Does CBD Oil Help With RA?
People with rheumatoid arthritis and other pain conditions are trying cannabinoids to alleviate their symptoms. Here’s what you need to know.
There was a time in Ron Lev’s life when the pain from his rheumatoid arthritis (RA) was so bad that he felt like nothing could help him.
“You just sit still because it’s too painful to stand,” says Lev, 44. “Everything you can imagine doing is painful. Even eating is painful. Driving a car, opening a door, turning the ignition.”
After decades of treating his RA with biologic drugs and steroids, Lev was on the verge of accepting the pain as his “new normal.” However, he’d heard of other people with the condition using cannabinoids (CBD) to alleviate their pain and, four years ago, he decided to give it a try, too.
“At that time, I’d been on steroids for 23 years,” he says. Some of the long-term side effects he’d experienced from the medication included thinned skin, bloating, and weight gain, among others. “I tried unsuccessfully to wean off the steroids, but the pain was so bad… that I just kept using them.”
Within months of starting on cannabinoids, with guidance and direction from his rheumatologist, Lev not only weaned himself off the steroids, he was also able to spread out his biologic infusions from every couple of months to every 6 months. Now, he only gets infusions once a year.
After seeing the tremendous pain relief CBD offered him personally, Lev started his own CBD company, Reclaim Labs, in 2018.
Stories like Lev’s are becoming more and more common among people with RA and other autoimmune disorders. According to a 2019 poll from the Arthritis Foundation, 29 percent of people with arthritis report currently using CBD — mainly in liquid or topical form — while nearly 80 percent were either using CBD, had used it in the past, or were thinking about using it.
There’s also growing scientific evidence, including a study published in September 2020 in the journal Cell Disease & Death, that cannabinoids can alleviate pain from RA and act as an effective anti-inflammatory agent, with few, if any, side effects — unlike anti-inflammatory drugs such as steroids or biologics options.
“We’re seeing more organized and well-done research on the benefits of cannabinoids and CBD when treating RA,” explains Anca Askanase, MD, a rheumatologist and associate professor of medicine and director of rheumatology clinical trials at Columbia University Medical Center in New York City. “As a culture we’ve embraced both medicinal and recreational use of marijuana, and we’re seeing that it does help alleviate pain, especially with RA patients.”
Research on CBD in RA Needed
Positive news aside, Dr. Askanase cautions that more studies doesn’t necessarily mean enough studies.
“We’re going about things backwards — it’s been approved before we have all the research there to support it,” she says. “My biggest concern is that we need to understand and use cannabinoids in a more organized and mindful way as opposed to just saying, ‘It’s legal, it sounds like it works, just take some.’”
One reason for the hesitation on the part of Askanase and her fellow rheumatologists is that while cannabinoids may significantly reduce pain and inflammation, they can also trigger other side effects when smoked. For example, people who have RA can have a greater risk of developing lung and heart issues, which can be exacerbated by smoking marijuana, according to the Centers for Disease Control and Prevention.
Another concern, says Askanase, is the potential addictive nature of the drug. “We’ve learned that most of the things that act on the brain like cannabinoids do have some addictive potential,” she explains. “This is something that needs to be further researched.”
The Truth About CBD Oil and RA
Still, there’s no denying that despite the lack of research, people with RA report that CBD has significantly lessened their pain.
A survey published in November 2019 in the Journal of Psychoactive Drugs found that, of the respondents taking legalized cannabis for pain relief, 80 percent described it as “very or extremely helpful.” Among respondents taking over-the-counter pain medications, 82 percent reported reducing or stopping use of those medications. Among respondents taking opioid analgesics, 88 percent reported reducing or stopping use of those medications.
“I tried for years to stop taking steroids and it’s incredibly difficult to do,” explains Lev. “CBD is the only thing that has helped get me off steroids and relieve my pain.”
Additionally, there’s research that shows cannabis has a powerful anti-inflammatory effect, which can help address the inflammation behind RA. According to a review published in May 2019 by the journal Current Opinion in Rheumatology, researchers have found that “cannabinoids show anti-inflammatory effects by activating cannabinoid type 2 receptors, which decrease cytokine production” (cytokines are proteins known to be involved in inflammation).
The authors concluded that cannabis may be a suitable option for treating RA.
While Askanase is among a growing number of rheumatologists who are interested in seeing more research on CBD in RA, she also cautions that it shouldn’t be used as a stand-alone treatment.
“We need to very clearly make an effort to say that cannabinoids are supplementary interventions but should not replace the traditional disease-modifying therapies we currently have available,” she explains. If you’re considering using CBD as a complementary treatment option, she says, you should seek out medical marijuana dispensaries, which have some medical supervision and control over the products and the amount being used.
CBD Oil for Arthritis Pain: Does It Relieve Symptoms?
Cannabidiol oil, known as CBD oil or hemp oil, is all the rage these days, touted as a panacea for everything from cancer pain to depression and anxiety. Some research has indicated that it can relieve the pain of various forms of arthritis as well. CBD oil contains extracts from cannabis plants, which is the same plant family that marijuana (pot) comes from.
But let’s get this out of the way: CBD is not the same thing as pot and it will not get you high. The only thing the two have in common is that they are both derived from members of the cannabis family. Marijuana is the plant that contains tetrahydrocannabinol (THC), the psychoactive substance that induces the “high.”
CBD is not the same thing as pot and it will not get you high.
While marijuana contains some CBD, it is grown for its THC content. The hemp plant is the one that provides the source for the majority of the CBD oil products on the market today. Hemp contains an insignificant amount of THC (less than 0.3 percent); in contrast, marijuana can contain anywhere from 5 percent to 35 percent.
Some people have started using CBD oil to help relieve pain and lower inflammation, but the jury’s still out on whether or to what degree using it can help people with arthritis. Here’s what we know so far:
CBD Oil and Arthritis Pain Relief
The mechanism responsible for CBD’s positive health effects is not entirely understood, but researchers believe that the compound attaches to receptors in the body known as cannabinoid receptors; these may, in turn, cause the body to produce natural cannabinoids.
CBD oil doesn’t affect your brain the same way that THC does. THC interacts with different receptors in the brain than does CBD. According to Healthline, CBD oil interacts with two receptors, called CB1 and CB2, which can help reduce pain and the effects of inflammation.
“These receptors are primarily involved with coordination, movement, pain, emotional output, and the immune system,” explains Faye Rim, MDD, a physiatrist and pain management specialist at the Hospital for Special Surgery in New York City.
CB2’s involvement in immune system could help explain why CBD oil may be helpful in people with inflammatory autoimmune forms of arthritis, like rheumatoid arthritis (RA).
Dr. Rim says some of her arthritis patients have found relief, but she points out that CBD oil is only intended for use as an adjunct to medications, not as a first-line treatment.
How Do You Use CBD for Arthritis Pain?
CBD can be taken as a liquid, a tincture, in capsules, or applied topically. You can take the capsules orally, add the liquid to foods or drinks, or apply creams with CBD to affected joints. Read more about to start using CBD products for arthritis pain.
Mild side effects of using CBD may include sleep problems or nausea. The topical CBD arthritis cream occasionally causes an allergic reaction, so test it on a small area of skin first.
Most studies on CBD and arthritis have been done on rodents, including one published in a 2017 issue of the journal Pain that suggests CBD oil may relieve joint pain in osteoarthritis. A study in a 2016 issue of Arthritis Care and Research found that CBD oil may improve pain relief, sleep, and quality of life in some rheumatoid arthritis (RA) patients, but the sample size was extremely small, making the study mostly insignificant.
As Medical News Today reports, “there a lack of scientific evidence to prove conclusively that CBD is an effective arthritis treatment for humans.” More research, especially on bigger groups of human participants, will need to be conducted to better understand how CBD oil affects arthritis symptoms like pain, inflammation, and fatigue.
“I find it’s hit or miss,” says Dr. Rim. “[CBD] helps some people and has no effect on others, but I recommend that my patients try it, as there don’t seem to be any problematic drug interactions or major side effects.”
Currently, the FDA has approved CBD oil only for use in people with two rare and severe forms of epilepsy. It is not approved for the treatment of arthritis or chronic pain.
What to Know Before You Buy CBD
Because CBD products are currently unregulated — and often imported — it is very difficult to know exactly what you’re getting, and how much of it, in any given formulation.
This lack of regulation can result in products that vary widely in quality, Marcel Bonn-Miller, PhD, an adjunct assistant professor of psychology in psychiatry at the University of Pennsylvania School of Medicine, told HealthDay News.
Furthermore, CBD is legal in most states, but not all. Make sure you understand your state’s laws before purchasing or taking CBD oil.
When recommending CBD oil to her patients, Dr. Rim says she has no specific dosages or brands in mind. “I generally refer them to a health food store and encourage them to try a small amount at first and to increase if it’s well-tolerated.”
The hope, she says, is that we will have more definitive data on dosages and quality products over time.
You should check with your doctor before trying CBD oil to make sure it’s safe for you and won’t negatively interact with any medications you take.