CBD Dosage: What’s the Right Dose of CBD for Pain Relief?
Take a look at the label on any over-the-counter pain reliever and you can easily figure out how much you’re supposed to take for your symptoms. Finding the right dose of cannabidiol (CBD) for pain relief, however, isn’t that simple.
Enthusiasts rave about CBD’s potential to ease pain, reduce inflammation, relieve anxiety and promote sleep. However, there’s no conclusive research about just how much CBD a person needs to take in order to experience benefits.
There are very few human studies on CBD, and those that have been done include doses that are all over the map: In some studies, patients used 5 mg of CBD; in others, they took as much as 600 mg. To further add to the confusion, CBD comes in a number of forms — oils and tinctures, creams and lotions, pills, vaping, and edibles — and each one has differences in terms of bioavailability (the percent of active ingredient that gets into your bloodstream).
“There are no standard doses for patients,” says Rachna Patel, DO, a physician who does consultations about medical marijuana and CBD and sells her own line of CBD products. “Ultimately, it’s trial and error, but you have to go about it in a methodical way.”
Here are some tips to guide you on how to find the right CBD dosage for your pain relief and other symptoms.
1. Work with an expert
Many factors, such as your body mass index (BMI), specific health condition(s) you have, medications you take, your health history, and the form of CBD you plan to use can influence how much CBD you may need to treat your symptoms. Although CBD is different than medical marijuana — which contains CBD as well as THC, an intoxicating ingredient — a doctor who’s well-versed in cannabis (marijuana) is probably the best person to help you help you sort it out.
“I wouldn’t recommend starting CBD without the supervision of a physician,” says Dr. Patel, author of The CBD Solution. “Many times people purchase a CBD product, try a dose that that doesn’t work for them, switch products and spin their wheels. Or, worse, they develop side effects.”
Ask your rheumatologist or primary care provider to recommend an expert, or find an expert near you by searching the directory of members of the Society of Cannabis Clinicians or the database maintained by your state’s medical marijuana program (if it has one).
2. Do some math
Let’s say you and your doctor settle on a dose of 30 mg of CBD per day. Now what? The answer depends on which form of CBD you take.
Figuring out how much CBD is in capsules or gummies is simple — just read the supplement facts section on the label. (If it says 10 mg of CBD per capsule, you’d take three capsules to get your 30 mg of CBD a day.)
Oils and tinctures can be trickier because the packaging often states the amount of CBD in the entire bottle, not in a dropper. This calculator can help you figure out how many drops you need based on the strength of the product.
When it comes to CBD in topical form (creams, lotions, and salves), you’ll probably see the total amount of CBD in the container listed on the label. You’ll then have to divide that total by the number of millimeters in the package to determine how much is in each milliliter. For example, if you have a 50 ml jar of salve that contains 200 mg of CBD, there’s 4 mg per ml. You should then use a metric measuring spoon to scoop out 7.5 ml to get a 30 mg dose of CBD.
3. Expect some trial and error
No two patients respond to CBD in the same way. You and your doctor will probably need to adjust the dose either up or down until you hit the right balance of benefits without side effects. “A lot of it depends on your biochemistry and the way your liver breaks down these chemicals. There’s a wide variety of factors that come into play,” says Dr. Patel.
It can take a little while to get it right, so be patient. Many people do not see a difference in symptoms after one or two doses of CBD. It can take up to eight weeks of regular use to feel an impact, says Bridget Seritt, co-founder of the Canna-Patient Resource Connection, a Colorado-based organization that is working to protect patient rights and end stigma against those who choose cannabis as medicine.
4. If you have side effects, stop or lower the dose
CBD won’t get you high the way that cannabis with THC can, but it may still cause side effects. “The most common side effects are fatigue and lethargy, and in rare cases diarrhea,” says Dr. Patel, who notes that CBD that’s taken topically less commonly causes side effects. Topical CBD is best used to address pain in a single joint, rather than widespread pain, she adds.
No matter which form of CBD you use, pay attention to how you feel. If you notice any negative side effects, stop or lower the dose and consult your doctor.
Best CBD Oil for Arthritis: Benefits & Uses for Rheumatoid Arthritis
As many as 54 million Americans are diagnosed with arthritis every year. According to NHIS data, it’s the leading cause of work disability leave in the United States.
Arthritis can be a real pain — literally and figuratively. The disorder often brings a lowered quality of life for those affected, forces people to take time off work, and makes it difficult to exercise and remain in good shape. Many people are therefore looking for an effective form of pain management to help with the disorder.
One of the most popular arthritis-supportive supplements being used today is cannabidiol (CBD) — one of the primary active ingredients in the cannabis plant.
Can CBD really help with arthritis? What’s the best CBD oil for arthritis?
We’ll explore these questions in detail in the article below. I’ll give you my top 5 CBD oils for arthritis pain, and give you some valuable insight into how to choose the best CBD oils for the job on your own.
This is a big topic so let’s dig in.
Best CBD Oils for Arthritis: Our Top 5 Brands of 2022
If you’re reading this article, you’re probably interested in finding a CBD product that can help you with your arthritis symptoms.
For those of you who want to understand how CBD works for arthritis, and what else you can do to make the effects of CBD even better, keep reading the sections below. If you’re simply looking for the best CBD oil to take, here’s a list of my top five CBD oils — including a breakdown of why I think it’s such a strong option.
Let’s dig into the list.
1. Royal CBD (Most Potent)
Get 15% off all Royal CBD products. Use code “CFAH” at checkout.
|Total CBD Content||250 – 2500 mg|
|Available Flavors||Natural, Peppermint, Vanilla, Berry|
|Potency||8.3 – 83.3 mg/mL|
What We Like About Royal CBD Oil:
A newcomer to the scene, Royal CBD is a premium manufacturer opting for high-grade organic ingredients in all its CBD products — including this full-spectrum hemp oil. The company’s product range is pretty simple, featuring only CBD oil, capsules, gummies, and some CBD-infused topicals.
The oil and capsules are full-spectrum extracts, while the gummies are made with a 99% pure CBD isolate. This oil has a few different options — you can choose between flavors like mint, berry, vanilla, or unflavored, and three separate potencies — 250 mg, 500 mg, 1000 mg, and 2500 mg of CBD per 30 milliliters (1 ounce) bottle. The strongest option carries 83.3mg of CBD in each milliliter.
For the best value, I recommend you aim for the higher potency option. This product has a higher initial cost than the others, but comes at a slight discount and will last a very long time — even if you use CBD on a daily basis. Only a few drops are needed to get a healthy dose of CBD.
If you don’t like the taste of natural CBD oil you can get their capsules instead. These come in an easy-to-swallow soft gel form and contain 25 mg per capsule.
All Royal CBD products are tested in third-party laboratories to ensure each batch is clean, has consistent levels of CBD, and is free from any potential contaminants.
- Made with organic Colorado-grown hemp
- All products are made with supercritical CO2 extraction
- You can buy both full-spectrum and CBD isolate products
- The highest potency bottle delivers 83.3 mg/mL
- Every batch of product has been tested by a third-party laboratories
- These products are priced on the higher end, although well justified
2. Gold Bee (Best Organic Formula)
- Made from US-grown, organic hemp
- Contains full-spectrum CBD
- 1200 mg of CBD per bottle (40 mg/mL)
- Extracted with supercritical CO2
- Delicious Kiwi flavor
- Sweetened with organic honey
- Third-party tested for cannabinoid content and purity
- Only one concentration available
- Limited flavor options
What We Like About Royal CBD Oil:
When it comes to arthritis, the quality of ingredients is paramount, as any pro-inflammatory compound can actually worsen your symptoms. With Gold Bee, this isn’t a problem, as the brand sells all-organic CBD oils formulated with full-spectrum hemp extracts. The hemp used by the company comes from organic farms in Colorado and is gently extracted with supercritical CO2 to provide the highest purity and consistent potency.
The full-spectrum of cannabinoids means you’re getting the synergistic effects from all naturally-occurring compounds in hemp, including the supportive cannabinoids and terpenes. As a result, you need less CBD to achieve the desired results than you would with CBD isolate. The Gold Bee CBD oil packs 1200 mg of CBD in a 30-mL bottle, translating into 40 mg of CBD daily. The dosage fits within the most common range for daily use.
Gold Bee also doesn’t use artificial flavorings and sweeteners in its products. The kiwi version of the CBD oil is infused with natural terpenes and sweetened with organic honey from Brazillian rainforests. The entire Gold Bee product line is rigorously tested in third-party laboratories for potency and purity.
|Total CBD Content||100 – 600 mg|
|Potency||1.6 – 10 mg/mL|
What We Like About CBDPure Hemp Oil:
CBDPure was founded in 2016 by cannabis aficionados from Colorado. The company has a simple mission — to make high-quality CBD oils made from organic hemp.
Although the company only sells CBD oil and capsules, it’s perfected both of these products. These extracts are made with supercritical CO2 and tested in third-party laboratories for quality assurance.
When it comes to CBDPure hemp oil, it isn’t as potent as those offered by Royal CBD — so if you’re looking for something high potency CBDPure may not be the best option available. However, if you want something cheap that maintains a high level of quality — CBDPure is an excellent choice.
CBDPure has an incredible return policy — which suggests the founders truly stand by their products. If you don’t like the product you can return it for 100% money back within 90 days. Most other CBD companies only offer this deal for 14 or 30 days, so this says a lot about the integrity of CBDPure as a company.
- CBDPure products are sourced from organic hemp grown in Colorado
- The company uses supercritical CO2 to make its extracts
- 100% Satisfaction Guaranteed program (full refund within 90 days)
- Narrow product range
- The oil is slightly less potent than Royal CBD
4. Hemp Bombs
|Total CBD Content||300 – 5000 mg|
|Available Flavors||Unflavored, Acai Berry, Orange Creamsicle, Peppermint, Watermelon|
|Potency||10 – 1166.6 mg/mL|
What We Like About Hemp Bombs:
Hemp Bombs are one of the longest-standing companies in the CBD space. They’ve been around for years now, dating back before the CBD boom. As a result, the company has had a chance to become well-established in the industry, and have a loyal customer base as a result.
Although the branding makes these oils resemble a gas station brand of an energy drink — the oil contained inside is nothing to scoff at.
Hemp Bombs is able to use its large presence in the industry to source some of the best hemps in the country. They process all the hemp within the United States in GMP-certified labs. The company chose to use a CBD isolate for this oil rather than a full-spectrum extract. Using CBD isolate is cheaper and more accurate than full-spectrum products, but lacks the synergistic benefits of the entire cannabinoid and terpene profile — a concept referred to as the entourage effects.
The real benefit of using a CBD isolate is that this is the only way to guarantee the product contains no THC — which is the psychoactive cannabinoid responsible for producing the high from marijuana plants.
Hemp Bombs, like the others on this list, conducts extensive third-party testing on every batch of hemp extract that comes out of its facilities. This is the only way to ensure complete transparency and build trust with consumers. Hemp Bombs publishes these test results on the website for anybody to see — and includes the entire gamut of testing (heavy metals, cannabinoid profile, residual solvents, and microbial contaminant testing).
- Made from high-grade CBD distillate
- Comes in all different flavors and potencies
- Third-party tested for transparency
- Lacks the benefits of the entourage effect
- Flavored with synthetic flavoring agents
5. Nuleaf Naturals
|Total CBD Content||240 – 4850 mg|
What I Like About Nuleaf Naturals:
Nuleaf Naturals has the simplest product lineup I’ve ever seen. The company only offers one oil — a 48 mg/mL full-spectrum hemp extract. They use this same oil for every product offering.
When you go to the company website, you’ll find you can buy this oil in all different bottle sizes — but the oil itself is exactly the same. Even the pet oil options the company sells use this exact same extract.
The benefit of using just one oil is that Nuleaf Naturals can put all their attention and energy into this one product — doing everything they can to make it as top-notch as possible. And that’s exactly what they’ve done.
This oil is one of the best tastings and has some incredibly powerful effects compared to many of the other oils I’ve tried.
In order to even qualify for my top 5 list, the company has to offer third-party testing. I can’t trust the test results from a company doing their own testing. Nuleaf Naturals remains up to date with ordering third-party tests for every batch produced by the company. You’ll find a new test uploaded to the company website every two or three months as they release new batches of products. I have a look at these tests every time I order a bottle and have yet to find anything that stands out.
Every test I’ve seen from Nuleaf Naturals proves the oil is free from contaminants like heavy metals or pesticides, and the potency is almost always exactly the advertised potency. Occasionally a batch will come out that’s 2-5% off the advertised amount — which is expected for full-spectrum extracts.
- Simple product lineup
- Offers oils for both humans and pets
- CBD oil comes in all different bottle sizes to support any budget
- No flavor options available
- All products use the same hemp oil
|Total CBD Content||1000 – 2000 mg|
|Potency||33.3 – 66.6 mg/mL|
What I Like About Medterra:
This is a new product offered by the CBD giant Medterra. This company specializes in making broad-spectrum hemp extracts. This means the oil contains CBD, and most of the other supplemental cannabinoids like CBC, CBG, CBN, and THCV — but all traces of the psychoactive THC have been removed.
Medterra is intimately involved in the cultivation process for the hemp they use to make this oil — which allows the company to control the amount of pesticide used, and the timing of the harvest. These factors play a big role in the overall quality of the oil. Most other CBD companies buy hemp from farms located around the United States or Canada and have little control over the growing process.
Like any high-end CBD oil, this product has been thoroughly tested by both Medterras analysis lab, and independent laboratories.
Medterra sells a lot more than just CBD oils — you can also buy topicals, capsules, and pet treats.
- Medterra has complete control of the entire manufacturing process from seed to bottle
- Extensive third-party testing
- Broad-spectrum THC-free hemp oil
- Limited bottle sizes and flavor options
- This oil is heavily processed
What is Arthritis?
Arthritis is one of the most common causes of disability in the United States. Millions of people in the United States alone suffer from debilitating joint pain and inflammation from arthritis.
The disease causes severe inflammation and pain, as well as swelling and loss of function in the joints.
There are two main types of arthritis:
- Rheumatoid arthritis — This form of arthritis is an autoimmune disease. This means that the cause of inflammation is triggered by our own immune systems. White blood cells mistakenly attack and destroy our own joint tissue, causing a cascade of inflammatory processes in the joints — causing them to swell up and feel hot and sore. This form of arthritis can affect any joint but tends to focus on the larger joints such as the knee, hips, elbows, and knuckles.
- Osteoarthritis — This form of arthritis is caused by physical trauma and wear and tear rather than the immune system. This form of arthritis is common in athletes and older people. The condition begins with a low-grade inflammation in the joint itself, which causes the degeneration of protective cartilage and synovial fluid (lubrication for the joints). As the joint tissue becomes damaged, inflammation and pain worsen and reduce the mobility of the joint. This condition is degenerative — which means it tends to worsen over time.
All forms of arthritis have the same basic symptoms — pain, inflammation, and reduced mobility of one or more joints. Despite having radically different underlying causes, CBD has become extremely popular among arthritis sufferers in recent years.
CBD Oil & Arthritis: Can it Help?
Let’s explore how CBD works, and why it’s become so popular among arthritis patients.
CBD is one of the active ingredients in hemp plants (Cannabis sativa). This phytochemical is completely non-psychoactive, which means it won’t cause the user to feel high. A related cannabinoid (THC) not found in high amounts in hemp plants is what causes marijuana users to feel high.
When CBD enters your bloodstream, it interacts with the endocannabinoid system — a complex neurochemical network responsible for maintaining various homeostatic functions in the body. This includes pain perception, immune response, temperature control, memory, mood, hunger, fertility, inflammation, and much more.
While research on CBD and arthritis is in the early stage, current evidence coming from animal studies and several human trials suggests it may alleviate the symptoms of arthritis while resulting in virtually no side effects.
Animal Studies on CBD & Arthritis
- A 2011 study discovered that CBD was able to reduce inflammatory pain in rats by changing the way pain receptors react to stimuli.
- A 2014 review of the existing animal-based studies concluded that CBD may be effective for relieving osteoarthritis.
- In a 2016 study, researchers found that CBD may relieve inflammation linked to arthritis in problematic areas when applied topically.
- A 2017 research paper suggested that CBD was a safe and effective treatment option for osteoarthritis joint pain.
The big question is whether these results can be replicated in actual human trials. Interestingly, this seems to be the case!
Clinical Trials on CBD & Arthritis
- In 2006, the first study on cannabinoids and rheumatoid arthritis concluded that a pharmaceutical CBD-enriched cannabis extract called Sativex had a “significant analgesic effect” in arthritis patients. Researchers reported that pain and inflammation were significantly reduced throughout the treatment despite having almost no reported side effects.
- A 2008 study involving cannabinoids in the management of chronic pain discovered that CBD offered effective pain relief and improved sleep quality in the test group.
- A 2016 analysis of human trials for rheumatoid arthritis, osteoarthritis, and fibromyalgia also found that CBD resulted in a reduction in joint pain and improvement in irregular sleep patterns caused by chronic pain.
CBD Oil For Sale: Where To Find High-Grade CBD Oil
Most people look for CBD oils online — myself included. Don’t get me wrong, it’s possible to find high-quality CBD oil in a local dispensary, but I’ve found online to offer a greater range of products, and quite frankly, better prices.
I recommend you check out the company websites listed in the section at the top of this article, or do your own research using the tips listed in the section below to find other reputable CBD brands online. Read reviews, and look for third-party testing before you buy the product to make sure it’s going to deliver on its promises.
Must-Know Details for People Buying CBD Oil for Arthritis
Knowing what to look for in the best CBD oil for arthritis will save you a lot of hassle — there are a lot of fly-by-night companies currently offering CBD oils with questionable quality, to say the least.
CBD is an emerging market, so it’s no wonder many companies want to capitalize on the booming trend before the dust settles and the industry stabilizes.
With such an abundance of different brands selling CBD in various forms, it’s important to find a trusted manufacturer who will ensure high standards for their products.
Here’s what you should pay attention to when shopping for CBD oil to help with your arthritis symptoms.
1. Hemp Source: Where is the Hemp Sourced?
Hemp plants are unique in that they will absorb and accumulate virtually any and all elements in the soil and air in which it’s grown — this includes both the good stuff and the bad stuff.
Plants grown in contaminated soils will often contain harmful levels of heavy metals like cadmium, lead, or mercury. For this reason, it’s important you look for products that have been grown in regions with little contamination — such as America or Canada.
Some companies source cheap hemp from India or China to cut costs — which are notoriously high in toxic heavy metal contaminants.
I prefer oils made from American-grown hemp because of the high standards here that prevent farmers from growing food or supplementing crops in contaminated soils or polluted air.
The best hemp comes from USDA-certified organic farms — but these are hard to come by at the moment.
2. Extraction Method: Did The Company Use Toxic Solvents to Make the Oil?
Most reputable companies use CO2 for making their CBD oil. Pressurized CO2 works as a solvent that pulls CBD and other compounds from the plant material. When the pressure is released, the CO2 evaporates completely, leaving no trace of harmful chemical solvents in the final product.
This is in opposition to the conventional extraction methods — which use toxic solvents to strip the cannabinoids from the plant material such as hexane, propane, butane, or ether. If these solvents are used they need to be evaporated out. Oftentimes, small amounts of these chemicals will remain in the final product which can cause many unwanted side effects to people using the oil.
3. Cannabinoid Spectrum: Could There be any THC in the Final Product?
The next thing to look at is the cannabinoid profile of the oil. This refers to the amount of CBD and other cannabinoids in the final product.
There are three main categories here:
- Full-spectrum extracts — these oils contain many different cannabinoids aside from just CBD
- Broad-spectrum extracts — these oils contain many cannabinoids with the exception of THC
- CBD isolates — these oils contain only one cannabinoid — CBD
Many experts argue that full-spectrum CBD oil is better for arthritis-related inflammation. A 2016 Israeli study found that unlike pure CBD isolate, full-spectrum extracts offered more reliable benefits for arthritis sufferers. However, there are benefits to using broad-spectrum or isolate-based products as well.
4. Route of Administration: How is the Oil Intended to be Used?
CBD comes in a few different forms and can be used in several different ways:
- Sublingual — placed under the tongue for fast absorption
- Edibles — helps mask the flavor of hemp oil bit has a slower onset of effects
- Vape liquids — used in vape pens to inhale the CBD for absorption via the lungs
- Topicals — applied directly to the skin for localized relief
Generally, the best CBD products for arthritis are going to be a combination of topical CBD and oral CBD. I rub CBD-infused joint cream on the affected area first and then use CBD oil sublingually for the fastest onset of effects. I know a few other people that prefer to use a CBD-infused vape pen and CBD topicals to relieve arthritis.
5. Third-Party Testing: Does the Company Provide Transparency for its Claims?
Every company has the option to send a batch of their product to a third-party laboratory for content analysis. In order to be considered a third-party lab, it needs to have no affiliation with the manufacturer — allowing for a completely unbiased assessment of the products in question.
These laboratories measure the potency of CBD, scan the entire cannabinoid profile of the product, and can detect over 200 common contaminants.
This form of testing offers transparency on the quality and potency of the product. If you can’t find third-party testing to confirm the CBD oil you’re looking at contains exactly what the company says it does — I recommend you look elsewhere until you find a company that publishes this data publicly. It’s the only way to ensure the product you’re buying is going to be safe and effective.
What’s the Ideal CBD Dosage for Arthritis?
There is actually no one-size-fits-all dosage of cannabidiol when it comes to inflammatory pain caused by arthritis. The dose will vary a lot from one person to the next.
However, information gathered from CBD users suggests that most arthritis sufferers take around 25 mg of CBD in the form of an oil twice a day. You may need to increase or decrease this dose depending on how you respond to the oil. Most people shouldn’t expect any improvement in the first couple of days.
If you don’t feel any difference, gradually increase the amount of CBD oil until you find an effective dose.
Final Thoughts on Using CBD Oil for Arthritis
So far, research investigating the benefits of CBD oil for arthritis shows promising results. More research is needed to fully understand the role CBD and other cannabinoids play in alleviating arthritis-related pain and inflammation.
Although a large share of the studies currently available come from animal models. There are only a handful of good-quality clinical trials (double-blind and randomized). Of the few we have available in the scientific literature, all have shown notably positive results from the treatment group using CBD rather than placebo.
With all that said, it’s important to remember that CBD isn’t an overnight fix to all your problems, and in more serious cases, it may need some time to make the impact you’re looking for.
If you’re planning to use CBD oil for arthritis, consult your doctor first to discuss any potential interactions with other underlying health conditions or medications you may be taking.
Have you used CBD oil for arthritis symptoms? Post your results in the comment section below!
- Schuelert, N. & Mcdougall, J.J. (2011). the Abnormal Cannabidiol Analogue O-1602 Reduces Nociception in a Rat Model of Acute Arthritis Via the Putative Cannabinoid Receptor Gpr55., Neuroscience Letters, 500(1), 72–76.
- La Porta, C., Bura, S.A., Negrete, R., Maldonado, R. (2014). Involvement of the Endocannabinoid System in Osteoarthritis Pain. The European Journal of Neuroscience, 39(3), 485–500.
- Philippot, H.T., O’Brien, M., McDougall, J.J. (2017). Attenuation of Early Phase Inflammation By Cannabidiol Prevents Pain and Nerve Damage in Rat Osteoarthritis. Pain, 158(12), 2442–2451.
- Blake, D.R., Robson, P., Ho, M., Jubb, R.W., McCabe, C.S. (2006) Preliminary Assessment of the Efficacy, Tolerability and Safety of a Cannabis-based Medicine (Sativex) in the Treatment of Pain Caused by Rheumatoid Arthritis. Rheumatology (Oxford), 45(1), 50–52.
- Russo E. B. (2008). Cannabinoids in the Management of Difficult to Treat Pain. Therapeutics and Clinical Risk Management, 4(1), 245–259.
- Fitzcharles, M.A., Baerwald, C., Ablin, J., Hauser, W. (2016). Efficacy, Tolerability and Safety of Cannabinoids in Chronic Pain Associated With Rheumatic Diseases (fibromyalgia Syndrome, Back Pain, Osteoarthritis, Rheumatoid Arthritis): a Systematic Review of Randomized Controlled Trials. Schmerz (Berlin, Germany), 30(1), 47–61.
- Gallily, R., Yekhtin, Z., Lumir, O.H. (2015). Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol. Pharmacology & Pharmacy, 6, 75–85.
Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.
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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.