Cannabidiol (CBD) is growing in popularity as an alternative treatment for arthritis. Some people take it in the form of CBD oil, whereas others apply CBD topically to the affected joints, or use both methods.
There are many reasons why CBD is becoming a sought-after option for people suffering from this condition.
For one, CBD is a safe, natural compound that comes from the hemp plant, whereas prescription medications — especially opioids — come with serious side effects, can become addictive, and only treat the symptoms rather than the root of the problem.
There’s also a growing volume of test-tube and animal research, with some early human studies, suggesting that you might be able to use CBD for arthritis.
CBD is a safe, natural compound that comes from the hemp plant
Can CBD relieve arthritis and its symptoms? Read on for a detailed look at the evidence.
Arthritis is an umbrella term for conditions that affect your joints. It can either be non-inflammatory or involve inflammation and affect one or several joints.
Inflammatory arthritis can be caused by autoimmune processes where the body’s immune system attacks the joints, infections, or crystal deposits (e.g., during gout attacks). It can also be accompanied by autoimmune diseases that affect other parts of the body, such as lupus.
There are well over 100 different types of arthritis. However, the most prominent ones are:
- Osteoarthritis: Also known as non-inflammatory or degenerative arthritis, osteoarthritis is the most common form of joint disease. It’s characterized by the wearing away of cartilage — the flexible, rubber-like padding that protects the ends of bones at the joints.
- Rheumatoid arthritis (RA): Another common type of arthritis, where an overactive immune system attacks healthy joint tissue.
- Juvenile arthritis: Any type of arthritis that affects children. In most cases, it has an autoimmune cause.
- Gout: A form of inflammatory arthritis caused by uric acid buildup in the joints. Gout is marked by sudden and severe episodes of joint pain and inflammation.
- Lupus: Lupus is a systemic autoimmune disease that can affect the joints and many other parts of the body, including blood cells, the skin, kidneys, brain, and other organs.
- Reactive arthritis: This condition is caused by an infection elsewhere in the body, such as the gut.
- Infectious arthritis: Also known as septic arthritis, this kind of arthritis is caused by joint infection.
- Psoriatic arthritis: a form of arthritis that occurs in about 20-30% of people with psoriasis, an autoimmune skin disorder. ¹
- Ankylosing spondylitis: An autoimmune disorder that causes inflammation in the spine but can also occur in other joints.
Arthritis Symptoms & Pathology
The main symptoms of arthritis are joint pain, stiffness, swelling, redness, weakness, reduced range of motion, and loss of function. ² However, depending on the underlying cause, it can also produce symptoms unrelated to the joints, such as fatigue and fever.
Having arthritis can also contribute to developing depression and anxiety.
Can CBD Help With Arthritis?
CBD and other cannabinoids hold serious potential in the treatment of arthritis. At the most basic level, CBD has anti-inflammatory and pain-relieving properties which can help relieve the symptoms of both non-inflammatory (osteoarthritis) and inflammation-related arthritis. ³
CBD may also address the underlying causes of joint diseases, such as the chronic inflammation seen in rheumatoid arthritis (RA).
Multiple animal and test-tube studies of RA have demonstrated that CBD can have a positive effect when applied either internally or topically.
In one frequently cited study from 2000, researchers examined the effects of oral or injected CBD in mice with RA. They found that it had a “potent anti-arthritic effect” through anti-inflammatory and immunosuppressive effects. ⁴
Meanwhile, the researchers of a 2016 study applied a transdermal CBD-infused gel to the joints of rats affected by RA. Again, CBD reduced joint pain and inflammation. ⁵
Furthermore, a 2020 test-tube study found that CBD may be able to alleviate RA by reducing the inflammatory effects of synovial fibroblast cells which play a key role in the condition. ⁶
There’s also some evidence that CBD may be helpful for osteoarthritis (OA), the non-inflammatory form of the disease. In one 2017 study, CBD prevented the development of neuropathic pain and nerve damage in rats with OA. ⁷
All in all, early research findings suggest that there’s great potential when it comes to using CBD for arthritis. Having said that, some researchers speculate that CBD may work best in combination with other specific cannabinoids because it can also activate anti-inflammatory mechanisms not related to cannabinoid receptors. ⁸
The Endocannabinoid System and Arthritis
Many of CBD’s beneficial effects on arthritis and other conditions come from its interaction with the body’s endocannabinoid system (ECS). This system’s main role is to help maintain your body’s homeostasis, a healthy state of balance.
The ECS has three parts:
- Endocannabinoids made by your body (anandamide and 2-AG)
- Enzymes used to make and break down endocannabinoids
- Cannabinoid receptors (CB1 and CB2) that interact with both phytocannabinoids such as CBD and endocannabinoids
Since the ECS regulates many of the processes involved in arthritis, namely immune system function, inflammation, and pain, it offers an innovative way to alleviate and treat joint conditions. ⁹
For instance, there’s evidence that activation of the CB2 receptor, which is especially abundant in immune system cells, may have a positive effect on RA by lowering the production of autoantibodies, inflammatory molecules called cytokines, and via other mechanisms. ¹⁰
Several studies have also reported that the levels of endocannabinoids, their associated enzymes, and cannabinoid receptors in individuals with arthritis significantly differ from those of healthy individuals, suggesting that the ECS is involved in the condition. ¹¹
Another interesting finding is that blocking the effects of FAAH — an enzyme that breaks down the endocannabinoid anandamide — seems to alleviate arthritis symptoms.
In one animal study of RA, researchers looked at mice that either lacked the enzyme completely or were given a drug to prevent its effects. They found that blocking FAAH reduced the severity of RA and associated pain. ¹²
Similarly, a study in mice with OA found that a FAAH blocker lowered acute joint inflammation, prevented nerve damage, and reduced chronic joint pain. ¹³
These studies are especially relevant to CBD because one of its major effects is suppressing this same FAAH enzyme.
Other Anti-Arthritic Mechanisms of CBD
As we mentioned earlier, one of the great things about CBD is that it also affects other systems aside from the ECS.
For example, there’s evidence that CBD can produce anti-inflammatory, pain-relieving, and other anti-arthritic effects by acting on serotonin, TRPV1, TRPA1, and PPARγ receptors, and suppressing the pro-inflammatory (NF)-κB pathway. ¹⁴ ¹⁵ ¹⁶ ¹⁷
What Does the Research Say?
Human studies looking at CBD for arthritis are just beginning, but the findings are promising.
In a 2018 trial on 320 people with knee OA, researchers compared the effects of a synthetic transdermal CBD gel with a placebo treatment. Although people in the CBD gel group reported lower average pain scores than placebo, this improvement was not statistically significant enough to rule out random chance.
However, further analysis showed that some people (responders) did see significant reductions in pain when treated with the CBD gel compared to placebo. ¹⁸
Meanwhile, a 2006 study on 58 RA sufferers compared placebo with the effects of Sativex, a drug with equal amounts of CBD and THC. Unlike placebo, the cannabinoid treatment significantly improved arthritis pain and severity. CBD also improved sleep and was associated with mostly minor side effects. ¹⁹
There’s also a case report of a 50-year-old woman suffering from RA, lupus, and Raynard’s disease, all of which are autoimmune conditions. She took 600 mg of CBD isolate oil for 28 days, resulting in significant pain relief, better mobility and mood, improved scores on quality-of-life metrics, and lower levels of inflammation. ²⁰
There are also many anecdotal reports of CBD’s beneficial effects on arthritis. In particular, a survey done by the Arthritis Foundation reported that arthritis sufferers saw improvements in physical function, morning stiffness, sleep, and overall well-being by using CBD oil and topical CBD products.
Overall, the evidence is promising but more well-designed, rigorous human studies of CBD’s effects on arthritis are needed.
How Much CBD Should I Take for Arthritis?
There are no official CBD dosage recommendations for arthritis or any other condition.
Although we have no conclusive guidance for an effective way to treat arthritis with CBD, we do know that an effective CBD dosage can vary between individuals based on their weight, unique body chemistry, and arthritis type and severity.
Additionally, CBD products come in a wide variety of forms, which can also influence the dosage.
In general, most health experts recommend the “start low and go slow” approach to dosing CBD and other cannabinoids. ²¹
In the case of arthritis, you can use CBD internally, in the form of CBD oil and other products, or apply it directly to the affected joints as a cream or another topical preparation.
Start with a small amount of CBD (10-15 mg) and wait a few hours to see if you notice any effects. If that’s not enough, raise the dose in small increments over time until you settle on the amount that relieves your arthritis symptoms.
Meanwhile, if you’re using a topical product, you can estimate the amount you’re using by dividing the total CBD content by the volume. For example, a 30 ml CBD cream with 900 mg of CBD provides 30 mg per ml.
Are There Any Side Effects?
According to decades of research, CBD is a well-tolerated, safe compound.
While it can cause minor-to-moderate side effects, including sleepiness, tiredness, diarrhea, dry mouth, low blood pressure, dizziness, and changes in appetite or weight, these have only been reported in studies using high doses of pure CBD. ²²
Additionally, the study of transdermal CBD gel in OA sufferers reported skin dryness and headaches in some participants.
However, most people take much lower doses of CBD and are unlikely to experience anything more than mild side effects.
Judging from preliminary research, CBD shows great promise to be developed into an alternative or complementary treatment plan for arthritis. It seems to offer beneficial effects for all types of arthritis, including its two most common forms: rheumatoid arthritis and osteoarthritis. It’s worth noting that most people report the best effects through topicals rather than other consumption methods, such as CBD gummies.
What’s more, full-spectrum CBD might not only alleviate arthritis symptoms, such as chronic pain, but also address the chronic inflammation that underlies rheumatoid arthritis and other inflammatory forms of the disease.
Furthermore, CBD is a very safe option that’s only been associated with mild-to-moderate side effects.
Still, like with most conditions people are trying to treat with CBD , there isn’t a ton of clinical research evidence. More high-quality studies are needed to confirm CBD’s anti-arthritic effects and figure out the best way to use it. If you are currently on prescription medication, we suggest consulting your doctor before taking CBD.