Prevalence of Cannabinoid Use in Patients With Hip and Knee Osteoarthritis
From the Department of Orthopedics, Mayo Clinic Arizona, Phoenix, AZ (Dr. Deckey, Dr. Lara, Dr. Hassebrock, Dr. Spangehl, and Dr. Bingham), and the Department of Orthopedics, Loma Linda Medical Center, Loma Linda, CA (Dr. Gulbrandsen).
Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.
This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
State legalization and widespread marketing efforts have increased the accessibility and consumption of off-label, non–FDA-approved, cannabinoid (CBD) products. Although clinical evidence is largely absent for the treatment of musculoskeletal pain, patients are experimenting with these products in efforts to relieve joint pain. Assessment of the prevalence, perceived efficacy compared with other nonsurgical modalities, and usage patterns is warranted. The purpose of this study was to report the prevalence and perceived self-efficacy of CBD products in patients with symptomatic hip and/or knee osteoarthritis (OA).
Two-hundred consecutive patients presenting with painful hip or knee OA were surveyed at their initial evaluation at a large academic center. Using Single Assessment Numeric Evaluation (SANE) scores, survey questions assessed perceived pain and effectiveness of CBD products, in addition to other nonsurgical treatment modalities. Chart review provided demographic factors. Descriptive statistics were used to characterize the data.
Of the 200 patients (80 hip OA, 108 knee OA, and 12 both), 66% were female, and average age was 67 years (range 36 to 89 years). Twenty-four percent (48/200) of patients endorsed use of CBD products before their presentation. The average presenting SANE score (range 0 to 100) for non-CBD users was 50.8 compared with 41.3 among CBD users (P = 0.012). Sixty percent of patients learned about CBD through friends, and 67% purchased CBD directly from a dispensary. Oral tinctures (43%) and topical applications (36%) were the most commonly used forms. In addition, 8% of participants in this study had tried marijuana for their pain.
A 24% incidence of CBD usage was found among patients presenting with hip or knee OA. No significant perceived benefit of CBD use seems to exist compared with its nonuse, as patients who used CBD reported significantly worse SANE and visual analogue scale scores than nonusers at baseline. Follow-up studies are warranted to assess these findings.
State legalization and widespread marketing efforts have increased the accessibility and consumption of off-label, non–FDA-approved, cannabinoid (CBD) products. Subsequently, these products have been promoted for the treatment of numerous ailments, including joint pain. Although clinical evidence is largely absent for the treatment of musculoskeletal pain, patients are experimenting with these products in efforts to relieve joint pain. 1,2,3,4,5,6 If proven effective, these medications could provide multimodal pain control in the treatment of arthritis-related pain.
Surgeons should be aware of the effects of over-the-counter medications, especially non–FDA-approved medications that their patients are consuming. Given the increased availability of CBD products, investigations into the prevalence and perceived efficacy of CBD for treatment of osteoarthritis (OA) are warranted. To our knowledge, data evaluating the prevalence and perceived efficacy of CBD products for the treatment of OA are limited. Therefore, the purpose of this study was to report the prevalence and subjective efficacy of CBD products in patients with symptomatic hip and/or knee OA presenting for an initial orthopaedic surgery consultation.
After institutional review board approval, 200 consecutive patients presenting with painful hip or knee OA were surveyed at their initial arthroplasty clinic evaluation at a single high-volume academic center. As part of the initial intake screening, patients were asked to complete a 21-question survey. Questions concerning function and perceived efficacy of treatments were assessed using Single Assessment Numeric Evaluation (SANE) on a 1 to 100 point scale, with a score of 100 indicating the highest perceived benefit (SANE). 7,8 In addition, medical chart review was undertaken for background demographic factors.
After completion of questionnaires (see appendix for questionnaire example, Appendix 1, http://links.lww.com/JG9/A108), answers were categorized and tabulated. Average SANE scores for interventions were calculated as well. Questions results were binary (yes/no), numeric (SANE/visual analogue scale [VAS]), or free text (ex “Question 14: ‘How did you hear about CBD?’”). Free text answers were manually reviewed for each respondent and categorized into nominal reviewable outcomes (Table (Table5). 5 ). Radiographs for every patient were reviewed by two independent reviewers. Descriptive statistics were performed to characterize the population; T-tests were used to compare the variation of continuous variables. Comparison of proportions for sample populations was performed with z-tests. All statistical analysis was performed with JMP statistical software (SAS Institute).
Characterization of CBD Use and Procurement Among the Sample Population
|Frequency of use|
|Three times daily||2|
CBD = cannabinoid, HCP = healthcare provider
Of the 200 consecutive patients, 100% completed the survey. Sixty-six percent were female, and the average age was 67 years. Knee OA was the most common complaint (n = 108) followed by hip OA (n = 80), and a minority of patients had symptoms in both joints at presentation (n = 12). Thirty-seven percent of these patients were symptomatic on the right side, 31% on the left side, and 32% presented with bilateral complaints. Knee OA had an average Kellgren-Lawrence OA grade of 2.7 (range 0 to 4). Average Tönnis scale grading of the affected hip OA was 1.8 (range 0 to 3) (Table (Table1 1 ).
Demographic and Radiographic Variables of Arthroplasty Clinic Sample Population
|No. of patients, n||200|
|Age (y) (±SD)||67.21|
|Female, n (%)||112 (56)|
|Joints, n (%)|
|Laterality, n (%)|
|Knee osteoarthritis grade a (n = 159), n (%)|
|Hip osteoarthritis grade b (n = 107), n (%)|
Twenty-four percent (48/200) of patients endorsed use of CBD products before their presentation. The average presenting SANE score (range 0 to 100) for non-CBD users was 50.8 compared with 41.3 among CBD users (P = 0.012). The average VAS score (range 0 to 10) for non-CBD users was 5.7 compared with 6.6 among CBD users (P = 0.036). No difference in the asymptomatic contralateral joint SANE score (range 0 to 100) was found when comparing non-CBD users with CBD users (81.9 versus 75.9, respectively, P = 0.129) (Table (Table2 2 ).
SANE and VAS Scores Among Non-CBD and CBD Users, Respectively
|Factor||Non-CBD Users (n = 152), n (%)||CBD Users (n = 48), n (%)||P Value|
|Symptomatic joint SANE (average)||50.8||41.3||0.012|
|Contralateral unaffected joint SANE (average)||81.9||75.9||0.129|
|VAS pain rating (average)||5.7||6.6||0.036|
CBD = cannabinoid, SANE = Single Assessment Numeric Evaluation, VAS = Visual Analogue Scale
Among non-CBD users, 73% had tried NSAIDs for symptomatic relief compared with 90% among the CBD using group. A statistically higher percentage of patients in the CBD group had used NSAIDs for symptomatic relief compared with non-CBD users (P = 0.017). No significant difference was found in the number of patients who had tried bracing treatment, steroid injections, or viscosupplementation injections between the two groups. A significantly higher percentage of marijuana use was found among the CBD group compared with non-CBD users (31% versus 1%, respectively, P < 0.001) despite similar rates of “Other” recreational drug use (15% CBD users versus 11% non-CBD users) (Table (Table3 3 ).
Frequency of Alternative Treatments for Symptomatic Osteoarthritis Used by Study Sample Population Non-Cannabinoid (CBD) and CBD Users, Respectively
|Factor||Non-CBD Users (n = 152), n (%)||CBD Users (n = 48), n (%)||P Value a|
|NSAID||111 (73)||43 (90)||0.017|
|Bracing treatment||43 (28)||26 (54)||0.289|
|Steroid injection||79 (52)||28 (58)||0.119|
|Viscosupplementation injection||30 (20)||11 (23)||0.575|
|Marijuana||2 (1)||15 (31)|
|Recreational “other” drug use||16 (11)||7 (15)||0.928|
A significant difference was seen after NSAID use; non-CBD users reported an improvement with an increase in the average SANE to 52.7, whereas CBD users decreased to a SANE of 39.0 (P = 0.012). Otherwise, the differences in SANE scores between the two groups after bracing treatment, steroid injection, viscosupplementation injection, or marijuana use were not statistically significant (Table (Table4 4 ).
SANE Score Averages Among Two Groups After Nonsurgical Treatments
|Average SANE Scores||Non-CBD Users (n = 152), n||CBD Users (n = 48), n||P Value|
CBD = cannabinoid, SANE = Single Assessment Numeric Evaluation
Among CBD users, 60% of patients learned about CBD through friends, and 67% purchased CBD directly from a dispensary. Oral tinctures (43%) and topical applications (36%) were the most commonly used forms of CBD. Twenty-two percent of all the patients in this sample reported ongoing CBD utilization (Table (Table5 5 ).
In this prospective cohort of 200 consecutive patients, 24% (48 patients) reported trying CBD-containing products for relief of their arthritis-related pain before their initial orthopaedic surgical consultation. Although CBD use has not been previously characterized in this population, its prevalence is similar to the reported 15% to 22% of the general US population that reported marijuana use. 9,10 However, this reported CBD use is much higher compared with marijuana use in an older population. Han and Palamar 11 found that 9% of adults aged 50 to 64 years and 2.9% of adults aged 65 years and older reported marijuana use, which was similar to the 9% of patients who reported marijuana use in our study. This large difference in CBD and marijuana usage in a similarly aged population demonstrates the growing trend and popularity of CBD utilization. Given that more and more patients will arrive in clinic having tried or wanting to try these products, it is crucial that the orthopaedic surgeon is aware of CBD products and current trends in utilization. In addition, in the setting of the opioid crisis, it is imperative that we continue to identify new and potentially less-addictive modalities for pain relief. The goal of this study was to characterize and analyze CBD usage and perceived effectiveness in patients presenting for primary consultation with hip and/or knee OA.
To understand why CBD has become such a rapidly growing trend, a brief history is helpful. The passage of the US Hemp Farming Act of 2018 removed hemp (defined as cannabis with less than 0.3% tetrahydrocannabinol [THC]) from Schedule I Controlled Substances. 12 CBD can be derived from cannabis, which comes from the plant Cannabis sativa. Virtually overnight, a new US industry was created. This industry brought with it a legal, unregulated product with broad claims of treating anxiety, insomnia, PTSD, and reducing pain and inflammation. Although not containing high percentages of THC, hemp can still contain CBD, which augments the body’s endogenous CBD system primarily through CB1 and CB2 receptors in both the central and peripheral nervous system. These receptors have been shown to play roles in modulating nociception and inflammatory pathways. 13 However, the full effects of CBD are still not fully understood. Although animal models have shown CBD to decrease OA-related pain, 14,15,16,17,18,19 its efficacy in humans has not been fully supported. 18,20,21
As the stigma surrounding THC and CBD use decreases and these products become more readily available, the prevalence of their use will likely increase. Previously, research has been hampered by lack of funding and the Schedule I classification of cannabis. Given the wide availability of CBD in the United States at present and movements to remove cannabis from the Schedule I classification, it is believed that more knowledge about how THC/CBD functions will come to light. A study using National Inpatient Sample database showed that marijuana/THC use was associated with decreased mortality in patients undergoing total hip arthroplasty (THA), total knee arthroplasty (TKA), total shoulder arthroplasty (TSA), and traumatic femur fixation. 22 In addition, two previous, recently published studies in the orthopaedic literature have explored the use of CBD and THC in arthroplasty. 4,5 Hickernell et al 4 examined the use of dronabinol, a synthetic form of THC, in a multimodal pain regimen after THA and TKA surgery. In their study, the group taking a prescribed dose of drocannabinol had significantly shorter stays and significantly fewer total morphine equivalents. However, this was a small (81 patients) retrospective study and warrants further studies to fully support this trend. Runner et al 5 found that 16.4% of patients following TKA or THA reported use of CBD or THC in the perioperative period. Compared with nonusers, no significant difference was observed in the length of narcotic use, total morphine equivalents used, postoperative pain scores, or the length of stay. Patients in this study were self-medicating without uniformity, which is in contrast to the prescribed dose of drocannabinol used in the Hickernell study.
Our study, however, showed no significant perceived benefit of CBD use compared with nonuse, and patients who used CBD actually reported significantly worse SANE and VAS scores at baseline than nonusers. The symptomatic joint(s)’ SANE score significantly differed between CBD users and nonusers at initial presentation (41.3 versus 50.8, P = 0.012). Previous literature has suggested that the minimally clinically important difference for knee injury interventions is approximately 7 to 19, suggesting that perhaps baseline presentation SANE scores may have been statistically different but not clinically measurable. 23 In addition, VAS pain rating for CBD users was significantly higher at baseline than nonusers (6.6 versus 5.7, P = 0.036). Interestingly, patients who used CBD products were also significantly more likely to use NSAIDs. This finding suggests that the patients taking CBD products may have had more symptomatic OA or more prone to self-medicating. Patients who reported CBD use were also significantly more likely to report marijuana use.
Several limitations of this study must be acknowledged. Although this was a prospective study, recall bias may be present as patients were asked to recall use of treatment and its effectiveness leading up to their first visit. In addition, only patients presenting for primary hip and knee arthroplasty consultation were included in this study. This restriction limits the generalizability of our findings to other orthopeadic specialties. Future studies are warranted in other subspecialties, such as sports medicine, where injuries are more acute. The perceived efficacy of CBD products may be different for acute pain than for chronic pain. The source of CBD product and route of administration was also not standardized, which may play a role in its effectiveness. In addition, this study had a limited sample size of 200 patients and as such may be subject to type 2 error when concluding no difference. Therefore larger, multicenter studies are needed to fully evaluate CBD use in this population and to enhance generalizability as well as a randomized controlled trial with placebo and a controlled dose of CBD. Finally, a substratification of severity of OA in either group would be useful in future studies attempting to determine the efficacy of CBD in symptomatic relief.
To our knowledge, this is the first prospective study to evaluate the usage of over-the-counter CBD products in a hip and knee OA population. A 24% incidence of CBD usage was found among these patients. We found no significant perceived benefit of CBD use compared with nonuse, and patients who used CBD actually reported significantly worse SANE and VAS scores than nonusers.
None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Deckey, Dr. Lara, Dr. Gulbrandsen, Dr. Hassebrock, Dr. Spangehl, and Dr. Bingham.
1. Fitzcharles MA, Clauw DJ, Hauser W: A cautious hope for cannabidiol (CBD) in rheumatology care . Arthritis Care Res (Hoboken). 2020. Mar 7. doi: 10.1002/acr.24176. Epub ahead of print. PMID: 32144889. [PubMed] [CrossRef] [Google Scholar]
2. Korsh J, Marvil S, Guttmann D: Cannabinoids Can Serve As Alternatives To Narcotic Pain Medication For Fracture Healing . Rosemont, IL, American Academy of Orthopaedic Surgeons; https://www.southpalmorthopedics.com/pdfs/edu-cannabinoids-can-serve-as-alternatives-to-narcotic-pain-medication-for-fracture-healing.pdf. Accessed on June 25, 2020. [Google Scholar]
3. Ware M, Beaulieu P: Cannabinoids for the treatment of pain: An update on recent clinical trials . Pain Res Manag 2005; 10 :27A-30A. [PubMed] [Google Scholar]
4. Hickernell TR, Lakra A, Berg A, Cooper HJ, Geller JA, Shah RP: Should cannabinoids be added to multimodal pain regimens after total hip and knee arthroplasty? J Arthroplasty 2018; 33 :3637-3641. [PubMed] [Google Scholar]
5. Runner RP, Luu AN, Nassif NA, et al. : Use of tetrahydrocannabinol and cannabidiol products in the perioperative period around primary unilateral total hip and knee arthroplasty . J Arthroplasty 2020; 35 :S138-S143. [PubMed] [Google Scholar]
6. Klein TW, Newton CA: Therapeutic potential of cannabinoid-based drugs . Adv Exp Med Biol 2007; 601 :395-413. [PubMed] [Google Scholar]
7. Austin DC, Torchia MT, Werth PM, Lucas AP, Moschetti WE, Jevsevar DS: A one-question patient-reported outcome measure is comparable to multiple-question measures in total knee arthroplasty patients . J Arthroplasty 2019; 34 :2937-2943. [PubMed] [Google Scholar]
8. Sueyoshi T, Emoto G, Yato T: Correlation between Single Assessment Numerical Evaluation score and Lysholm score in primary total knee arthroplasty patients . Arthroplasty Today 2018; 4 :99-102. [PMC free article] [PubMed] [Google Scholar]
9. Baron EP, Lucas P, Eades J, Hogue O: Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort . J Headache Pain 2018; 19 :37. [PMC free article] [PubMed] [Google Scholar]
10. Kondrad EC, Reed AJ, Simpson MJ, Nease DE: Lack of communication about medical marijuana use between doctors and their patients . J Am Board Fam Med 2018; 31 :805-808. [PubMed] [Google Scholar]
11. Han BH, Palamar JJ: Marijuana use by middle-aged and older adults in the United States, 2015-2016 . Drug and Alcohol Dependence 2018; 191 :374-381. [PMC free article] [PubMed] [Google Scholar]
13. Zuardi AW: Cannabidiol: From an inactive cannabinoid to a drug with wide spectrum of action . Braz J Psychiatry 2008; 30 :271-280. [PubMed] [Google Scholar]
14. Philpott HT, O’Brien M, McDougall JJ: Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis . Pain 2017; 158 :2442-2451. [PMC free article] [PubMed] [Google Scholar]
15. Gamble L-J, Boesch JM, Frye CW, et al. : Pharmacokinetics, safety, and clinical efficacy of cannabidiol treatment in osteoarthritic dogs . Front Vet Sci 2018; 5 :165. [PMC free article] [PubMed] [Google Scholar]
16. Hammell DC, Zhang LP, Ma F, et al. : Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis . Eur J Pain 2016; 20 :936-948. [PMC free article] [PubMed] [Google Scholar]
17. Malfait AM, Gallily R, Sumariwalla PF, et al. : The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced arthritis . Proc Natl Acad Sci U S A 2000; 97 :9561-9566. [PMC free article] [PubMed] [Google Scholar]
18. O’Brien M, McDougall JJ: Cannabis and joints: Scientific evidence for the alleviation of osteoarthritis pain by cannabinoids . Curr Opin Pharmacol 2018; 40 :104-109. [PubMed] [Google Scholar]
19. Schuelert N, McDougall JJ: The abnormal cannabidiol analogue O-1602 reduces nociception in a rat model of acute arthritis via the putative cannabinoid receptor GPR55 . Neurosci Lett 2011; 500 :72-76. [PubMed] [Google Scholar]
20. Richardson D, Pearson RG, Kurian N, et al. : Characterisation of the cannabinoid receptor system in synovial tissue and fluid in patients with osteoarthritis and rheumatoid arthritis . Arthritis Res Ther 2008; 10 :R43. [PMC free article] [PubMed] [Google Scholar]
21. Fitzcharles MA, Baerwald C, Ablin J, Häuser W: Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis) . Schmerz 2016; 30 :47-61. [PubMed] [Google Scholar]
22. Moon AS, Smith W, Mullen S, et al. : Marijuana use and mortality following orthopedic surgical procedures . Subst Abus 2019; 40 :378-382. [PubMed] [Google Scholar]
23. Winterstein AP, McGuine TA, Carr KE, Hetzel SJ: Comparison of IKDC and SANE outcome measures following knee injury in active female patients . Sports Health 2013; 5 :523-529. [PMC free article] [PubMed] [Google Scholar]
Using CBD for Arthritis: Tips for How to Get Started
Enthusiasts of cannabidiol (better known as CBD) rave about the substance’s health benefits. Some small studies have shown that CBD could be a remedy for anxiety and help children with post-traumatic stress disorder get to sleep. The substance was even FDA-approved last year as a prescription drug to manage rare, severe forms of epilepsy.
So naturally, you might be wondering: Can CBD help people with arthritis and related diseases cope with pain? Anecdotal reports from patients and some preliminary research suggests yes, but the science is still emerging and more research is needed.
Here’s what you need to know right now about how to use CBD to ease arthritis symptoms, how to find a high-quality CBD product, and how to work with your doctor to incorporate CBD into your arthritis treatment plan.
What Is CBD, and Can It Help with Arthritis?
CBD is a chemical found derived from hemp. Hemp and marijuana are both types of cannabis plants, but they are very different from each other. They each have different quantities of various phytocannabinoids, which are substances naturally found in the cannabis plant. (It’s sort of like how different kinds of berries contain different combinations of antioxidants.)
- Marijuana contains an abundance of THC (tetrahydrocannabinol), which is the cannabinoid that gets you high.
- Hemp contains less than 0.3 percent THC. It contains CBD, which is a cannabinoid that doesn’t have any psychoactive effects. CBD cannot make you feel high. Instead, CBD works in other ways with your endocannabinoid system, which is a group of receptors in the body that are affected by the dozens of other documented cannabinoids.
“Cannabinoids can inhibit or excite the release of neurotransmitters [brain chemicals] and play a role in modulating the body’s natural inflammatory response, which are the two things we’re concerned about when talking about CBD for arthritis,” says Hervé Damas,MD, a Miami-based physician and founder of Grassroots Herbals, a CBD product company.
CBD is thought to work on pain in two parts of the body: the site of soreness (such as your finger joints) and the central nervous system, which sends pain signals to the brain when it detects certain stimulation or damage to nerves and cells.
The ability for CBD to calm that response is one reason the compound might be a viable pain remedy for people with arthritis. Another is CBD’s anti-inflammatory properties. Inflammation occurs when your body is fighting a perceived infection. In autoimmune diseases such as rheumatoid arthritis, the immune system is attacking healthy parts of your body like your joints.
It’s important to note that while early research on animals has shown promise for CBD, more research is needed before we can draw anything conclusive for humans. However, anecdotal reports from people who have started incorporating CBD into their arthritis treatment are positive. One CreakyJoints member shared on Facebook that topical CBD “helps better than any other ointment I’ve ever used.” CBD could be worth exploring as a potential solution to pain as part of an overall arthritis treatment plan.
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How to Find the Right CBD Product for You
From supermarkets and pharmacies to health food stores and online retailers, CBD can be found just about everywhere. But how do you choose the right CBD product for your health needs?
1. Pick the CBD Formulation You Want to Use
CBD comes in a few different forms. Commonly used ones include:
- Edibles: You eat CBD infused into gummies, chocolates, sodas, baked goods, and other edible items
- Vaporizer: You inhale CBD through a vape pen that heats up the oil
- Sublingual drops: You take a few drops under your tongue of a high-concentrate solution of CBD
- Topicals: You apply creams, lotions, balms and other products with CBD directly to your skin
The different types of CBD take effect in your body at different rates. Here’s how long you can expect different types of CBD products to kick in, according to Dr. Damas:
- Edibles: 30 minutes to two hours
- Vaporizer: Two minutes
- Sublingual drops: 15-30 minutes
- Topicals: 10 minutes
2. Look for Signs of High-Quality CBD
Don’t just buy the least expensive one on the shelf. There are lots of poor-quality CBD products on the market (some of which don’t contain the amount of CBD they claim, per these FDA warning letters).
Dr. Damas recommends looking for CBD products that are made in the United States, use a carbon dioxide-based extraction method (“It’s the cleanest,” he says), come from organically grown hemp, and don’t contain a lot of extra ingredients. Consumer Reports also has a thorough guide to shopping for CBD that can help you find a high-quality product.
3. Pick the Right Dose
As for dosing of CBD oil, the jury’s still out on just how much you should take. Start with a low dose (such as 5 to 10 mg), and gradually work your way up over a few weeks until you notice the effects.
“Usually people find pain relief when they take 20 to 35 milligrams of CBD daily,” says Dr. Damas.
You can take the full dose at once or break it up throughout the day. Experiment with what makes you feel best. You should start seeing improvements shortly after you start supplementing with CBD, with more noticeable effects kicking in after two weeks.
How to Discuss CBD with Your Doctor
You should talk to the doctor who treats your arthritis before you start taking CBD or any other supplement. They can let you know if CBD might interact with any medications you currently take or potentially worsen a chronic condition. For example, “CBD may make it easier to bleed,” says Dr. Damas. “So if you’re going to have surgery, you might want to stop taking it before the procedure.”
Check out this list of potential drug interactions with CBD from the U.S. National Library of Medicine, but you should always check with your doctor about your individual case.
Keep in mind that your doctor’s knowledge of CBD might be limited. There isn’t a lot of research about the benefits of CBD or about ideal dosages or formulations, so your doctor might not be able to be overly specific in terms of their recommendations. However, they still need to know that you’re taking CBD. Chances are, they’ll be interested in hearing about your experience using CBD products and your self-reports on how CBD may be helping to manage your pain or other symptoms.
- Was This Helpful?
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CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We represent patients through our popular social media channels, our website CreakyJoints.org, and the 50-State Network, which includes nearly 1,500 trained volunteer patient, caregiver and healthcare activists.
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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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