Can CBD Oil Reduce Symptoms of Psoriatic Arthritis?
Some doctors and alternative health practitioners have begun to include this hemp product in their treatment arsenal.
There’s been an explosion of interest in CBD (cannabidiol) oil as a treatment for pain, anxiety, depression, and a host of other ailments. Now some doctors and alternative health practitioners are using CBD, a natural chemical found in the cannabis plant (also known as industrial hemp), to help patients with psoriatic arthritis.
Psoriatic arthritis affects about 30 percent of people with psoriasis. Psoriasis is an autoimmune condition that causes cells to build up on the surface of the skin, resulting in thick red patches with silver scaling. Psoriatic arthritis develops when the immune system begins to attack healthy cells and tissue, causing swelling, pain, fatigue, and inflammation in joints.
James W. Baumgartner, PhD, head of research and development and a manufacturing partner for the CBD business BIOS Labs, believes that CBD oil and medical marijuana extracts may be new alternative treatments for psoriasis and psoriatic arthritis.
According to Baumgarnter, there is scientific evidence that cannabinoids, which include CBD and other active compounds in the cannabis plant, help regulate the immune system through the body’s endocannabinoid system. Researchers are still trying to understand the underlying mechanisms, he says.
A review of the scientific literature on this subject, published in a 2016 issue of the journal Current Clinical Pharmacology, makes the same point. The investigators conclude that there’s reason to believe cannabinoids have the potential to help treat psoriasis.
In a small study published in the April 2019 edition of the Italian medical journal La Clinica Terapeutica, researchers concluded that for patients with some skin disorders, especially those related to inflammation, topical CDB is a safe, effective, noninvasive way to reduce symptoms and improve quality of life.
How Do You Use CBD?
Hervé Damas, MD, founder of the medical marijuana business Grassroots Wellness in Miami, uses an array of CBD products for patients with inflammatory skin disorders. Depending on the severity of the disease, he says, he’ll either use topical CBD or a combination of a cream and systemic treatments (formulations that are absorbed into the bloodstream, such as drops that go under the tongue). “For issues such as psoriasis, dermatitis, and eczema, I’ve found CBD very effective at decreasing flare-ups, irritation, and discomfort in patients,” he says.
Aly Cohen, MD, a rheumatologist and integrative medicine practitioner in Monroe Township, New Jersey, and the founder and medical director of the website The Smart Human, says it’s important for patients to take CBD oil under the guidance of a practitioner who has expertise in this area and knows all the benefits and potential risks. “You need to watch for dangerous interactions with antidepressants, chemotherapy drugs, anticoagulants, and anti-seizure medications,” she says.
How Much CBD Oil Should You Use?
Dr. Damas finds that dosing with CBD is more art than science at this point. “For patients with inflammatory skin disorders I typically recommend 20 to 30 milligrams for daily maintenance, but this dosage varies based on a person’s body weight, health, and other medications they may be taking,” he says. “Applying topical applications to an affected area two or three times daily usually suffices.”
What Kind of CBD Oil Should You Buy?
Damas suggests buying full-spectrum oil (containing all cannabinoids and other compounds naturally occurring in the cannabis plant), as some research has shown this form of CBD to be more effective than isolates (just CBD).
How Do You Know if Your CBD Is Pure?
Shital Mars, CEO of PharmCo RX, an independent pharmacy in Miami, explains that the U.S. Food and Drug Administration (FDA) does not regulate CBD products (with the exception of a single CBD-based drug, Epidiolex, used to treat two rare forms of epilepsy).
“The best way to choose a CBD product is to do your research, work with a licensed physician or trusted pharmacist, and get a verified certificate of third-party analysis from the manufacturer,” says Mars. “That is the only way to know you are getting a quality product.”
Mars explains that manufacturers that offer transparency merit the most trust, so ask how much CBD you are actually getting in each dose. Understand that most labels show CBD content by volume, not by dose.
Complementary treatments and arthritis – from turmeric to cannabis oil
People use complementary medicine for many different reasons, including:
- wanting to use more natural treatments
- their symptoms aren’t fully controlled by conventional medicine.
Read more about complementary therapies which can help to ease the symptoms of arthritis, from yoga to meditation.
Are they right for me?
As with all complementary treatments, different things work for different people and it isn’t possible to predict which might be the most useful or effective.
There are some key points to consider if you’re thinking about using any complementary treatments.
- What are you hoping to achieve? Pain relief? More energy? Better sleep? Reduction in medication?
- What are the financial costs?
- Is there any evidence for their effectiveness?
Are complementary medicines safe?
Complementary medicines are relatively safe, although you should always talk to your doctor before you start any new treatment.
In specific cases they may not be recommended, for example, if you are pregnant or breastfeeding, or they may interact with certain medication.
A starter for five
Here we share a spotlight on the most popular complementary medicines that people call our helpline about.
It’s thought that turmeric can possibly reduce inflammation, which could help people with arthritis.
People with knee osteoarthritis who took part in a research trial reported improvements to their pain levels after taking turmeric. The evidence is limited however, as it is from just one trial. What evidence there is suggested that people only had minor side-effects after taking turmeric.
Turmeric can be bought from health food shops, pharmacies and supermarkets in the form of powder.
Glucosamine sulphate and glucosamine hydrochloride are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage.
The results for the use of glucosamine for osteoarthritis are mixed and the size of the effect is modest. There’s some evidence that more recent trials and those using higher-quality methods are less likely to show a benefit.
Capsaicin is taken from chilli peppers. It works mainly by reducing Substance P, a pain transmitter in your nerves. Results from randomised controlled trials assessing its role in treating osteoarthritis suggest that it can be effective in reducing pain and tenderness in affected joints, and it has no major safety problems. Evidence for its effectiveness for fibromyalgia is related to a single trial.
Other names: Axsain®, Zacin®, chilli, pepper gel, cayenne
Capsaicin is licensed in the UK for osteoarthritis and you can get it on prescription in the form of gels, creams and plasters.
There are no major safety concerns in applying capsaicin gel/cream. A review of capsaicin applied to the skin to treat chronic pain (not specifically related to osteoarthritis, rheumatoid arthritis or fibromyalgia) concluded that around one third of people experience a reaction around the area where the treatment is applied. It’s important to keep capsaicin away from your eyes, mouth and open wounds because it will cause irritation. There have been no reported drug interactions.
Fish oils are rich in omega-3 essential fatty acids, which have strong anti-inflammatory properties. Fish liver oil is also a rich source of vitamin A (a strong antioxidant) and vitamin D (which is important for maintaining healthy joints).
Evidence suggests that fish body oil can improve the symptoms of rheumatoid arthritis. Unconfirmed evidence also suggests a combination of fish body and liver oils might also be useful in the long term, particularly in reducing the use of non-steroidal anti-inflammatory drugs (NSAIDs). There isn’t enough evidence for the use of fish liver oil for osteoarthritis.
Omega-3 fatty acids also play a role in lowering cholesterol and triglyceride levels in your blood, so they can reduce the risk of heart disease and stroke in people with inflammatory arthritis.
In the UK, dietary guidelines recommend eating two portions of fish a week, including one oily. Fish oil is considered to be well tolerated at this dose.
At the correct doses, side-effects are usually minor and uncommon.
Cannabis oil (CBD)
CBD is type of cannabinoid – a natural substance extracted from the cannabis plant and often mixed with an oil (such as coconut or hemp) to create CBD oil. It does not contain the psychoactive compound called tetrahydrocannabidiol (THC) which is associated with the feeling of being ‘high’.
Research in cannabinoids over the years suggests that they can be effective in treating certain types of chronic pain such as pain from nerve injury, but there is currently not enough evidence to support using cannabinoids in reducing musculoskeletal pain. We welcome further research to better understand its impact and are intently following developments internationally.
CBD oil can be legally bought as a food supplement in the UK from heath food shops and some pharmacies. However, CBD products are not licensed as a medicine for use in arthritis by MHRA (Medicines and Healthcare products Regulatory Authority) or approved by NICE (National Institute for Health and Care Excellence) or the SMC (Scottish Medicines consortium).
We know anecdotally from some people with arthritis, that CBD has reduced their symptoms. If you’re considering using CBD to manage the pain of your arthritis, it’s important to remember it cannot replace your current medicines, and it may interact with them, so please do not stop/start taking anything without speaking to a healthcare professional.
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How Does CBD Oil Work for Psoriatic Arthritis?
Lindsay Curtis is a health writer with over 20 years of experience in writing health, science & wellness-focused articles.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles, California.
CBD (cannabidiol) has exploded in popularity in recent years, in large part because it has shown promise in reducing pain, alleviating anxiety, and reducing symptoms of certain health conditions.
One such condition that may benefit from CBD oil is psoriatic arthritis (PsA), a chronic (long-term) disease affecting the joints. While there is no cure for the condition, some people are turning to CBD to manage the symptoms of the disease.
Here are a few things to know if you want to try using CBD to treat the symptoms of psoriatic arthritis.
What Is CBD Oil?
Cannabis plants contain chemicals called cannabinoids. The two major cannabinoids are:
- Tetrahydrocannabinol (THC), which makes a person feel “high”
- Cannabidiol (CBD), which has no psychoactive effects but can provide a number of therapeutic benefits
Both CBD and THC act on a communication system in the body known as the endocannabinoid system (ECS). The ECS is a complex biological system that affects appetite, fertility, sleep, mood, and memory. The ECS is active in the body even if you do not use cannabis.
CBD isolate is the purest form on the market. It contains 99% CBD, with no other additives or chemicals from the cannabis plant from which it is derived.
CBD binds to and activates receptors in the brain that create a therapeutic effect in the body, which allows users to get relief from symptoms without feeling impaired.
Types of Arthritis
Arthritis is a term to describe conditions that affect the joints and surrounding tissues. Though there are over 100 types of arthritis, they all cause inflammation and swelling in one or more joints.
Psoriatic arthritis (PsA) is an autoimmune disease that causes an overactive immune system to attack normal cells and tissues in the joints. PsA affects some people who have psoriasis—a skin condition that causes the formation of itchy red patches topped with silvery scales.
PsA typically is diagnosed after psoriasis. PsA can cause pain, stiffness, and swelling in the joints and surrounding tissues. An estimated 2.25 million Americans have psoriatic arthritis.
PsA most commonly affects joints in the arms and legs, including the elbows, wrists, hands, and feet. It can also impact the spine, hips, and shoulders, though this is less common.
There are several types of psoriatic arthritis, which are categorized by the joints they affect.
The five types of psoriatic arthritis are:
- Distal interphalangeal predominant, which affects the end joints of the fingers and toes and can cause nail changes (such as pitting, spotting, and separation from the nail bed)
- Asymmetric oligoarticular, which affects fewer than five joints in the body and typically occurs on one side of the body
- Symmetric polyarthritis, the most common type of PsA, affecting five or more joints on both sides of the body
- Spondylitis, which involves inflammation of the spinal column and can cause neck pain, stiffness in the lower back, and limited mobility
- Arthritis mutilans, a severe type of PsA that can wear down, destroy, and deform joints in the fingers, hands, wrists, and feet
CBD and PsA Symptoms
Stress can cause psoriasis and psoriatic arthritis to flare up. People with PsA may find CBD helps reduce anxiety and prevent flares in addition to decreasing pain and inflammation in the joints.
CBD for Psoriasis Symptoms
Approximately one in four people with psoriasis will develop psoriatic arthritis. Some will develop symptoms of PsA slowly over time, and others will experience the onset of severe symptoms quickly.
Some common symptoms of PsA include:
- Swollen fingers and toes
- Stiffness, pain, throbbing, swelling, and tenderness in affected joints
- Pain, tenderness, and swelling in tendons (flexible fibrous tissue connecting muscle to bone)
- Nail changes (like pitting and separation from nail bed)
- Redness and pain in one or both eyes
- Limited range of motion
- Morning stiffness
- Anxiety and depression
CBD is being studied as a treatment for many conditions, including psoriatic arthritis, but research supporting its effectiveness is still limited. There is research demonstrating that CBD can effectively manage and reduce pain, however, so it might help some people with PsA.
CBD cannot cure conditions like psoriasis and psoriatic arthritis, but research has shown that it might help some people cope with their symptoms by decreasing pain sensation, inflammation, and the anxiety that a person might experience related to the condition.
A review of 49 studies found that CBD may help with generalized anxiety disorder and social anxiety disorder. A 2019 study found that 80% of participants had reduced anxiety after a month of taking CBD.
What Triggers Flares?
Psoriasis can be triggered by certain factors in a person’s environment or even conditions within their own body, such as illness, foods, and medications.
Some common psoriasis triggers include:
- Allergies (such as those to certain foods, alcohol, or environmental conditions)
- Medication interactions
- Skin trauma/injury
- Smoking (dry and cold weather, in particular)
Some people are genetically predisposed to developing psoriatic arthritis, and approximately one in three people with psoriasis will develop PsA.
Are There Any Side Effects?
CBD is generally well-tolerated but can cause some side effects, particularly when taken in large amounts.
Possible side effects of CBD include:
- Dry mouth
- Gastrointestinal issues
- Reduced appetite
Best CBD for Managing Psoriasis Pain
There is limited research into CBD’s effectiveness at treating psoriasis, but its anti-inflammatory and pain-relieving properties are well documented. Anecdotally, some people have found that CBD helps them manage their psoriasis symptoms.
Types of CDB
There are three basic types of CBD:
Verywell / Michela Buttignol
- Full-spectrum CBD contains all the natural components found in cannabis plants (and hemp plants), including terpenes, flavonoids, and fatty acids as well as cannabinoids. Full-spectrum CBD oil contains trace amounts of THC. When these plant compounds interact with the body, they help a user obtain the desired therapeutic benefits.
- Broad-spectrum CBD is similar to full-spectrum CBD but with all traces of THC removed. Users will not experience any mind-altering effects.
- CBD isolates are produced by using a detailed extraction and purification process of the cannabis/hemp plant. All other cannabinoids, terpenes, and flavonoids are removed to create a 99% pure CBD.
There is not enough research to determine which form of CBD is best for treating psoriasis or psoriatic arthritis. You might want to try different forms and types to determine which works best for you.
Products and Delivery Methods
There are many different ways to use CBD, which means that you can tailor it to your preferences and needs. Examples of CBD products that are available include:
- Topicals (lotions, rubs, and creams)
- Tinctures (alcohol-based extracts)
- Edibles (like gummies)
- Capsules and pills
- Vaping products (oil)
How Much to Use
The Food and Drug Administration (FDA) has only approved CBD for treating epilepsy. As a result, there is no standard dosage of CBD for treating psoriasis.
Follow the recommended usage guidelines on the products that you are using. You may want to slowly increase the amount that you use until you feel that you’ve reached the right dosage for symptom relief.
How to Buy CBD
Although CBD is generally safe, the industry is poorly regulated. When you are looking for a product that meets your needs, there are a few key factors to consider.
CBD from reputable companies should have information about the product on the label, including:
- Amount of CBD per serving
- Suggested use and dosage
- Whether it is full-spectrum, broad-spectrum, or isolate
- List of ingredients
- Manufacturer and distributor name
In addition to checking the labels, make sure that you:
- Avoid products that make sweeping, definitive health claims (like promises to ‘”cure”).
- Look for companies that provide third-party testing results of their products.
- Check customer reviews for products since testimonials from users can tell you a lot about a product.
Before you try a CBD product, ask your doctor if it could interact with any over-the-counter (OTC) or prescription medications or supplements that you take.
Frequently Asked Questions
How long does it take to feel the effects of CBD for PsA?
The type of CBD that you use will determine how long it will take to feel the effects. It generally takes 15 minutes to feel the effects after vaping or using sublingual tinctures (those placed under the tongue). Ingesting CBD oil or gummies will take longer (up to two hours). Topicals may take up to an hour for effects to be felt, and they peak around 90 minutes after application.
How much CBD oil should I use for psoriatic arthritis pain?
The FDA has not released an official dosage guide for specific conditions, but many people with psoriatic arthritis report taking around 20–40 milligrams per day. Some people take higher doses during a flare-up.
Is full-spectrum CBD better for psoriasis than isolates?
Research suggests that full-spectrum CBD has more obvious health benefits than isolates. Isolates are generally better for people who have negative reactions to other cannabinoids found in full-spectrum CBD.
A Word From Verywell
Psoriasis and psoriatic arthritis are painful, chronic conditions that can cause stress and anxiety. CBD is an alternative treatment that may help reduce pain and inflammation and relieve anxiety related to PsA.
Talk to your doctor before trying CBD. A physician might be able to recommend specific products and dosages that can help manage your psoriatic arthritis symptoms.