Arthritis Pain Relief
Arthritis is a classification of disease-causing joint pain and joint degeneration and does not merely refer to one disease. There are currently over 100 forms of arthritis, including similar conditions. In the U.S., arthritis is the leading cause of disability, and over 50 million adults and 300,000 children suffer from some form of arthritis. Arthritis affects women and older adults more frequently than other demographics but can occur in anyone regardless of age, sex, or race.
The most commonly reported symptoms of arthritis are swelling, pain, stiffness, and a reduced range of motion. The degree of symptoms can range from mild to severe. It’s not uncommon for symptoms to progressively get worse as time goes on. Arthritis typically results in chronic pain, which can be debilitating by preventing the ability to complete daily tasks such as walking or carrying a dinner plate.
Arthritis can induce permanent physiological changes to affected joints, which can be seen on an X-ray. There are also forms of arthritis that affect peripheral organs such as the heart, eyes, lungs, kidneys, and skin, instead of strictly joints.
Types of Arthritis
The most common form of arthritis is osteoarthritis (OA). OA occurs when the cartilage deteriorates, causing bones to rub directly against each other, resulting in pain, inflammation, and stiffness. As time goes by, OA affected joins begin degrading further, causing severe pain that may become chronic. The risk of OA depends on several factors, including weight, genetics, age, and previous injury, such as a tear.
Joint replacement surgery may be necessary if at-home treatments aren’t effective at achieving adequate pain relief. To prevent the onset of osteoarthritis, exercise regularly, maintain a healthy weight, and avoid repetitive or straining movements.
Inflammatory and Autoimmune Arthritis
Inflammation is a normal immune response to infection and injury with the goal of removal and prevention of disease. However, the immune system can become dysfunctional and begin attacking the joints with uncontrolled inflammation, which can result in joint degradation and organ damage. The most common forms of inflammatory arthritis are rheumatoid arthritis (RA), psoriatic arthritis, and gout. This autoimmune response is believed to be contributed by several factors, including genetics and environmental triggers. Cigarette smoke is considered an environmental risk factor for developing rheumatoid arthritis in genetically susceptible individuals.
Rheumatoid Arthritis (RA)
Rheumatoid arthritis (RA) is an autoimmune disorder that may cause severe inflammation in the joints and potentially throughout the entire body. RA frequently affects more than the joints and can damage organs such as the eyes, kidneys, lungs, and several other organs.
Rheumatoid arthritis directly damages the lining of the joints instead of the cartilage between bones, causing swelling, severe pain, inflammation, and progressive bone and joint deterioration. RA is classified as an autoimmune disorder, which means the immune system begins attacking its own healthy cells. Today there are several pharmaceuticals to treat rheumatoid arthritis, but there is no known cure, and RA often causes physical disability.
Rheumatoid arthritis typically comes and goes with common reports of the disorder flaring up then going dormant. The severity of RA symptoms ranges from mild to severe and frequently involve swelling, pain, and inflammation. Without active intervention, RA can cause progressive bone and joint deformity.
Psoriatic arthritis is a type of arthritis that develops in some individuals with psoriasis. Psoriasis is a skin condition that produces red patches with surface silver scales. Typically, psoriatic arthritis is a later diagnosis that develops when someone already has psoriasis. However, joint inflammation may occur before psoriasis patches show up.
The symptoms of psoriatic arthritis are swelling, pain, and stiffness of the joints. Psoriatic arthritis can affect any joint of the body from the fingertips to the toes and varies in severity. Both psoriasis and psoriatic arthritis symptoms appear as flare-ups and then disappear as alternating periods.
Psoriatic arthritis requires an immediate diagnosis to begin preventing the bones and joints from degrading over time. There is no known cure for psoriatic arthritis, but there are some treatments available to reduce the severity of symptoms and prevent further joint damage from occurring.
When uric acid excessively accumulates in the body, needle-like crystals are formed on a joint, causing an episode of severe pain affected the joint, known as gout. Uric acid is produced by breaking down purines, the building blocks of DNA found in human cells, and a variety of foods. Gout occurs when a person creates an excess of uric acid, or their body cannot remove it fast enough.
Gout can occur unexpectedly, frequently causing an abrupt awakening in the night by creating a severe episode of pain in the big toe. Gout affected joints will appear red and swollen and feel incredibly tender to the touch. Gout often induces periodic episodes, and unless active measures are taken to reduce uric acid concentration, it can become chronic. Chronic pain is one of the leading causes of disability worldwide.
Doctors use one or more medications called disease-modifying antirheumatic drugs (DMARDs) to achieve remission in those affected by inflammatory and autoimmune arthritis. These drugs may help achieve pain relief, increased joint function, and prevention of further joint deterioration. There isn’t a known cure for inflammatory arthritis, so symptom relief is best achieved by preventing the disease from progressively degrading the affected joints.
Infectious arthritis conditions result from either a bacteria, virus, or fungus entering the joint and causing inflammation. This category usually refers to septic arthritis. Consuming food contaminated with salmonella or shigella can create a joint infection. Sexually transmitted diseases, such as chlamydia and gonorrhea, can also induce infectious arthritis. Sharing needles may cause arthritis due to a blood infection from hepatitis C. A course of antibiotics may effectively treat the joint for infection, but there’s a chance that arthritis may become chronic.
Septic arthritis is a type of arthritis that causes pain and inflammation in a joint due to infection. The cause of infection can vary dramatically, as discussed above. Septic arthritis can occur after an injury exposes the joint to certain germs, leading to infection of the joint.
Infants and elderly adults are the most susceptible to developing septic arthritis. The most common affected joints are the knees, hips, shoulders, elbows, and fingers, but can affect any joint in the body. The infection can rapidly destroy the cartilage and bone inside the joint, making the immediate treatment necessary to prevent permanent bone and joint deformity.
Doctors treat septic arthritis by draining joint fluid with a needle, but surgery may be required depending on the joint and severity of the infection. Antibiotics are typically taken to kill off the bacteria, causing the infection.
Arthritis requires early diagnosis and prompt medical intervention to prevent the affected joints from becoming further deteriorated. A primary care physician will perform a physical examination and may decide to complete blood work and order X-rays to diagnose the specific form of arthritis. A doctor may refer someone to a rheumatologist who specializes in arthritis if the diagnosis isn’t confident or if it’s suspected that the arthritis is inflammatory. A rheumatologist should be able to provide an accurate diagnosis if the symptoms are caused by arthritis. An arthritis specialist will discuss treatment options in the event of a diagnosis of RA, gout, or a different type of arthritis. Other medical specialists may become involved in treatment if a diagnosis of reactive arthritis is reached. Reactive arthritis occurs when a joint becomes inflamed due to an infection affecting a separate part of the body.
Arthritis Pain Relief Treatment & Medications
There is no known cure for arthritis. However, there are several treatment options that can help prevent further joint degradation, increase joint mobility, and improve the overall quality of life. When the symptoms of arthritis are mild or moderate some at-home pain management techniques are:
- Ensuring adequate rest after exercise or strain
- Applying hot and cold therapies (water, ice packs, and heating bags)
- Engaging in exercise at least three times a week for a minimum of 30 minutes
- Maintaining a healthy weight
- Strengthening the muscles around the joint (weight lifting, stretches, specific exercises)
- Using assistive devices (braces)
- Consuming over-the-counter (OTC) pain relievers or anti-inflammatory drugs
- Avoiding excessive repetitive movements (take short breaks periodically)
If joints symptoms become too severe, joint replacement surgery may be required to restore joint mobility and dramatically improve the quality of life. Cannabidiol or CBD is currently being investigated as a potential treatment option for arthritis, particularly rheumatoid arthritis, where it appears to prevent arthritis pain and nerve damage. Research remains limited, but studies have already demonstrated CBD’s enormous therapeutic potential in treating the symptoms of numerous conditions, diseases, and disorders. Continue reading to learn more about CBD and how it can help with arthritis pain relief.
CBD For Arthritis Pain Relief?
CBD is already being considered as an effective treatment option for pain from arthritis due to its anti-inflammatory properties. Osteoarthritis is a joint disease that may cause severe pain and discomfort due to joint degeneration, swelling, and inflammation. A 2017 study published in the journal Pain found that local administration of CBD prevented pain from osteoarthritis. Application of transdermal CBD also prevented pain and nerve damage from later developing in osteoarthritis affected joints. This study suggests that CBD may be a safe treatment option for those suffering from neuropathic pain caused by osteoarthritis.
Another study from 2016 found that topical CBD application possesses “therapeutic potential” for providing relief from pain and inflammation caused by arthritis, without apparent side-effects. This research is exciting because traditional treatments for arthritis often induce undesirable side-effects.
What Is CBD (Cannabidiol)?
CBD is short for cannabidiol, a naturally-occurring non-psychoactive cannabinoid derived from the cannabis plant. CBD has become popular due to its anti-inflammatory and muscle relaxing properties. Tetrahydrocannabinol (THC) is the psychoactive compound found in marijuana. CBD does not share the same psychoactivity and, instead, may provide effective pain relief without intoxication. CBD is usually well-tolerated and possesses a strong safety profile.
CBD popularity has surged due to new research revealing its role as an effective treatment for epilepsy and neuropathic pain. People are now curious as to whether they can treat their pain with CBD instead of highly addictive opioids. Also, after the passing of the Agriculture Improvement Act of 2018, hemp is no longer a schedule 1 substance, making it legal to grow as an ordinary agriculture commodity.
How Does CBD Work for Pain Relief?
As of now, CBD’s pharmacological mechanism is not entirely understood. However, we do know that CBD indirectly interacts with specific cannabinoid receptors of the endocannabinoid system (ECS). These receptors can be found throughout the body, including the peripheral and central nervous systems, as well as the brain. Briefly, the ECS is responsible for regulating several physiological functions of the body, such as pain sensory, memory, appetite, sleep, mood, immune function, and many other processes.
There is also evidence demonstrating that CBD activates several serotonergic receptors, inhibits the uptake of noradrenaline, dopamine, serotonin, and gamma-aminobutyric acid (GABA), as well as anandamide. This means that CBD is responsible for inducing an excess of all of these neurotransmitters. It may also explain how CBD produces increased positive mood (noradrenaline, dopamine, serotonin), decreased anxiety (GABA), and reduced pain sensation (anandamide).
Cannabidiol is a potent endocannabinoid modulator that possesses anticonvulsant, muscle relaxing, anxiolytic, and antipsychotic properties — producing its effects by increasing the concentration of natural endocannabinoids found in the body. It’s also worth noting that CBD may also be an effective neuroprotector, anti-inflammatory, and antioxidant. With this in mind, CBD does appear to be able to provide arthritis pain relief.
Is CBD Legal?
CBD has surged in popularity due to exciting new research demonstrating its therapeutic and medical benefits. It may be a potential replacement to traditional painkillers amid an opioid crisis, and the passing of the 2018 Farm Bill which legalized the growing and sale of hemp and its extracts.
CBD extracted from hemp cannot exceed a 0.3 percent tetrahydrocannabinol (THC) concentration. Anything more is considered a schedule 1 drug by the Drug Enforcement Administration and consequently illegal. Hemp crops may become pollinated with THC producing cannabis plants since they grow in the wild, and the wind can carry their pollen for miles. Hemp growers must prevent cross-pollination from THC-producing cannabis at all costs.
Currently, the only FDA approved CBD treatment is Epidiolex, a seizure drug. Even though research has demonstrated CBD’s robust therapeutic potential, the FDA has yet to recognize CBD in the treatment of any other conditions. The FDA also prohibits the sale of CBD in any unapproved products, dietary supplements, or food, which is practically everything except Epidiolex, which is used to treat epilepsy.
To answer the question, CBD can legally be purchased if it’s extracted from a hemp plant containing less than 0.3 percent THC. However, some states possess some legal restrictions on the possession of CBD. Make sure you check state and local laws regarding the purchase and possession of CBD-containing products.
CBD Products For Arthritis Pain Relief
CBD products are sprouting up practically everywhere, with products ranging from gummies and drinks to concentrated oil and creams, it’s easy to become overwhelmed when trying to determine which product is the best for relieving arthritis pain. Let’s discuss a few of the most popular products available on the market today.
CBD Oil For Arthritis Pain Relief
Easily the most popular CBD product is CBD oil, a natural oil found in the budding flowers and leaves of the cannabis plant. It is typically sold as a tincture where drops are placed under the tongue and readily absorbed. However, people use CBD oil in a variety of ways around the world.
There are several types of CBD oil and contain ranging concentrations of terpenes and cannabinoids. CBD products often contain additional ingredients such as omega-3 fatty acids, amino acids, essential oils, vitamins, and minerals. Here’s a list of the different types of high-quality CBD oil:
- PCR (phytocannabinoid-rich) CBD hemp extract — A high-quality, full-spectrum product that is rich in CBD and contains all the therapeutic compounds found in hemp.
- CBD concentrate or distillate — A processed full-spectrum concentrate where any undesired compounds are removed from the final product.
- CBD isolate — Purified CBD processed to remove all other beneficial terpenes and cannabinoids.
- PCR CBD oil — Full-spectrum CBD concentrate or oil combined with CBD concentrate,
- Full-spectrum oil — Contains high amounts of CBD and other beneficial terpenes and cannabinoids found naturally in hemp except for THC.
There are limited studies investigating the most effective type of CBD oil. However, one study from 2018 found that CBD-rich extracts appear to have more therapeutic potential than pure CBD isolate when treating a population of patients with refractory epilepsy. This is believed to be due to CBD possessing synergy with other terpenes and cannabinoids, particularly THC, in what’s known as the “entourage effect.”
The most popular way to take CBD oil for arthritis pain is the sublingual method. To do this, drops of CBD oil are placed under the tongue to be absorbed into the bloodstream relatively quickly. However, another way to use CBD is to apply it directly to the skin of the affected area. To apply CBD topically, you would need a cream, balm, or salve.
CBD Cream For Arthritis Pain Relief
The next most common type of CBD product is CBD topicals, which include skin creams, lotions, salves, and oil. These topicals are infused with either pure CBD isolate or Full-spectrum CBD oil. Most products contain several different ingredients that are used to make the product as beneficial as possible. Some components may be moisturizers, vitamins, collagen, capsaicin, and seed oils. Salves typically contain ingredients that are soothing when applied, such as aloe vera. Pain topicals may include a local anesthetic or other ingredients designed to allow the product to be more easily absorbed by the skin to provide pain relief.
There isn’t enough research on CBD topicals to determine their complete efficacy for treating arthritis pain. However, Zynerba Pharmaceuticals announced that the results of their Phase 2 clinical trial of transdermal CBD for knee pain associated with osteoarthritis have qualified for Phase 3. Also, a March 2019 study found that applying a pure CBD-isolate ointment was a “safe and effective non-invasive alternative for improving the quality of life in patients with some skin disorders.” While the study only involved 20 people, there’s no doubt CBD possesses therapeutic potential. Thankfully, CBD-infused topicals don’t appear to induce any severe or noticeable side effects, suggesting that it’s a safe alternative to traditional pain drugs.
CBD Dosage For Arthritis Pain Relief
As of yet, there are no established clinical guidelines to dose CBD for pain accurately. You should begin by consuming or applying the lowest amount of CBD and steadily increase the dosage until pain relief is effectively reached. CBD products often come with dosing instructions, so always make sure to read the label for instructions. Since the best dosage of CBD for pain is highly subjective, the optimal dose depends on several factors, including weight, pain severity, metabolism, and likely more. Finding the right dose of CBD for pain relief will mainly be a series of trial and error until you figure out which dosage is perfect for you.
You can create your own dosing protocol by accurately measuring CBD consumed or applied and taking notes. Document when and how much CBD was taken, pain relief on a scale from 1-10, and any relevant notes about the treatment, such as if any side effects occurred. Thankfully, due to CBD’s efficacy and well-tolerated profile, you don’t have to worry about overdosing or becoming critically ill as a result of taking CBD.
Is CBD Safe?
While most medical professionals and researchers will likely agree that CBD has a strong safety profile, it is always important to implement harm reduction techniques and know the risks of using any type of substance.
Cannabidiol’s side effects tend to be mild and include dry mouth, lightheadedness, low blood pressure, and drowsiness. Liver injury has been reported in a small number of individuals but is extremely rare and is suspected of having occurred in predisposed patients.
CBD is potentially safe when taken orally or sublingually (under the tongue). CBD doses up to 300 mg a day have been shown to be safe for up to six months when consumed orally. Larger doses of 1200 to 1500 mg a day have been safely taken by mouth for up to one month. The FDA-approved epilepsy drug Epidiolex can be taken in doses of up to 10 to 20 mg/kg a day. CBD delivered by spraying under the tongue has been well-tolerated in doses of 2.5 mg for up to two weeks.
CBD Drug Interactions
CBD should NOT be taken with the following medications:
- Clobazam (Onfi)
Take caution when consuming CBD with the following medications:
- Eslicarbazepine (Aptiom)
- Chlorzoxazone (Lorzone)
- Theophylline (Theo-Dur, others)
- Amitriptyline (Elavil)
- Haloperidol (Haldol)
- Ondansetron (Zofran)
- Propranolol (Inderal)
- Verapamil (Calan, Isoptin, others), and others.
- Omeprazole (Prilosec, Omesec)
- Clozapine (Clozaril, FazaClo)
- Progesterone (Prometrium, others)
- Lansoprazole (Prevacid)
- Flutamide (Eulexin)
- Oxaliplatin (Eloxatin)
- Erlotinib (Tarceva)
There are many other drugs that CBD can interact with. These drugs are listed because they interact with liver processing, which can affect how quickly the compounds are broken down in addition to their concentration. This does not necessarily mean the combination is inherently dangerous. These interactions are also rare and often require extreme doses of CBD to occur.