By Luke Sumpter Reviewed by: Carles Doménech

Although modern medicine lacks a cure for arthritis, several treatments help slow down the disease's progression. Early treatment such as lifestyle interventions are particularly effective, but where does cannabis fit into the prevention and treatment of the condition? We're going to take a closer look at arthritis, the different types, and how cannabinoids such as THC and CBD may help.

What Is Arthritis?

Arthritis describes a range of conditions that involve the swelling and tenderness of one or more joints. Although primarily associated with the ageing process, even young people can experience the condition. Check out these key facts[1] about arthritis to learn more about the disease:

  • It affects a lot of people: A staggering 54.4 million people in the United States have doctor-diagnosed arthritis, and it's estimated that over 40 million[2] people in Europe have osteoarthritis
  • It affects women more than men: Arthritis occurs in women slightly more than in men, although experts aren't entirely sure why.
  • Lack of physical activity may contribute to the condition: Arthritis affects those that report no physical activity more than those that meet physical activity recommendations

Arthritis has a massive impact on both the individual and society as a whole. So, it will come as no surprise that scientists are keen to find new ways to treat the condition, improve quality of life, and reduce the number of people affected. However, the difficulty in treatment stems from the various types of arthritis and symptoms.

Types of arthritis

Some of the most prevalent forms of the disease include:

Osteoarthritis Gradual wearing down of joint cartilage
Rheumatoid arthritis An inflammatory disease in which the immune system attacks healthy cells in the body
Gout Intense pain and swelling caused by the build-up of uric acid crystals in joints
Lupus An autoimmune condition with a variety of causes, including viral infection, certain medications, and menopause
Psoriatic arthritis A form of arthritis that affects people with the skin condition psoriasis

Moreover, there are two primary forms of arthritis; degenerative and inflammatory. Degenerative arthritis involves the breakdown of connective and cushioning tissues in the joints, eventually leading to the erosion of bones.

Inflammatory arthritis doesn't originate from wear and tear. Instead, it occurs when the immune system mistakenly attacks healthy cells, leading to potential joint erosion. With these two forms in mind, let's take a closer look at a common diagnosis for each.

  • Osteoarthritis

As a form of degenerative arthritis, osteoarthritis occurs when the cartilage—a firm and slippery form of connective tissue found between joints—begins to break down. As cartilage continues to degrade, the bone surface becomes exposed and friction increases. Eventually, the condition leads to ligament damage, bone erosion, and inflammation within joints.

The symptoms of osteoarthritis include:

Pain Stiffness
Tenderness Reduces flexibility
Grating sensation Swelling
Bone spurs
  • Rheumatoid arthritis

Rheumatoid arthritis autumns into the inflammatory category. As an autoimmune disease, the condition stems from a malfunction in the immune system that causes it to start attacking healthy cells in the body. Unlike the mechanical wear and tear of osteoarthritis, immune cells attack the lining of the joints, which leads to bone erosion and joint deformity. The assault from the immune system also extends beyond the joints and can affect the skin, eyes, lungs, and heart.

The symptoms of rheumatoid arthritis include:

Tender and swollen joints Joint stiffness
Fatigue Fever
Loss of appetite

Are arthritis and rheumatism the same?

Not quite. Arthritis derives from the Greek for "disease of the joints" and specifically refers to chronic or acute inflammation of joints, alongside structural damage and pain. In contrast, rheumatism describes any disease marked by inflammation and pain in the joints, muscles, tendons, ligaments, and other fibrous tissues.

Are arthritis and rheumatism the same?

Can Cannabis Help With Arthritis?

Clearly, the development of new treatments may help to relieve the suffering of millions of people. So, how does cannabis stand as a treatment for the condition? Well, ongoing research shows that cannabis might play a role by impacting one of the most important systems in the human body.

  • A primer on the endocannabinoid system

To understand how cannabis is related with arthritis symptoms, we need to touch briefly on the endocannabinoid system (ECS). This network of receptors, signalling molecules, and enzymes help to control everything in the human body, from appetite and mood to bone remodelling and neurotransmitter firing. The components of this system exist in all tissues, including the nervous system, reproductive system, skeleton, digestive tract, and connective tissue.

But what does it do there? Well, the ECS helps the body maintain biological balance or homeostasis. It prevents things from either underworking or overworking, enabling other systems to carry out their functions optimally. The classical ECS consists of two main receptors—cannabinoid receptor 1 (CB1) and cannabinoid receptor two (CB2). It also includes signalling molecules known as endocannabinoids and various enzymes.

Progression in ECS research has also uncovered many other components of this system, including several different receptor types such as TRPV1, PPAR, and other GPR receptors, as well as a host of other signalling molecules. Together, these components make up the expanded ECS, also known as the endocannabinoidome[3].

Ongoing studies are exploring how the ECS plays a role in the cause and development of arthritis. For example, researchers from the University of Edinburgh suggest a strong link between osteoarthritis and ECS components found in the synovial tissue and fluid surrounding joints.

While studying mice, the team found up to 40% more cartilage degeneration in mice deficient in the CB2 receptor. Interestingly, when they administered a synthetic cannabinoid, they found it significantly inhibits the progression of the disease in young mice with normal levels of CB2. The mice deficient in the receptor showed no changes.

These findings align with the idea of clinical endocannabinoid deficiency (CECD), a theory proposed by cannabis researcher Dr Ethan Russo. CECD suggests that a lack of endocannabinoids, cannabinoid receptors, or enzymes could impact the ECS. Because this system plays such a fundamental role in the body, a lack of components could lead to several diseases and health conditions.

THC vs CBD for Arthritis

The cannabis plant produces over 100 cannabinoids, and just like the body's endocannabinoids, these molecules can interact with the ECS receptors. This means that cannabis phytochemicals can directly impact one of the most important systems in the human body—but what does this mean for those living with arthritis? Well, ongoing studies are exploring the role of the ECS as a therapeutic target in the condition.

THC and CBD are the two most prevalent cannabinoids in most modern cannabis cultivars. Both of these molecules impact the ECS in different ways. THC binds directly to both the CB1 and CB2 receptors. It produces psychoactive effects by activating CB1 receptors in the central nervous system, which leads to altered neurotransmitter firing.

In contrast, CBD has a low affinity for both of these sites. Instead, it manages to increase endocannabinoid levels by disturbing key enzymes. CBD also binds to the ECS receptor TRPV1—a site involved in pain processing. Continue reading to discover what the research says about the potential impact of both cannabinoids on arthritis.

THC vs CBD for Arthritis
  • THC and arthritis

Unfortunately, no human trials have explored the role of THC in arthritis patients. However, data from ongoing studies for other conditions may translate over to forms of arthritis. Currently, researchers are exploring the effects of high-THC cannabis[4] on neuropathic pain, sleep quality, and inflammatory pain.

THC might also affect some of the psychological problems that arthritis patients encounter. Many people with the condition experience mood disorders due to pain and reduced mobility. THC causes an acute rise in dopamine levels[5]—a neurotransmitter that profoundly impacts mood.

  • CBD and arthritis

Again, a lack of human clinical trials means researchers haven't had the chance to test CBD against arthritis in people. However, animal studies offer a clue as to how the cannabinoid might work in humans. Researchers are currently exploring how CBD is related to pain and inflammation in animals[6].

CBD has a low binding affinity for CB1 and CB2 but produces much of its activity by disrupting ECS enzymes. The enzyme fatty acid amide hydrolase (FAAH) is responsible for breaking down a host of endocannabinoids. Researchers are currently exploring how FAAH inhibition could increase the levels of endocannabinoids[7] that reduce pain and inflammation.

Oils, Sprays, or Topicals for Arthritis?

As researchers uncover how cannabinoids might influence arthritis, they'll also start to discover the best ways to apply these phytochemicals.

Many arthritis patients looking into cannabis often ask questions such as "how to use CBD oil for arthritis?" and "should I used CBD cream for arthritis pain?". Although we can't answer these questions yet, future studies will hopefully shed light on the best ways to use weed for arthritis.

In the meantime, cannabis users can apply oils both orally and sublingually. The oral route sends cannabinoids such as THC and CBD through the digestive tract and liver, converting them into different metabolites before moving through the body. In contrast, the sublingual route (placing oil under the tongue) introduces cannabinoids directly into the bloodstream for rapid effects.

Sprays and topicals applied directly to affected joints might offer local relief. Sprays applied to the skin won't achieve great absorption, as externally applied cannabinoids largely target cells in the skin. However, transdermal patches offer a form of topical cannabis application that can penetrate deeper into the blood supply around the joint.

Oils, Sprays, or Topicals for Arthritis?

Is Cannabis Safe for Arthritis?

The side effects of THC in human trials usually include impaired cognitive function[8], while common CBD side effects often manifest as dry mouth, diarrhoea, reduced appetite, drowsiness, and fatigue.

Overall, cannabis has a superior safety profile to many medications and a mild risk of minor side effects. However, THC can cause psychological distress in some people, especially those predisposed to mental health conditions. When it comes to CBD, the World Health Organisation reports that the cannabinoid is generally well tolerated with a good safety profile[9].

Cannabis for Arthritis: A Promising Future?

Unfortunately, arthritis patients have a long way to go before they see any real conclusive evidence. High-quality human trials are required to determine the effects of the herb on the symptoms of the condition. However, the involvement of the ECS in the condition points towards cannabis as a promising agent. Hopefully, studies will discover which cannabinoids work the best for arthritis and which route of administration offers superior relief.

External Resources:
  1. Arthritis-Related Statistics | Data and Statistics | Arthritis | CDC
  2. Osteoarthritis in Europe: impact on health status, work productivity and use of pharmacotherapies in five European countries | Rheumatology | Oxford Academic
  3. (PDF) Endocannabinoidome
  4. Cannabis and joints: scientific evidence for the alleviation of osteoarthritis pain by cannabinoids - PubMed
  5. The effects of Δ9-tetrahydrocannabinol on the dopamine system
  6. CBD for Arthritis Pain: What You Should Know
  7. Cannabinoid-based drugs targeting CB1 and TRPV1, the sympathetic nervous system, and arthritis | Arthritis Research & Therapy | Full Text
  8. Cannabis and joints: scientific evidence for the alleviation of osteoarthritis pain by cannabinoids - PubMed
  9. World Health Organization Reports CBD Oil Is Generally Safe
This content is for educational purposes only. The information provided is derived from research gathered from external sources.

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