Cannabidiol (CBD) is known to have beneficial anti-inflammatory properties. This means using CBD for inflammation could be beneficial for a number of conditions that are related to it. Of the 2,600 people surveyed by the Arthritis Foundation, 79% said they are currently using CBD for arthritis, have used it in the past or are considering using it as an alternative therapy.5 While the FDA believes more study on CBD is needed, Arthritis patients using CBD believe it may help manage their arthritis pain.
What Is Inflammation?
Concepts of Biology defines inflammation as “the localized redness, swelling, heat, and pain that results from the movement of leukocytes through opened capillaries to a site of infection.” Inflammation is an innate immune response. Innate immune responses can be thought of as an automatic first line of defense.2 To initiate inflammation, the body uses chemical messengers called cytokines.
The Inflammation Process
- The immune system senses damage and sends out cytokine messengers.
- White blood cells like neutrophils and macrophages are attracted to the inflamed area.
- Antibody proteins circulating in the blood bind to any foreign toxins or pathogens (antigens).
- The antigen-antibody complex stimulates inflammation and attracts phagocyte cells that clean up and dispose of cellular debris.
Immune Tolerance and Inflammation
If the body cannot properly regulate the immune system, it can produce wasteful and even harmful responses.2 Such is the case with conditions like allergies and autoimmune disorders where the body attacks itself. The ability of the body to prevent the immune system from attacking itself is known as immune tolerance. T cells are the cells responsible for suppressing immune cells from attacking themselves. Special regulatory T cells called “Treg” are specifically responsible for suppressing inflammation.
Pain and Inflammation
Very often inflammation is accompanied by pain. Whether the pain is acute or chronic, it is a trigger for the biological inflammation process. In some cases, the immune system’s inflammation process can actually be the source of pain. Such is the case with rheumatoid arthritis.
Rheumatoid Arthritis Inflammation
According to Mayo Clinic, major signs and symptoms of rheumatoid arthritis are:
- Tender, warm, swollen joints
- Joint stiffness (worse in mornings and after inactivity)
- Fatigue, fever, and loss of appetite
Rheumatoid arthritis starts to manifest in small joints of the hands and feet and progresses to larger joints like knees, hips, shoulders, and elbows.3 Mayo Clinic also explains that rheumatoid arthritis can manifest in other areas of the body such as the skin, eyes, heart, lungs, nerve tissue, bone marrow, and more. Rheumatoid arthritis can come and go in flare-ups and have periods of remission. Ultimately it can also cause major problems like joints deforming and shifting out of place. Persistent discomfort and joint swelling is the first sign to talk to a doctor about rheumatoid arthritis.
Rheumatoid Arthritis Treatments
For inflammatory disorders like rheumatoid arthritis, there is no cure.2 Reducing inflammation in joints and throughout the body is important for reducing pain and damage to tissue and joints. Traditional rheumatoid arthritis treatment can include anti-inflammatory measures like aspirin, topical pain relievers, and corticosteroid injections. In some cases, surgery is needed.
Pain relievers like acetaminophen are also commonly taken for pain and inflammation. Interestingly, acetaminophen products like Tylenol take the same mode of action as the cannabinoid THC. Both act by inhibiting an enzyme called cyclooxygenase.
Ethan Russo recalls the research of Evans in 1991 that found “…[THC] has 20 times the anti-inflammatory power of aspirin and twice that of hydrocortisone.4” Could CBD have similar benefits for rheumatoid arthritis and inflammation?
Can CBD Help With Inflammation?
CBD possesses many properties that make it helpful for inflammation and pain. The Arthritis Foundation and its medical experts recognize that there are not currently established clinical guidelines for CBD.5 They also recognize that it could provide many benefits to those suffering from inflammatory disorders like rheumatoid arthritis. According to the Arthritis Foundation, the following CBD benefits are of interest for rheumatoid arthritis patients:
“CBD may help with arthritis-related symptoms, such as pain, insomnia, and anxiety…
While no major safety issues have been found with CBD when taken in moderate doses, potential drug interactions have been identified.
CBD should never be used to replace disease-modifying drugs that help prevent permanent joint damage in inflammatory types of arthritis.
CBD use should be discussed with your doctor in advance…
Experts recommend starting with a low dose, and if relief is inadequate, increase in small increments weekly.“
What Scientific Researchers Say About CBD Benefits
Ethan Russo elaborates from his research, saying, “CBD is an analgesic, is a neuroprotective antioxidant more potent than ascorbate or tocopherol, without COX inhibition, acts as a TRPV1 agonist analogous to capsaicin but without noxious effect, while also inhibiting the uptake of AEA and weakly inhibiting its hydrolysis… CBD is anticonvulsant, anti-nausea, cytotoxic in breast cancer and many other cell lines while being cyto-preservative for normal cells, antagonizes tumor necrosis factor-alpha (TNF-a) in a rodent model of rheumatoid arthritis, enhances adenosine receptor A2A signaling via inhibition of an adenosine transporter, and prevents prion accumulation and neuronal toxicity.4”
In addition to CBD, hemp plants also produce terpenes like alpha-pinene and beta-myrcene.4 Alpha-pinene and beta-myrcene have anti-inflammatory properties of their own. When terpenes are combined with CBD they can synergize and work together against inflammation.
What Is CBD?
Cannabidiol (CBD) is a cannabinoid compound naturally found in the cannabis plant. In the US, CBD can be legally extracted from hemp containing less than 0.3% THC. CBD products can be full spectrum, broad-spectrum, or isolate depending on how it is refined after the crude hemp oil is extracted.
CBD products come in a variety of preparations. There are CBD tinctures, CBD creams and salves, CBD capsules, CBD gummies, CBD vapes, and hemp flower that can be smoked like marijuana.
Will I Get High?
CBD products will not get you high like marijuana products. However, the small amounts of THC in full-spectrum CBD products can accumulate in the body’s fat cells and cause false-positive drug tests.
Is It Safe?
CBD is reported to have very few side effects. It is important to know that CBD can interfere with some medications. Before starting CBD, talk to your doctor about how to use CBD oil.
How to Use CBD for Inflammation
There are many different ways to take CBD oil. One option that is very good for pain and inflammation is CBD topicals. Topical products include creams, lotions, balms, salves, and patches. Products like CBD salve are taken up by endocannabinoid receptors in the joints and skin. This provides on-the-spot relief for joint discomfort and swelling. CBD massage oils are also available and can take your next massage to the next level of relaxation.
CBD For Dogs With Arthritis
Some veterinary researchers believe that CBD can help relieve arthritis symptoms in dogs as it does in humans. While trials have been limited, there is growing research supporting the benefits of CBD for arthritis in dogs. Special CBD pet products are available for dogs. They come in lower doses than human products and some are specially flavored.
CBD Product Reviews
[Chart of products coming soon!]
Final Thoughts
In inflammatory disorders like rheumatoid arthritis, pro-inflammatory cytokines are elevated and antibodies misidentify the body’s own cells and attack them.1 Medical organizations are speaking out on the benefits of CBD for inflammation even though the FDA has held up CBD regulation. The World Health Organization (WHO) has indicated that CBD is useful for rheumatoid arthritis, pain, and inflammatory diseases.6 WHO attributes the benefits of CBD for those ailments to evidence that CBD inhibits inflammatory signals and has an analgesic effect on treatment-resistant neuropathic pain.
Resources
- Finckh, A. (2009). Early inflammatory arthritis versus rheumatoid arthritis. Current opinion in rheumatology, 21(2), 118-123. Retrieved from: https://journals.lww.com/co-rheumatology/Fulltext/2009/03000/Early_inflammatory_arthritis_versus_rheumatoid.6.aspx
- Fowler, S., Roush, R., Wise, J., & Stronck, D. (2013). Concepts of Biology. OpenStax College, Rice University. Retrieved from: https://openstax.org/details/books/concepts-biology
- Mayo Clinic Staff. Rheumatoid arthritis. Mayo Foundation for Medical Education and Research. Retrieved from: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648
- Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid‐terpenoid entourage effects. British journal of pharmacology, 163(7), 1344-1364. Retrieved from: https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1476-5381.2011.01238.x
- Villines, C. (24 Sept 2019). Arthritis Foundation Releases First CBD Guidance for Adults With Arthritis. Arthritis Foundation. Retrieved from: https://arthritis.org/about-us/news-and-updates/cbd
- World Health Organization. (2017, November). Cannabidiol (CBD) pre-review report agenda item 5.2. In Expert Committee on Drug Dependence Thirty-ninth Meeting, Geneva. Retrieved from: https://www.who.int/medicines/access/controlled-substances/5.2_CBD.pdf
