Pain Relief

CBD and Joint Pain: What You Need to Know and Ask

By Anna McGeehan
Nino Liverani/Unsplash

We often dismiss joint pain as a symptom of getting older: some knee pains here and there, a sore neck in the morning, or a tight lower back after sitting too long.

The reality, however, is that 91 million people suffer from joint pain or some form of arthritis, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, including 61 million people between the ages of 18 and 64.

This is roughly 68 percent higher than previously reported, particularly among young-to-middle-aged adults, according to the institute.

Joint pain can have far-reaching consequences well beyond the physical pain or quality of life impacts. As the institute’s lead statistician explains, “our findings are important because of underestimated, yet enormous, economic and public health impacts of arthritis including healthcare costs and costs from loss of productivity and disability, including in adults younger than 65 years of age,”

The challenge, however, is how to treat joint pain.

On one hand, acute discomfort after a long day of skiing or hiking is likely to fade. In this case, rest, ice, and maybe a nonsteroidal anti-inflammatory drug like ibuprofen might do the trick.

On the other hand, neglecting minor aches can potentially lead to more serious conditions down the road, requiring a more prescribed pharmacologic approach.

Although prescription pain medications such as opioids are very common in treating chronic pain, the Centers for Disease Control and Prevention notes that “there is insufficient evidence for and serious risks associated with long-term use of opioid therapy to treat chronic pain.” There are even serious warnings associated with traditional over-the-counter pain medication, with most medical experts suggesting the lowest possible dose for the shortest period of time, leading some sufferers to wonder when and how to treat joint pain.

Some researchers think that cannabidiol oil holds promise in the field of joint pain management, particularly as an alternative or adjunctive pain therapy.

Though conclusive scientific results are preliminary and, in some ways, limited, medical experts are finding CBD to have a range of therapeutic properties, particularly in the areas of inflammation and pain management.

What Do We Mean By Joint Pain?

According to the Mayo Clinic, joint pain can be “discomfort, pain or inflammation arising from any part of a joint,” including cartilage, bone, ligaments, tendons, or muscles.

It can get confusing, however, once you start to pinpoint the source of pain. Sometimes, joint pain is actually stemming from the structures outside the joints, such as ligaments, tendons, or muscles. This type of pain might actually be inflammation of the tendons (e.g. tendonitis), bursae (e.g. bursitis), or something else.

When pain stems from the actual joint, it is known as arthralgia. Joint pain is sometimes, but not always, accompanied by joint inflammation, also known as arthritis. Essentially, if you have arthritis (joint inflammation), you likely also have arthralgia (joint pain).

What Are The Different Types of Joint Pain?

Joint pain is generally acute or chronic.

Acute joint pain is usually that temporary ache or inflammation flare-up you might feel after a period of overexertion or overuse, including a long run, repetitive motions such as weight lifting, or a minor injury like a rolled ankle. This type of joint pain is usually treated with anti-inflammatory applications such as topical creams, ice, or over-the-counter medication.

Acute joint pain becomes more serious when it turns chronic, which can happen if left untreated.

Chronic joint pain is more severe and long-term and is often characterized as a pain condition that seriously compromises the quality of life and mobility. This type of severe joint pain has increased significantly over the last two decades, reaching nearly 15 million in 2015, compared with approximately 10 million in 2002, according to the Centers for Disease Control and Prevention.

According to the Arthritis Foundation, there are over 100 different types of joint-related diseases and conditions. The most common types include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Fibromyalgia
  • Gout
  • Lupus
  • Musculoskeletal pain
  • Back and spine conditions (e.g. sciatica, slipped disc, spinal stenosis)

Each condition develops differently and affects the joints, ligaments, tendons, and muscles in separate ways, making treatment highly variable and based on the individual’s specific conditions.

What Kinds of Treatment Options Are Available For Joint Pain?

Since joint pain can vary widely among patients, the CDC recommends that management strategies be flexible, tailored to meet each patients’ needs, and include options that do not involve medication.

Common treatments for acute joint pain include:

  • Over-the-counter medications such as acetaminophen, ibuprofen, and other nonsteroidal anti-inflammatory drugs.
  • Low impact exercise, including biking, swimming, or walking.
  • Weight loss and weight management.
  • Cognitive behavioral therapy, which is a psychological, approach aimed at helping patients learn how to modify physical and emotional triggers of pain and stress.

Chronic joint pain such as gout and rheumatoid arthritis generally require a more targeted medical approach, including various anti-inflammatory medications designed to calm inflammation or the underlying disorder or disease.

Where Does CBD Fit In?

There is a growing body of scientific research studying CBD’s anti-inflammatory and analgesic effects, with the general conclusion that CBD appears safe and effective.

However, joint pain is multi-faceted, and an effective treatment largely depends on the patient, the specific joint condition, and a doctor’s recommendation.

Additionally, medical studies often assess CBD’s effects on specific joint conditions such as neuropathic pain, osteoarthritis, or rheumatoid arthritis rather than the broad field of joint pain at large. This means that, although one study may reveal CBD’s beneficial effects on a specific joint condition, we cannot necessarily extrapolate those conclusions to the field of joint pain at large.

The growing interest in CBD as a natural alternative to traditional medication is nevertheless pushing researchers to examine CBD more closely. And although scientific evidence is preliminary, many experts are expressing cautious optimism.

So, here is what we know about CBD and specific joint conditions:

Joint Pain

One of the few cannabinoid studies focusing on the broad field of joint pain evaluated the effects of THC, not CBD. However, researchers concluded, “there are numerous anecdotal reports of the effectiveness of smoking cannabis for joint pain,” though “these reports generally do not extend to regulated clinical trials for rheumatic diseases.”

Nevertheless, the study stated, “the preclinical and human data that do exist indicate that the use of cannabis should be taken seriously as a potential treatment of joint pain.”

Inflammation

A 2016 study found that a daily topical application of CBD in arthritic rats reduced joint swelling and inflammatory responses without adverse side effects.

Another study evaluated the effects of CBD on microglial proliferation, which are cells that can trigger inflammatory responses. Researchers found that CBD helped inhibit adenosine uptake and produced an immunosuppression response in mice, though they caution more research is needed to determine the long-term effects of CBD use on adenosine receptors.

Rheumatoid Arthritis

In 2000, researchers studied the effects of CBD on rats induced with a version of rheumatoid arthritis. They found that CBD had “a slight therapeutic effect” at 10 and 20 mg/kg per but not at 5 mg/kg per day or lower. Researchers concluded that the dose-dependent effects of CBD closely resemble clinical patterns in the human disease with “no obvious side effects” in the mice subjects.

Another rheumatoid arthritis study involving human subjects tested the cannabis-derived medicine, Sativex, over a five-week period. Researchers observed a “significant analgesic effect” and a decrease in disease activity, though they pointed out the need for further research.

Osteoarthritis

A 2017 study evaluated CBD’s potential to mitigate pain, inflammation, and joint neuropathy in osteoarthritic rats. Researchers found that CBD helped decrease joint inflammation and increased weight bearing thresholds, and helped prevent the development of joint pain. Researchers concluded that CBD also might have the potential to act as a prophylactic (i.e., preventative) treatment.

Is There A Safe Way To Try CBD For Joint Pain?

There is a lot of buzz around CBD, especially its ability to treat sore joints with minimal adverse side effects.

Athletes have started trading in traditional pain medication for CBD products, including tinctures, creams, and supplements, and it’s popping up in health and wellness stores all over the map.

Whether you’re looking to test out CBD for a sore neck or a more serious join condition, it’s imperative to be an informed consumer. In the unregulated world of CBD, you get what you pay for.

For acute joint pain, look for pure, minimally processed CBD oil, whether it be a tincture, cream, supplement, or vape pen. Consider starting with the smallest dose and see how your body reacts. Medical experts at the Arthritis Foundation, for example, suggest starting at 5 to 10 mg twice daily, and increasing up to 50 to 100 mg per day, depending on your condition, weight, age, etc.

For more chronic conditions, work with your doctor to decide which CBD products and dosing levels might be right for you.

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