How To Use CBD for Arthritis
Arthritis is a condition marked by inflammation of the joints. The main symptoms of arthritis are joint pain, redness, tenderness, swelling, and stiffness. Many people also have significant stiffness in the joints and reduced mobility of that joint—this is usually referred to as a decreased range of motion.
Origins of Arthritis
350 million people around the world suffer from arthritis, including osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.
- Osteoarthritis (OA) is due to wear and tear from use and overuse of joints. It affects the cartilage on the ends of the bones of the joints, causing the joints to “grind” against each end. OA increases as we age and is more common in women and can also be associated with obesity, joint pain, and overuse.
- Rheumatoid arthritis (RA) is an autoimmune disorder—the immune system gets “confused” and begins to attack the lining of the joint capsule- the synovial membrane which then becomes inflamed, swollen, and painful. Rheumatoid arthritis is more common in women. . It can affect any joint either on just one side or both sides of the body.
- Other forms of arthritis —there are over 100—include gout, juvenile arthritis, reactive arthritis, infectious arthritis, and ankylosing spondylitis.
- The long-term effects of arthritis are degeneration and destruction of the joints.
While many conventional medications that treat arthritis pain are available, they are not always effective and some carry significant adverse side effects.
Many arthritis sufferers are choosing to use medical cannabis for its anti-inflammatory properties, pain management, and minimal side effects. CBD is derived from hemp—a cousin of cannabis—and has been shown to have potential benefits for arthritis pain.
Enjoying your read? Sign up to be a part of the CBD School community, and we’ll send you a free eBook called The Beginner’s Guide to CBD. It will get you caught up in all things CBD. Additionally, you’ll get updates on the best CBD products and discounts in the industry.
Potential Benefits of Using CBD for Arthritis Pain Relief
The pain associated with arthritis is mainly due to inflammation. CBD has been shown to reduce inflammation and thus possibly reduce the chronic pain of arthritis.
CBD oil is non-intoxicating which is a fancy way of saying it will not get you high. Its primary benefit appears to be the anti-inflammatory actions—this action has been shown in several different animal studies to benefit arthritis pain. 1 , 2
While human studies are limited—keep your eye on these pages as more data is published—preliminary evidence indicates that topical application of CBD products can directly and positively affect pain in arthritic joints. 3 , 4 , 5
- Chronic pain management
- Reduced need for opiates
- Reduced need for NSAIDs
- Reduced side effects from conventional arthritis treatments
- Improved mobility
- Better sleep
Side Effects of Using CBD for Arthritis
Side effects are always possible and you should always be aware of drug interactions with CBD, especially if you plan to use CBD oil in high doses (in the hundreds of milligrams).
Side effects that can occur with CBD products are drowsiness, upset stomach, diarrhea, sedation, and dry mouth. 6 Generally, CBD oil is very well tolerated and most people have few significant side effects with CBD.
If you are new to CBD, start with a low dose to assess if you will have any side effects. Then you can start slowly increasing the dose until you reach noticeable pain relief.
How Does CBD Work for Arthritis?
CBD is considered an effective anti-inflammatory agent—and inflammation is at the root of arthritic pain. CBD oil appears to decrease inflammation in the body and at the affected joint so that a person with arthritis symptoms will have less chronic pain, and overall reduce pain in the body.
Other important cannabinoids with anti-inflammatory properties include THC, cannabichromene (CBC), tetrahydrocannabinolic acid (THCA), cannabigerol (CBG), cannabidiolic acid (CBDA), cannabidivarin (CBGV), and cannabigerolic acid (CBGA).
How Should I Use CBD for Chronic Pain from Arthritis?
Always speak with a doctor before using CBD products, especially if you already take other medications.
CBD can cause drug interactions. It may increase or decrease the blood levels of different drugs—it is best to talk to your doctor and pharmacist about your specific risks for interactions. This may be especially important if you are taking any of the following medications: 7
- Macrolide antibiotics such as erythromycin or clarithromycin
- Anticoagulants or blood thinners
- Some heart medications including calcium channel blockers (eg. Amlodipine, diltiazem, felodipine, verapamil)
Because of the connection between joint inflammation, arthritis and chronic pain , using CBD products may reduce the arthritic pain and discomfort.
Most delivery methods all work well for relief from arthritis but for smaller areas, topical may often be best. Other delivery methods can include vaping, tinctures, edibles, and capsules.
The fastest relief can come from vaping, using tinctures, and applying topicals to treat local pain. You should be aware, however, that while vaping can produce the fastest results, there are still a number of health conditions with vaping. While vape products from reputable companies, like cbdFX, appear to be safe, there is much we don’t know about the effects of long-term or short-term vaping on the lungs.
CBD and THC (medical or recreational marijuana) may work synergistically together for relieving chronic pain conditions. The ratios of CBD to THC most commonly used for pain relief vary from 2:1 (CBD to THC) to 1:2 (CBD: THC). Keep in mind that if you use larger doses of CBD, maintaining those ratios may not be legal in your state. Both cannabinoids are anti-inflammatory.
If you dislike the psychoactive effects of THC, you can stick to just CBD, or mostly CBD oil during the day and add in some THC products at night.
Always start with a low dose of CBD oil and increase it in small, even increments until you reach the desired relief you are seeking.
What are Terpenes?
When CBD is extracted from the hemp plant, another very large class of plant substances—the terpenes—are extracted as well. Terpenes are currently a “hot research” topic because many have beneficial medicinal properties that may work alongside CBD in what is known as the “entourage effect”.
Are Terpenes Helpful for Arthritis?
The following terpenes are good to look for because they work synergistically with CBD to provide relief from inflammation. 8
- β-caryophyllene (beta-caryophyllene)
- α-Pinene (alpha-pinene)
What Does the Research Say About CBD for Arthritis?
- CBD, cannabinoids, and compounds in cannabis decrease inflammation by blocking the formation of pro-inflammatory cytokines. Cytokines are a general term for substances that act as intracellular messengers and are made in response to an infection, injury, or triggered by an improperly working immune system (as in an autoimmune disease). 9 , 10
- Pre-clinical studies—ie. animal studies—have shown that CBD can act through a variety of mechanisms to reduce the inflammatory response thereby reducing pain. 11 , 12 , 13
- There have been no studies done in humans to date—but watch this space!
- THC has been shown to be 20 times more anti-inflammatory than aspirin and 2 times more anti-inflammatory than hydrocortisone. 14
Recently, the Arthritis Foundation produced a set of guidelines for the use of CBD in arthritis. In these Arthritis Foundation guidelines, it was stated:
“We are intrigued by the potential of CBD to help people find pain relief and are on record urging the FDA to expedite the study and regulation of these products. While currently there is limited scientific evidence about CBD’s ability to help ease arthritis symptoms, and no universal quality standards or regulations exist, we have listened to our constituents and consulted with leading experts** to develop these general recommendations for adults who are interested in trying CBD” 15
CBD For Rheumatoid Arthritis
Kimberly is a health and wellness writer with 8 years of experience in healthcare and a special passion for mental health awareness.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Scott J. Zashin, MD, specializes in the treatment of rheumatologic and musculoskeletal conditions using both traditional and alternative therapies.
As cannabidiol (CBD) has grown in popularity over the years, major organizations like the Arthritis Foundation have released guidelines pertaining to its use in the treatment of rheumatoid arthritis (RA). CBD is a non-psychoactive component of cannabis. The CBD in most products is extracted from hemp, a variety of cannabis that only has traces (up to 0.3%) of THC, the active compound that gets people high. Studies have shown CBD can help reduce chronic pain by impacting endocannabinoid receptor activity, which may also reduce inflammation.
CBD comes in different forms, including oil, vape, edible, and topical. Oils, vapes, and edibles are taken orally, while topical CBD lotions can be applied to the skin. CBD dosage varies depending on the form, the indication, and other treatments being used.
What Is Rheumatoid Arthritis?
RA is an autoimmune inflammatory disease, in which the immune system attacks healthy cells in the body and causes inflammation. RA commonly affects joints in the hands, wrists, and knees, causing the joint lining to become inflamed and damaging the tissue. This causes chronic joint pain and leads to deformity. RA can also affect other tissues throughout the body, such as the lungs, heart, and eyes.
Vera Livchak / Getty Images
Health Benefits of CBD for RA
Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties, but these effects have not been validated with quality studies in humans. Anecdotally, some people who have tried CBD for treatment of arthritis symptoms report noticeable pain relief, improved sleep improvement, and reduced anxiety.
The trials that have been conducted in humans have not yielded strong evidence for the use of CBD in managing arthritic pain.
- A randomized trial of topical CBD for treatment of knee osteoarthritis lasted only 12 weeks, and results were mixed.
- One of the largest reviews examining the health effects of cannabis and CBD concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults. There was, however, no specific conclusion regarding CBD, as definitive studies were not available.
- More recently, a new study showed that CBD can potentially help alleviate RA pain and inflammation by acting on immune cells that are attacking healthy cells in the body. It’s important to note that this study was also not conducted with human subjects.
Research in this area is ongoing.
If you are interested in trying CBD for RA pain management, be sure to talk to your healthcare provider first before using any CBD products.
Rising Popularity of CBD for RA
Based on a 2019 national survey of 2,600 people conducted by the Arthritis Foundation, 79% of respondents said they were using CBD, have used it in the past, or were considering using it to help with their arthritis pain.
Health Benefits Related to Arthritis
Given the lack of strong scientific evidence supporting the use of CBD, it is not recommended as the first choice for pain relief in RA.
If you have RA, you should not stop taking your prescribed medications that may be protecting your joints from future damage. You should discuss any changes you want to make to your medication regimen with your healthcare provider.
Additional Health Benefits
The strongest scientific evidence for effectiveness of CBD as a medical treatment is for seizure prevention in Dravet syndrome and Lennox-Gastaut syndrome, which are severe childhood epilepsy disorders that typically don’t respond to antiseizure medications. Several years ago, the FDA approved the first cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.
Other potential health benefits of CBD include:
- Reduce anxiety, insomnia, and depression
- Relieve cancer or cancer treatment symptoms
- Clear acne
- Slow the progress of neurologic disease like Alzheimer’s disease
Possible Side Effects
Treatment with CBD should be started slowly and under the supervision of a healthcare provider, who will oversee its effectiveness and side effects. There have been reports of mild side effects of CBD.
The most common side effects include:
It’s important to note that CBD may interact with other drugs, including some of the medications that are prescribed for the treatment of RA.
Warnings and Interactions
There are some warnings and adverse drug interactions to be aware of before beginning using CBD for management of RA-associated pain.
Do not stop taking any other treatments without consulting your healthcare provider. Additionally, CBD shouldn’t be a replacement for other therapies you are using.
Pregnant people and children should consult a healthcare provider before using CBD since there isn’t enough research on the effects of CBD on these populations. There has been concern about a possible link between inhaled cannabis and lower-birthweight babies, but it’s not clear if this applies to CBD.
Currently, the U.S. Food and Drug Administration (FDA) does not regulate the safety and purity of CBD products, so you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. The product may contain other unknown elements. The most effective therapeutic dose of CBD for any particular medical condition has not been established.
Are CBD Products Legal?
CBD products derived from hemp are no longer considered schedule I drugs under the federal Controlled Substances Act, but they still remain in a legal gray zone. There are changes underway on federal and state levels that will ultimately clarify the laws and regulations related to CBD-based products and sales. Despite that, they’re widely available in nearly every state and online. People who want to use CBD should check their own state laws.
Studies have found moderate interactions between CBD and medications commonly prescribed for treating RA.
Interactions can occur with these medications:
CBD can increase your level of coumadin, a blood thinner.
CBD may also raise levels of other medications in your blood by the same mechanism that grapefruit juice does.
Medications that interact with grapefruit juice can potentially interact with CBD, including:
- Cholesterol medications
- High blood pressure medications
- Organ-rejection medications
- Anti-anxiety medications
- Heart medications
- Some antihistamines
Preparation and Dosage
If you’ve decided to try CBD for treating your RA pain, the next step is figuring out how much to take.
Your dosage depends on a number of factors:
- Body weight
- Medical indication
- The concentration and form of CBD that you’re taking
You will likely need to start with a low dose and find what works for you. Studies have found extreme differences in dosages, with some people using 5 milligrams (mg) and others as much as 600 mg.
Your healthcare provider may direct you to start with 20-40 mg per day and increase slowly each day until you feel the relief you’re looking for.
To ensure that you are using CBD safely and effectively for pain management, you should:
- Choose an oral treatment (rather than inhaled products) and start with a low dose
- Establish initial goals of treatment within a realistic period of time. For example, a reduction in knee pain that allows you to walk around the block within two weeks of starting treatment; later, if improved, the goals can be adjusted
- Tell your healthcare provider(s) about your planned and current CBD treatment; monitor your pain and adjust medications with your medical providers, rather than with non-medical practitioners
- When preparing to take a liquid form, be aware that the CBD extract is mixed with a carrier oil, so there are two measures to know: the amount of the liquid product to take (the dose) and the amount of CBD in each dose
If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, you could consider talking to your healthcare provider about taking CBD with a very low-dose THC product. Be aware that even at low levels, THC may make you feel high, resulting in cognitive, motor, and balance impairment.
If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your healthcare provider.
What To Look For
Look for the following when choosing a CBD product:
- Look for products manufactured in the United States with ingredients grown domestically
- Choose products made by companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements or required by the state where they are manufactured
- Buy from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP), or the Association of Official Agricultural Chemists (AOAC)
- Avoid companies that claim their products have disease benefits
- Be aware that marketers and people behind retail counters are not health professionals. Your healthcare provider is your best source for guidance and monitoring when using an unregulated product
A Word From Verywell
CBD may sound like an appealing option for pain relief, but do your due diligence before jumping on the bandwagon. A lot of people say CBD can help reduce pain and inflammation for those with RA, but not a lot of strong scientific data have substantiated that claim. That said, serious effects are not commonly associated with CBD use.
If this is something you are interested in, you can work with your healthcare provider to figure out whether CBD is something you can try safely. Remember that CBD should not be used as a first-line treatment for RA pain and that it’s not advisable to stop taking disease-modifying treatments for RA.