Arthritis

Arthritis is marked by painful inflammation of one or more joints. With known effects of cannabinoids in the reduction of pain and inflammation and in bone formation, cannabinoids offer great potential in the treatment of arthritis. However, to date, no large-scale, double-blind clinical trial has proven this potential.

Alternative Names: 
osteoarthritis
rheumatoid arthritis
Prescription Advice: 

Clinical research suggests that (a mixture of) THC and CBD can be effective in the treatment of arthritis. Given the nature of the disease direct application to the skin/affected joint might be most efficient and avoids potential psychoactive effects of THC. Alternatively sublingual application could be effective.

Please follow generic prescription advice.

Please note that, while based on preclinical and/or clinical research, this prescription advice is solely intended as a guideline to help physicians determine the right prescription. We intend to continuously update our prescription advice based on patient and/or expert feedback. If you have information that this prescription advice is inaccurate, incomplete or outdated please contact us here.

Receptors: 
Phytocannabinoids: 
Literature Discussion: 

In mice genetically deficient for CB2, experimentally induced osteoarthritis was significantly worse than in control mice (Sophocleous et al., 2015). In addition, naturally occurring osteoarthritis was more severe in CB2 deficient mice than in controls.

This suggests that CB2 is involved in the development of (osteo-)arthritis and that CB2 activation may protect against osteoarthritis.

In mice with collagen-induced Arthritis 5 mg/kg/day i.p. or 25 mg/kg/day oral effectively blocked disease progression and suppressed joint damage, lymphocyte proliferation and IFNγ and TNF expression (Malfait et al., 2000).

References:

Malfait, A.M., Gallily, R., Sumariwalla, P.F., Malik, A.S., Andreakos, E., Mechoulam, R., and Feldmann, M. (2000). The nonpsychoactive cannabis constituent cannabidiol is an oral anti-arthritic therapeutic in murine collagen-induced Arthritis. Proc. Natl. Acad. Sci. U. S. A. 97, 9561–9566.

Sophocleous, A., Börjesson, A.E., Salter, D.M., and Ralston, S.H. (2015). The type 2 cannabinoid receptor regulates susceptibility to osteoarthritis in mice. Osteoarthr. Cartil. OARS Osteoarthr. Res. Soc.

Clinical Trials: 

In one trial, a mixture of THC and CBD (Sativex) was found to be effective in reducing pain and stiffness and improving sleep (Blake et al., 2006)

In another study, inhibition of FAAH (which should increase endocannabinoid levels) failed to reduce pain in arthritis (Huggins et al., 2012). More and larger studies are required to assess the therapeutic potential of cannabinoids in arthritis.  

References:

Blake, D.R., Robson, P., Ho, M., Jubb, R.W., and 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 45, 50–52.

Huggins, J.P., Smart, T.S., Langman, S., Taylor, L., and Young, T. (2012). An efficient randomised, placebo-controlled clinical trial with the irreversible fatty acid amide hydrolase-1 inhibitor PF-04457845, which modulates endocannabinoids but fails to induce effective analgesia in patients with pain due to osteoarthritis of the knee. pain 153, 1837–1846.

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