Arthritis is one of the most common conditions experienced worldwide, in the UK alone it is estimated around 10 million individuals suffer from arthritic pain. With such a high prevalence in the population it is unsurprising there has been a groundswell of interest in using medical cannabis to treat this progressive and painful condition.
There are two primary kinds of arthritis, osteoarthritis and rheumatoid arthritis. In osteoarthritis, degradation of the cartilage surrounding joints leads to increased inflammation and pain. For many patients, as the joints lose structural integrity and inflammation persists, characteristic bony prominences can be seen on the fingers.
Rheumatoid arthritis is associated with an autoimmune response, where the body’s immune system attacks the fluid that lubricates joints. The cause of this is unconfirmed but certain triggers have been identified such as infection, smoking or trauma.
There is a range of other arthritic conditions that affect all age groups. While it’s easy to associate arthritis as a condition that only affects the elderly, many types such as juvenile-onset arthritis and ankylosing spondylitis can begin as early as adolescents.
Unfortunately there is a dearth of human clinical trials conducted in relation to medical cannabis specifically for arthritis. However, one randomised placebo-controlled trial with 58 patients showed significant improvements in pain scores for rheumatoid arthritis sufferers.
More broadly the action of cannabinoids as an anti-inflammatory has been investigated. By decreasing inflammatory factors and messengers, which are key drivers in arthritis, medical cannabis has the potential to positively influence symptoms and disease progression in arthritic conditions.
In terms of pain, varied medical cannabis formulations have shown statistically significant decreases in pain scores in both cancer-related and non-cancer related pain. Both THC and CBD (together and separately) have been investigated for their ability to relieve pain.
The effects of THC on pain is attributed to its interaction with the endocannabinoid system. CBD, unlike its psychoactive counterpart, is thought to inhibit pain along the same pathways as standard ibuprofen.
Suffice to say there is plenty of evidence now indisputably acknowledging the importance of the endocannabinoid system (ECS) in human health. This system is comprised of receptors and endocannabinoids (cannabis-like products the body innately produces) that have influence over our circadian rhythm, appetite, mood, experience of pain and much more.
The CB1 receptors are expressed prominently in the central nervous system, these neuronal pathways act as highways for pain impulses. CB2 receptors can found in aspects of the immune system. The fact these receptors both coincide with key aspects of the pathology and presentation of arthritis -pain and inflammation- strongly implicates the ECS as a therapeutic target.
Animal studies have shown us there is a strong basis for the continued exploration of using the ECS to treat arthritis. In rats, CBD was shown to decrease inflammation, as well as decrease the firing of pain neurons and pain-related behaviours in advanced osteoarthritis models.
In the same research paper, CBD given prior to the onset of osteoarthritis blocked acute inflammatory responses and prevented pain and nerve damage. While this being a rat study may not sound super exciting, it is some of the first solid evidence showcasing CBD as an anti-inflammatory and pain-relieving agent specific to osteoarthritis.
Standard treatment for arthritis involves non-steroidal anti-inflammatories and paracetamol. For cases of severe arthritic pain, which is prevalent, opioids are sometimes prescribed.
Given that medical cannabis is being researched globally for its opioid-sparing effects and that up to 60% of arthritis patients are unsatisfied with their current treatment outcomes, medical cannabis may be a viable treatment option for patients whose pain hasn’t been effectively controlled with conventional, licensed treatments.
Despite its promise and all-important opioid-sparing potential, accessing medical cannabis for arthritis in the UK is still problematic. But not impossible. Current regulations allow for medical cannabis to be prescribed when other treatment options have shown to be unsuccessful.
At CA Clinics we have consultants and specialist doctors who can assess your suitability and eligibility for medical cannabis. To find out if medical cannabis would be helpful in treating your arthritis, you can find out what the process looks like here or book an eligibility consultation here.
By Jessica Kindynis