How CBD Helps With Arthritis Pain
Studies suggested CBD topical’s therapeutic potential in arthritis pain and inflammation relief with minimal to no apparent side effects(1).
Arthritis is characterized by the tenderness or swelling of the joints(2). It is commonly used as a term for joint pain or joint disease(3). Arthritis or joint pain is typically prevalent among aging people, particularly women(4).
There are two main kinds of arthritis: osteoarthritis and rheumatoid arthritis(5). Rheumatoid arthritis causes the immune system to disrupt the joints, while osteoarthritis results in the breakdown of the joints’ cartilages(6).
Some of the osteoarthritis’ most apparent symptoms include chronic pain, inflammation, swelling, stiffness, decreased range of motion, and redness.
Arthritic pain can result from sensory nociceptive irritation or a consequence of somatosensory nervous system malfunction (neuropathic)(7).
Recent studies over the last 25 years have discussed the role of the human endocannabinoid system (ECS) in neuromodulatory functions in the central nervous system(8).
The endocannabinoid system is a crucial endogenous system in the human body that regulates pain(9). It has two primary cannabinoid receptors: CB1 receptors, found in the peripheral and central nervous systems, and CB2 receptors, mostly found in immune cells.
A study noted that cannabinoid receptors may inhibit chronic and acute pain and reduce inflammation(10). Meanwhile, research conducted in 2017 suggested that the bodies’ endogenous compounds affect inflammation and pain modulation(11).
Cannabidiol (CBD), the non-psychoactive endogenous compound found in hemp plants, modulates and decreases joint pain in people with osteoarthritis(12). The individuals were given peripheral dosing.
CBD also demonstrated potential in treating arthritis pain and exhibited anti-inflammatory properties(13). Moreover, the combination of CBD and THC showed synergistic effects leading to reduced inflammation(14).
Uses of CBD in Arthritis Pain
According to the Arthritis Foundation, more than 50 million adults and 300,000 children are suffering from some type of joint pain or arthritis(15).
Synthetic anti-inflammatory drugs, some of the conventional arthritis medications, may have harmful side effects, including gastric irritation, hepatic failure, and skin rashes(16). Two of the most common medications used in arthritis pain are disease-modifying anti-rheumatic drugs (DMARD) and nonsteroidal and anti-inflammatory drugs(NSAID).
Although NSAID has proven effective in treating pain and inflammation, these drugs are also known for their side effects, primarily on the elderly(17).
In contrast, a study said that topical preparations may elicit safety and possible benefits for children and the elderly(18). Meanwhile, another research involving osteoarthritic rats suggested that CBD may be a safe treatment for osteoarthritis joint neuropathic pain(19).
CBD is mainly used as a treatment for pain and inflammatory disorders(20). Thus, arthritis pain is one of the chronic inflammatory pain that CBD may address.
A scientific paper on collagen-induced arthritis (CIA) in mice proposed that CBD may be a potent anti-arthritic for the CIA because of its immunosuppressive and anti-inflammatory actions(21).
Despite CBD’s potential pain-relieving effects, a study showed that it has a low oral bioavailability compared to other administration routes(22). Other delivery systems include transmucosal, transdermal, and intranasal delivery.
A study said that the application of CBD topicals, like CBD cream, is one way to effectively administer CBD for arthritis inflammation and pain management(23). These CBD topicals are also used for back and muscle pain.
CBD for arthritis pain may be consumed using different delivery methods. These administration routes include ingestion, inhalation, and transdermal, topical, and sublingual application.
CBD Product Forms and Routes of Administration
The most common CBD route of administration is inhalation and sublingual absorption. CBD products that may be inhaled include CBD vape and CBD flower for smoking, while products that can be used for sublingual absorption are the CBD oil tinctures.
Inhalation of CBD through vaping and smoking is said to have the fastest onset effect with a 2 to 15-minute waiting time only. In contrast, CBD edibles, like CBD gummies and CBD capsules, have the longest efficacy duration, lasting six to eight hours of subsistence(24).
The sublingual or mucosal method involves the mucosal membranes under the tongue or in the cheeks during CBD absorption. According to a study on animals, this administration route allows terpenes to be more well-absorbed(25).
Terpenes are naturally occurring compounds in plants known to have the potential to act as an antidiabetic and anti-cancer agent(26).
CBD creams, CBD salves, CBD lotions, and CBD balms are common forms of CBD topicals commonly used in the skin for targeted pain relief, including alleviation of muscle aches and soreness. They are applied or rubbed directly to the affected area.
The research highlighted findings that support the benefits of topical CBD’s preparations in nociceptive and neuropathic pain relief(27).
Topical administration may last up to two to four hours, with an onset time of 15 to 30 minutes(28). These CBD topicals affect the skin’s CB2 receptors and may reduce pain and inflammation associated with arthritis(29).
Another way to use CBD on the skin is through transdermal methods. They are commonly used for generalized pain, like diabetic neuropathy and fibromyalgia.
Although the transdermal route has the same onset time as topical administration, the former has a higher absorption rate than the latter CBD administration(30).
Things to Consider in Buying CBD Cream for Arthritis
Most CBD brands claim to offer high-quality CBD products. They often assert their safe and clean manufacturing practices and even offer a money-back guarantee to assure customers of their products’ excellent quality.
Despite these CBD companies’ promises, there are still apprehensions regarding CBD’s legality, safety, and quality(31). In choosing the best CBD cream for arthritis pain, the following should be considered:
Type of CBD Extract
There are three types of CBD oils: full-spectrum CBD, broad-spectrum CBD, and CBD isolates(32).
A full-spectrum CBD oil or whole-plant extract has all the cannabinoids, like tetrahydrocannabinol (THC) and cannabidiol (CBD), and terpene profiles of a hemp plant. This type of CBD is believed to produce a synergy called the entourage effect(33).
A THC-free alternative for people who are apprehensive about THC use is the broad-spectrum CBD hemp extract. It has all the phytocannabinoids and some terpene profiles that a full-spectrum oil has, except the psychoactive compound THC(34).
Lastly, CBD isolate is made from pure cannabidiol. It does not contain THC, terpenes, or other cannabinoids conventionally found in whole-plant extracts.
However, CBD isolates may require users to take higher doses to feel their beneficial effects(35).
Source of Hemp
Knowing the hemp source is essential because it gives information on how the cannabis plant was grown, what farming procedures were employed, and if the farming protocols were implemented during production.
Most CBD companies will argue that their hemp oil products are from non-GMO, organic hemp. However, the only way to verify this is by inspecting the farms its hemp extracts were sourced from.
Colorado is known to set the standards in the hemp industry since 2014. For instance, the Colorado Department of Agriculture (CDA) administers a certified seed program that inspects and ensures Colorado-grown hemp plants’ genetic identity.
Aside from Colorado, other known hemp cultivars that are a part of the hemp pilot programs in the United States include Kentucky, North Carolina, and Oregon(36).
Certificate of Analysis
One of the most important things to look for when inspecting the quality of CBD products is the certificate of analysis (COA).
Some CBD brands use in-house lab tests for their CBD extract. However, third-party lab reports provide unbiased lab results that may help establish the integrity of the CBD brand.
The COA shows the cannabinoid content of the product per container and the potency of CBD per serving. It also allows you to view the lab results for microbials, pesticides, and other chemicals.
Inspecting the COA for contaminants is one way for customers to be assured of safe and quality products from CBD companies.
Amount of CBD Concentration and Potency
The CBD concentration per container and the potency in mg of CBD per serving can be seen in the product COA.
This information can help you determine if the product is true to its label when it promised a certain amount of CBD or THC.
CBD isolate products may need higher CBD concentrations to increase your chances of experiencing CBD isolates’ beneficial effects compared to full-spectrum CBD extracts.
The extraction method will determine the purity and cleanliness of the hemp extract. Terpenes, flavonoids, and other cannabinoid content are dependent on what extraction process was used to obtain them.
There are two kinds of extraction methods: mechanical and chemical processes(37). The mechanical extraction method does not use any solvents to obtain the phytocannabinoids from the hemp plant, while chemical extraction uses different solvents, like ethanol and CO2.
The CO2 extraction process is a kind of chemical extraction that is one of the most common methods in obtaining CBD-rich hemp extracts(38).
Looking at the ingredients will give you further information on what is in the product aside from the CBD-rich hemp oil.
Some CBD products are infused with other ingredients and carrier oils that aim to contribute additional benefits or flavor profiles.
Two of the most common carrier oils are medium-chain triglyceride (MCT) coconut oil and hempseed oil.
Hempseed oil is typically pressed from hemp seeds and is a good source of digestible proteins(39). Meanwhile, MCT coconut oil is known to have cardiovascular benefits(40).
Most topical products may include ingredients that may help in skincare and overall health, such as essential oils, shea butter, vitamin E, beeswax, and aloe vera.
Shea butter is known to have a moisturizing effect on the skin. It also has healing benefits ad anti-inflammation properties(41). Meanwhile, aloe vera has various immunomodulatory and anti-viral properties(42).
Other CBD pain creams may also contain additional pain-relieving components, like arnica, peppermint, eucalyptus, and camphor or menthol.
Camphor or menthol demonstrated benefits in blood circulation in the skin and muscles(43).
Risk and Side effects
Although studies have shown the health benefits of CBD in arthritis pain, the research available on the topic is still in its infancy. CBD products are mostly recommended for enhancing wellness instead of treating diseases.
There are noted side effects that have to be considered before trying any CBD product. These side effects include drowsiness, dry mouth, fatigue, diarrhea, and reduced appetite(44).
Before exploring CBD products, like CBD pain cream, a doctor’s consultation is a must. Some people who are already taking arthritis medications or using pain relief pharmaceutical drugs may still be considering taking CBD.
However, there is a risk to consider in taking CBD alongside other medicines. A study discussing the possible adverse effects of CBD’s interactions with other drugs noted the following(45):
- Molecular targets of CBD
- Metabolic induction and inhibition
- Metabolic pathways
- Drug transport
- Pharmacodynamic effects
According to another study, CBD’s possible effects, like somnolence, fatigue, and abnormal occurrences of lack of energy (asthenia), are similar to that of opioids, antidepressants, and antihistamines. Taking CBD with these medications may cause excessive sedation and interruption of daily activities(46).
The Food and Drug Administration (FDA) in the USA has set standards and protocols on the legality of the cultivation of cannabis plants. Hemp is a term used to define cannabis plants with less than 0.3% THC in dry weight(47).
In 2018, the cultivation of industrial hemp was made legal in America. However, the US FDA approved one pharmaceutical CBD-infused drug only: Epidiolex.
This drug is specifically made for treating severe and rare forms of seizures, Gastaut-Lennox syndrome, and Dravet syndrome(48).
The legality of CBD products depends on the laws and regulations of a specific state in the US.
Despite these restrictions, some US CBD brands still offer shipping in 50 states and even worldwide. It is imperative to research these guidelines to avoid unlawful repercussions.