms vary from one person to another and it may include swelling, pain in joints, persistent fatigue, stiff joints especially in the morning, sleep difficulties owing to pain and weakness in muscles.
Making a diagnose is not so hard as the disease shows itself over a few months. Only an expert can tell after complete examination and check-up. Blood tests also help identify rheumatoid arthritis factor that is present in almost 80 percent of people suffering from rheumatoid.
Arthritis: Risk Factors
There are certain factors that increase the chances of developing rheumatoid arthritis. These are age (25 to 45), gender (three-quarter patients are female), family history of rheumatoid arthritis, ethnicity (Americans, Caucasians have a higher risk) and obesity.
There are ways through proper methods and techniques to alleviate the discomfort.. Physiotherapy that involves heat, cold and exercises to relieve stiffness and pain is an effective way.
Rest and occupational therapy are also effective. Drugs are also available that include NSAIDs (non-steroidal anti-inflammatory drugs) to treat inflammation but these have side effects.
Corticosteroids are also used that suppress immune reaction. DMARDs (disease modifying anti-rheumatic drugs) slow down the progress of the disease but they can bring about serious side effects.
CBD for Arthritis: CBD Oil as a Treatment?
CBD oil has shown lots of improvement in the treatment of arthritis. According to research, cannabidiol helps reduce pain and inflammation caused by arthritis of all types like rheumatoid arthritis, gout, osteoarthritis, psoriatic arthritis and other types of inflammatory joint conditions.
Cannabidiol (CBD) is a compound (Cannabinoid) that is found in all Cannabis species of this genus of plants. So it is present in countless Hemp and Cannabis Strains.
Doctors have successfully treated rheumatoid arthritis with CBD oil that gives relief from inflammation and pain. According to a study conducted in 2006 where patients used CBD oil for a five-week period.
They experienced improvement in less pain and inflammation. It also slowed down the progression of rheumatoid arthritis considerably. Patients who are fed up with drugs and want to go for a natural treatment of this disease can use CBD oil according to the instructions given by experts.
What qualities does CBD have in the treatment of arthritis?
Cananbidiol Suppresses T-Cells
T-cells form a group of white blood cells that serves the immune system. T-cells together with the B lymphocytes represent the acquired immune response. The “T” in the name stands for the thymus in which the cells mature. These T-cells thus represent an important part of the human immune system.
Rheumatoid arthritis is one of the autoimmune diseases in which the immune response of the body can be directed against the body’s own processes / components. An overreaction of the immune system to the body’s own, non-pathogenic substances. The development of T-cells serves to recognize and combat foreign substances, which could pose a danger to the body.
The formation of T-cells are also seen as co-causative agents in the development of Rheumatoid arthritis. Research has shown that the use of CBD suppresses the development of these T-cells. Which in turn represents one of the immunosuppressive properties of CBD (cannabidiol) and, among other things, its anti-inflammatory properties.
These properties of suppressing the development of T-cells in the autoimmune disease rheumatoid arthritis are one of the benefits of the use of CBD in RA.
The Effects of CBD on the Immune System in Arthritis
As mentioned, CBD also affects the immune system of the body. Research has shown that CBD can regulate and balance overstimulation of the immune system. Overstimulation (overreaction) often leads to autoimmune diseases such as multiple sclerosis, psoriasis, arthritis or in general to a chronic inflammation.
People who suffer from rheumatoid arthritis usually also have to fight with inflammation in the joints. These inflammations are accompanied by severe pain and immobility. The strong anti-inflammatory properties of CBD may therefore be helpful in chronic inflammatory processes in RA.
- The anti-inflammatory properties of CBD are mainly due to the regulation of an over-stimulated immune system. In chronic inflammation caused by an autoimmune disease, CBD can be very helpful.
- Inflammation, however, is an important body process that normally serves to localize foreign bodies, isolate them and heal damaged tissue. Therefore, it is not always advisable to suppress inflammation, even not with CBD.
- How does CBD affect the Human Immune System?
- CBD Effects & the Importance of Homeostasis for the Human Body
Studies of CBD in Arthritis
Since these properties of CBD described above and the resulting advantages in the use of CBD and other cannabinoids in rheumatoid arthritis are well known, some studies have been carried out here as well. We took a closer look at 4 studies that all used a different approach and gave interesting results. Let’s take a closer look at these studies.
Cannabis-based Medicine for pain caused by rheumatoid arthritis
This is the first controlled trial of a cannabis-based drug (CBM) in rheumatoid arthritis. This study is a preliminary assessment of the tolerability and efficacy of Sativex (a pharmaceutical cannabis preparation) in the treatment of pain associated with rheumatoid arthritis.
Sativex is a cannabinoid preparation containing both THC and CBD in a ratio of approximately 1: 0.8. So this is not a pure CBD product. Nevertheless, this study is very interesting and as CBD also plays a role in this product, we also want to take a look at it.
In this study, 58 patients underwent a double-blind study with Sativex and a placebo, to test the efficacy and tolerability of Sativex. The cannabis based medicine (CBM) was administered in the evening and the next morning a review was conducted. Half of the group received a placebo, the other half received CBM (Sativex). This procedure was performed over 5 weeks.
The assessment was based on the following criteria:
- Pain on movement
- Pain at rest
- Morning stiffness
- Sleep quality
In the evaluation of the 5-week treatment, the following result was found:
The CBM (Sativex) was able to significantly improve pain on movement, pain at rest & quality of sleep when compared to the placebo. There was no difference in morning stiffness. However, the baseline values were also very low and it is more difficult to detect a difference.
There was no adverse effect on the inflammatory symptoms or severe side effects of the cannabis preparation used in this treatment. In general, the side effects were mild to moderate nature.
The conclusion of this study:
A significant analgesic effect was observed in the treatment of RA patients with Sativex and the disease activity was significantly suppressed. These findings are clinically relevant and suggest that further detailed investigation is required. The cannabinoids THC and CBD obviously have a strong positive effect in the treatment of RA patients. Which cannabinoids and which proportionality play a decisive role in this study was not investigated.
CBD as an oral Anti-arthritic therapeutic in induced Arthritis
Another therapeutic potential of CBD in arthritis has been found in a experiment with mice.
In this study, mice were induced arthritis, which in medical terms is called “murine collagen-induced arthritis”. Either a classic acute or chronic recurring arthritis was triggered.
Once clinical symptoms of arthritis were detected, mice were given CBD.
It turned out that in both arthritis models, treatment with CBD effectively blocked the progression of arthritis.
The efficacy of CBD was confirmed in both cases of administration and was administered as follows:
- Intraperitoneal: Through an injection into the abdominal cavity
- Oral: By administration in the mouth
An optimal effect was observed at the following doses:
- 5 mg CBD / 1 kg body weight per day with intraperitoneal
- 25 mg CBD / 1 kg body weight per day when administered orally
The clinical improvement in the treated mice is associated with the protection of the joints from severe damage. After completion of the treatment, the investigations were continued in two ways:
- Ex- Vivo: Refers to processes in which living biological material, in particular cells, tissues or organs, is taken from a living organism and usually cultivated outside it for a limited time.
- In Vitro: Are organic processes that take place outside of a living organism, as opposed to those that occur in the living organism (in vivo)
In Ex-Vivo, a reduction in the specific substances associated with the formation of induced arthritis was found in the lymph’s and a reduction of tumor necrosis factor by so-called knee synovial cells.
In Vitro effects showed a dose-dependent suppression of lymphocyte proliferation (growth of lymphocytes) and the blockade of zymosan-induced reactive oxygen burst.
Conclusion of this Study:
The data in this study show that CBD has a strong anti-arthritic effect on collagen-induced arthritis (CIA) due to its immunosuppressive and anti-inflammatory properties.
The role of the Endocannabinoid System in Osteoarthritis pain
The degenerative joint disease osteoarthritis is associated with articular cartilage degradation and is leads to neuropathic and nociceptive pain.
- Neuropathic pain: Is caused by damage or diseases of the nervous system. While in all other types of pain – the so-called nociceptive pain – the nerve tracts act only as a “transmitter” of pain stimuli, in neuropathic pain, the nervous system itself is the cause of pain.
- Nociceptor: Is a free sensory nerve end, which generates electrical signals in case of threatened or damaged tissue damage by thermal, chemical or mechanical Noxen. Nociceptors are the point of departure for nociception and their irritation is typically accompanied by pain.
Currently, there are no drugs that can control the disease progression of osteoarthritis, so the current therapeutic approaches are very limited. However, there are more and more preclinical studies suggesting the endocannabinoid system as a therapeutic target for osteoarthritis pain. Some studies have shown that the properties of cannabinoids have an antinociceptive effect in osteoarthritis and suggest an active involvement of the endocannabinoid system in the pathophysiology of this disease.
The endocannabinoid system extends through the body through many cannabinoid receptors that interact directly or indirectly with the cannabinoids. In addition, the ECS (endocannabinoid system) plays a physiological role in the regulation of inflammation, pain and joint function. All this supports the therapeutic potential of cannabinoids such as CBD, THC, CBN etc. in the treatment of osteoarthritis.
To date, too few clinical evidence (studies) have been provided to substantiate these promising preclinical evidence for the use of cannabinoids in the treatment of osteoarthritis. To get cannabinoids officially as a therapeutic for osteoarthritis, there is still a long way to go, which will hopefully start soon with new studies.
- What is the Endocannabinoid System? Human Cannabinoid System
- The Endocannabinoid System – As a therapeutic target
CBD reduces Nociception in a Rat-Model of acute Arthritis
The purpose of this study is to determine how and if CBD is effective in acute arthritis and joint nociception. Nociception is a sensory nerve pain (read more about this in the previous study).
Normally, cannabinoids interact with the cannabinoid receptors (CB1 & CB2) and may thereby modulate nociception. However, there are also other receptors, such as GPR55 receptors, on which cannabinoids have an influence.
Among other things, GPR55 is attributed to promote osteoclast cell function, which facilitates bone reabsorption. However, an overactive GPR55 receptor signaling pathway is associated with the formation of osteoporosis.
In this study, a synthetic agonist to the GPR55 receptor is used to see if it can alter the joint nociception in acute joint inflammation. An abnormal CBD analogue O-1602 was used to activate this receptor.
- Agonist: Pharmacology refers to a substance that activates signal transduction in the associated cell by occupying a receptor.
- Antagonist: Chemical compounds that bind to a receptor but do not activate it, thus blocking and inhibiting.
Administration of the agonist (O-1602) significantly reduced nociceptive pain in the joint caused by movement. The administration of an antagonist (O-1918) reversed this positive effect by blocking the GDPR55 receptors.
This study clearly demonstrated that atypical cannabinoid receptors such as GPR55 are involved in joint nociception and that this finding may lead to new treatment approaches.
Anti-Inflammatory Properties of CBD in Osteoarthritis
In this last but also very interesting study it was to be determined whether CBD, which is believed to have potential analgesic properties, is an anti-nociceptive agent in osteoarthritis. In addition, it should be determined, if the anti-inflammatory properties of CBD can prevent the development of pain in osteoarthritis and neuropathic joint pain.
For this purpose, osteoarthritis was induced in rats. through the administration of chemical substances. (Yes, I know, the poor rats. But that’s the way research works today).
After 14 days, the rats reached the end-stage of OA (osteoarthritis), and during this development the therapeutic and prophylactic effects of peripheral CBD (100-300 μg) were investigated.
- In the final stage, CBD lowered the pain in the joints and increased the withdrawal threshold and weight bearing. Acute arthritis could be reduced by local CBD treatment.
- In addition, prophylactic administration of CBD could prevent the development of joint pain at later times and was also found to be neuroprotective.
This study showed that prophylactic CBD treatment can prevent the subsequent development of pain and nerve damage in joints in osteoarthritis. Local administration of CBD again can block (reduce) pain in OA. It has been concluded that CBD may be a safe and effective therapeutic agent in the treatment of osteoarthritis joint pain.
- Involvement of the endocannabinoid system in osteoarthritis pain.
- The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis.
- Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis.
- The abnormal cannabidiol analogue O-1602 reduces nociception in a rat model of acute arthritis via the putative cannabinoid receptor GPR55.
- Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis