Most people use CBD oil to relieve chronic pain, especially from joint diseases like rheumatoid arthritis and osteoarthritis. CBD may reduce joint inflammation and slow disease worsening. Read on to find out if it works and whether you should take it.
The Science Behind Using CBD Oil for Arthritis
The only FDA-approved use of CBD oil is for reducing epileptic seizures. However, many people take CBD oil for other investigational, non-proven uses .
The main medical use of CBD oil is, indeed, not to improve epilepsy but to relieve chronic pain. Among the various painful conditions people use CBD oil for, inflammatory joint disorders such as rheumatoid arthritis and osteoarthritis rank first. In a survey of 1500 medical CBD users, almost half reported suffering from arthritis .
Similarly, many people smoke medical cannabis to relieve arthritic pain. In 2 surveys on 5k people, 20% did so for this purpose. They often reported good results, but most of them used cannabis types with higher THC than CBD levels, such as indica strains [3+, 4].
This leaves us with the question: does CBD alone relieve arthritic pain or is THC the main cannabis-derived compound responsible for the benefits? Unfortunately, the question remains unresolved because no clinical trials have tested CBD in people with arthritis and the only studies carried out so far have been done in animals.
How Does It Work?
The term ‘arthritis’ includes a group of joint diseases with inflammation, pain, and cartilage damage. It can be caused by repeated mechanical damage (e.g., osteoarthritis), autoimmunity (e.g., rheumatoid arthritis), or by other diseases (e.g., psoriatic arthritis) [5, 6].
While there is no cure for arthritis, therapies can relieve pain, reduce inflammation, and slow the progression of the disease. Let’s take a look at how CBD can help.
Activating the Endocannabinoid System
The endocannabinoid system is made up of two receptors: CB1 and CB2. The cannabinoids naturally produced in the body – such as anandamide and 2-AG – bind to and activate them. Though CBD blocks CB receptors, it increases anandamide by preventing its breakdown [7+, 8, 9, 10, 11].
Two studies in humans and dogs found that animals with rheumatoid arthritis or osteoarthritis had higher levels of both CB receptors and several cannabinoids in the joints. This suggests that the body activates the endocannabinoid system to fight arthritis. In line with this, increasing cannabinoids may be a good therapeutic strategy [12, 13].
Alternatively, a blocker of the enzyme that breaks down anandamide (FAAH) reduced pain in rats and guinea pigs with osteoarthritis. Anandamide seems to work by activating CB1, since blocking this receptor prevented the pain-relieving effect .
Blocking Pain Pathways
CBD activates a receptor involved in inflammatory pain (TRPV1). Although this receptor causes pain in the joints of rats with osteoarthritis, its activation by CBD or the chili pepper compound capsaicin reduces pain perception [11, 18, 19, 20].
CBD also binds to another receptor with a similar function in inflammatory pain (TRPA1). Activating this receptor (as well as TRPV1 and CB2) by a synthetic cannabinoid reduced inflammation in joint cells taken from people with arthritis [21, 22].
CBD is a strong anti-inflammatory. It blocks the major inflammatory hub NF-kB, activates the anti-inflammatory PPAR-gamma, and prevents the removal of the anti-inflammatory compound adenosine [25, 26, 27].
In animals with arthritis, CBD reduced the production of two pro-inflammatory cytokines (IFN-gamma and TNF-alpha). In animals with other inflammatory conditions, it also reduced inflammatory messengers (IL-1beta, IL-6, NO, and prostaglandins) while increasing two anti-inflammatory cytokines (IL-4 and IL-10) [28, 29, 30, 31, 32, 33].
Suppressing the Autoimmune Response
Additionally, CBD prevents T cells from dividing, migrating to inflammation sites, and producing pro-inflammatory cytokines. This is particularly relevant in autoimmune arthritis types such as rheumatoid arthritis or when the condition is caused by autoimmune diseases such as psoriasis, celiac disease, and lupus [28, 34, 35, 36, 37, 38, 39, 5].
When Does It Work?
Evidence from Animal Studies
Osteoarthritis is a chronic degenerative condition in which the repeated damage of the joints due to wear and tear, overload, or injuries leads to their inflammation and breakdown. Therapies for this condition normally focus on reducing inflammation and relieving pain [5, 6].
In rats with this type of arthritis, topical CBD reduced inflammation and slowed the progression of osteoarthritis in the early stages. In animals with advanced osteoarthritis, CBD injected at the inflammation site reduced sensitivity to pain and increased weight-bearing capacity .
In dogs, oral CBD relieved pain but had no effect on limb mobility and weight-bearing capacity .
Although osteoarthritis is a chronic condition, these studies only tested CBD for up to 19 days. Longer treatments may also be effective, since CBD had sustained effects in mice with other inflammatory conditions given this compound for up to 8 months [42, 43].
Nevertheless, it’s important to note that these studies were done only in animals. There is no evidence that CBD oil will have the same effects in people with osteoarthritis.
Rheumatoid Arthritis & Autoimmunity
Rheumatoid arthritis is an autoimmune disease in which the body’s immune system attacks the joints, causing inflammation and damage. In this case, blocking the autoimmune response may yield better results [5, 6].
In mice with this condition, oral and injected CBD relieved inflammation and slowed the joint damage progression. CBD also prevented T cells and joint cells (synoviocytes) from reproducing and releasing pro-inflammatory cytokines (TNF-alpha and IFN-gamma) .
Similarly, a topical CBD gel reduced joint swelling, pain, and the levels of inflammatory markers (such as TNF-alpha) in the nerves of rats with rheumatoid arthritis .
Again, these preliminary results cannot be considered any evidence that CBD oil improves rheumatoid arthritis.
No human studies tested CBD for arthritis yet. A trial testing CBD – both alone and followed by an add-on of THC – in people with rheumatoid arthritis and ankylosing spondylitis is underway .
In contrast, a mouth spray delivering the same amount of CBD and THC (nabiximols) reduced pain and morning stiffness while improving sleep quality in a small trial on 58 people with rheumatoid arthritis .
Alternatively, CBD prevented skin cells from over-dividing – as they do in case of psoriasis – and a gel with CBD but no THC improved psoriasis in a small trial on 5 people. This suggests that topical CBD oil may help prevent psoriasis from worsening and developing into arthritis [48, 49].
Taken together, the evidence to support the benefits of CBD in people with arthritis is extremely limited for psoriatic arthritis and non-existent for rheumatoid arthritis. Further clinical trials such as the ongoing one should shed some light on the potential use of CBD oil for arthritis.
The only available clinical trial used a mouth spray with similar levels of CBD and THC. Animal research with CBD shows promising results for relieving and slowing the progression of both rheumatoid arthritis and osteoarthritis, but clinical trials have yet to determine if it’s helpful in humans.
CBD Oil Dosage for Arthritis
Because CBD is not approved for any arthritis types, there is no official dose. The fact that CBD alone hasn’t been tested in clinical trials means that there is no proven dose either. We can only estimate the optimal one based on the guidelines from manufacturers and natural health blogs.
They generally recommend starting with a low dose (5-10 mg, 2x/day) and gradually increasing it until you achieve the desired effects. According to them, most people experience relief with 20 mg 2x/day but some with more severe pain may need to increase the dose to 80-100 mg. If CBD alone doesn’t work, you may want to try products with some THC for additional pain relief.
Another possibility is to estimate the dose based on data from animal studies. In animals with rheumatoid arthritis, researchers used oral doses of 10-50 mg/kg and topical doses of 20-240 mg/kg. For osteoarthritis, they reduced the dose to 0.5-2 mg/kg for oral, topical, and injected preparations [28, 29].
In any case, remember that the right dose will also depend on your weight, pain intensity, and tolerance to CBD. Consult your best starting dose with your doctor and never take CBD oil in place of the proven therapies for arthritis that he or she recommends or prescribes.
How to Use
You may choose your preferred form of CBD oil based on the type and distribution of your pain [50+].
Topical forms may be a good option for arthritis since you can apply them to a targeted area. They may be most beneficial for localized joint pain and inflammation.
Oral forms distribute CBD throughout the body. Capsules, edibles, and teas release CBD more slowly and their effects last longer – possibly a better choice if you are constantly in pain. Vapes, mouth sprays, and oil tinctures provide a faster, more temporary relief; they may be preferable for sudden, acute pain.
Importantly, loading a vaporizer can be troublesome for people with arthritis because they may have reduced hand dexterity. If you have acute, episodic pain but there’s nobody around to help you load it, go for other fast-acting forms such as tinctures and sprays .
Best CBD Oil for Arthritis
In addition to choosing a CBD oil adjusted to your budget (you may want to calculate the price per mL or mg to compare different brands), you should also evaluate the product quality. Read about how to choose the best CBD oil here.
The opinions expressed in this section are solely those of CBD oil users who may or may not have medical or scientific training. Their reviews do not represent the opinions of SelfHacked. SelfHacked does not endorse any specific product, service, or treatment.
Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare providers because of something you have read on SelfHacked. We understand that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.
People using CBD oil for joint pain most often had osteoarthritis, rheumatoid arthritis, or psoriatic arthritis. Users were generally satisfied and reported that CBD reduced their pain and improved their quality of life. However, some dissatisfied users didn’t notice any effects.
CBD oil is a safe anti-inflammatory many people with arthritis turn to. Clinical studies are currently underway to test its effectiveness for rheumatoid arthritis and osteoarthritis.
Based on data from animal studies, CBD oil may relieve the symptoms of arthritis by increasing natural cannabinoids like anandamide, blocking pain pathways, suppressing autoimmunity, and lowering inflammation. For this reason, it may also help people with arthritis from other autoimmune diseases such as psoriasis or lupus.
Topical forms – creams, gels, and lotions – may be a good option for localized joint pain and inflammation. If your pain and inflammation are severe, you may combine topicals with CBD oil capsules or tinctures to achieve a stronger and longer-lasting effect.