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Osteoarthritis

Cannabis for Osteoarthritis

old woman holding and pinching her palm

Osteoarthritis (OA) occurs when the cartilage in your joints — the cushiony tissue that helps bones move smoothly — wears down over time. This leads to bones rubbing together, causing pain, stiffness, and swelling.

As of 2024, 53 million U.S. adults have arthritis, with osteoarthritis being the most common subtype. This number is expected to increase as the population ages, and arthritis is becoming a leading disability. Although there is no cure for arthritis, it is possible to manage the condition and slow down its progress.

Novel medications are required to treat osteoarthritis. Medical cannabis could help manage symptoms and triggers like chronic pain, inflammation, insomnia, and anxiety.

Osteoarthritis causes

There are a number of factors that can increase your risk of osteoarthritis, including:

    • Aging: Cartilage naturally wears down as we age
    • Extra weight: Carrying excess weight puts added pressure on joints, and those with obesity have an increased risk of arthritis
    • Genetics: A family history of OA can increase your chances
    • Inflammation: Chronic low-level inflammation may speed up cartilage breakdown
    • Joint injuries: Past injuries, like sports or work-related trauma, can lead to OA
  • Lifestyle: Excessive alcohol consumption and tobacco use can increase the risk of osteoarthritis
  • Medications: Some types of medication, like non-steroidal anti-inflammatory drugs (NSAIDs, e.g. ibuprofen), proton pump inhibitors, and statins, can cause joint pain and/or increase the risk of arthritis

Osteoarthritis symptoms & health effects

OA symptoms can vary but often include:

  • Joint pain and stiffness, especially after activity or long periods of inactivity
  • Reduced movement in the affected joints
  • Swelling and tenderness in the joint area
  • A grating or clicking sound (crepitus) when you move the joint

Living with OA can affect your ability to move around, work, or enjoy hobbies. It may also lead to emotional impacts like anxiety or depression from living with chronic pain.

Osteoarthritis diagnosis

Doctors use several tools to diagnose OA, including:

  1. Your medical history: Questions about your symptoms and family history
  2. A physical exam: Checking for joint swelling, stiffness, and range of motion
  3. Imaging tests:
    • X-rays to spot bone changes and cartilage loss
    • MRI scans for a detailed look at soft tissues
  4. Lab tests: Blood tests or joint fluid analysis to rule out other forms of arthritis, like rheumatoid arthritis or gout

Osteoarthritis prognosis

OA is a long-term condition without a cure, but you can manage it with the right approach. Factors that help include:

  • Catching it early and starting treatment
  • Staying active and maintaining a healthy weight
  • Following your doctor’s advice on medications and therapy

Osteoarthritis treatments

Treatments for osteoarthritis often include medications, various types of physical therapy, and lifestyle changes. There is no cure for osteoarthritis, but it is possible to slow it down and reduce symptoms.

First-line treatments

  • Lifestyle changes: Losing even a small amount of weight can reduce pressure on your joints. Gentle exercise like walking or swimming helps keep joints flexible
  • Physical therapy: Exercises tailored to strengthen muscles around the joint
  • Over-the-counter (OTC) medications: Pain relievers like acetaminophen (paracetamol) or NSAIDs (like ibuprofen) can reduce discomfort and inflammation

Other treatments

  • Injections: Steroid injections can offer temporary pain relief, while hyaluronic acid may improve joint lubrication
  • Surgery: Joint replacement may be considered for severe cases when other treatments don’t help

Adjunctive therapy & alternative treatments

  • Acupuncture: May help reduce pain for some people
  • Heat and cold therapy: Use heat to relax stiff joints and cold to reduce swelling
  • Herbal remedies: Turmeric/curcumin, black pepper/piperine, and ginger extracts may reduce pain and inflammation associated with arthritis
  • Supplements: Glucosamine and chondroitin might support joint health

Cannabis for osteoarthritis

Medical cannabis is becoming a popular option for managing OA symptoms, as it may:

  • Reduce pain: Cannabinoids like cannabidiol (CBD) and tetrahydrocannabinol (THC) interact with the body’s endocannabinoid system to lower pain signals
  • Ease inflammation: CBD has anti-inflammatory properties
  • Improve sleep and mood: Cannabis may help with insomnia and anxiety caused by chronic pain
  • Spur bone growth: Some evidence suggests that cannabinoids like CBD and cannabigerol (CBG) may promote bone healing and growth

What the research says:

  • Studies show that CBD-rich products can reduce OA symptoms without major side effects
  • THC combined with CBD may provide additional pain relief
  • Beta-caryophyllene, a terpene/cannabinoid that is found in many cannabis varieties, can help manage pain and inflammation associated with arthritis via interaction with CB2 receptors
  • Other terpenes like myrcene and linalool may also help manage pain and insomnia due to their sedative properties

How to use it safely:

  • Choose products like oils, capsules, or creams
  • Start with a low dose and adjust under medical guidance
  • Talk to your doctor to ensure it won’t interfere with other medications

cannabis tinctures

Additional information for patients

Other forms of arthritis

There are over 100 subtypes of arthritis, with the most common being:

  • Rheumatoid arthritis (RA): Unlike OA, RA is an autoimmune disease where the body’s immune system attacks joint tissue. This leads to swelling, pain, and joint damage. Treatments include immune-suppressing medications and anti-inflammatories.
  • Gout: Caused by a buildup of uric acid crystals in the joints, gout results in sudden, severe pain and swelling, often in the big toe. Managing gout involves diet changes, medications to lower uric acid levels, and anti-inflammatory drugs.
  • Ankylosing spondylitis: A type of arthritis that causes inflammation in the joints and ligaments of the spine. People with the genetic marker HLA-B27 have a higher risk of developing this type of arthritis.
  • Psoriatic arthritis: A type of arthritis that affects people who have psoriasis, and often impacts the hands, feet, wrists, ankles, and knees. It can also cause scaly spots on the scalp, elbows, knees, and lower spine.
  • Juvenile idiopathic arthritis (JIA): The most common type of chronic arthritis in children

Tips for living well with osteoarthritis

  • Exercise smart: Focus on joint-friendly activities like swimming or yoga
  • Eat an anti-inflammatory diet: Include foods like fatty fish, nuts and seeds like walnuts and flax seeds, berries, and leafy greens. Avoid processed foods and sugary snacks.
  • Use assistive tools: Devices like braces or walking aids can reduce strain on your joints
  • Take breaks: Rest your joints when they feel overworked

Charities and organizations

Support groups are available, with many run by charities like Arthritis Foundation, American Arthritis Foundation, or Juvenile Arthritis Research (JAR).

Osteoarthritis FAQs

Can OA be cured?

No, but symptoms of osteoarthritis can be effectively managed.

Is exercising safe for those with osteoarthritis?

Yes. Low-impact activities like yoga, cycling, or swimming are great for your joints. Although exercising can be painful with OA, it can also help reduce pain and inflammation associated with arthritis.

Does weight matter when managing arthritis?

Yes. Losing even a small amount of weight can significantly reduce joint pain.

What are the risks of using medical cannabis for OA?

Side effects like dizziness or dry mouth are possible. Always consult your doctor before starting.

Smoking tobacco can increase the risk of arthritis – is it the same with cannabis smoke?

There is little evidence to suggest that cannabis smoke specifically increases the risk of arthritis. However, those who want to avoid inhaling smoke may opt for administration routes like tinctures or edibles.

Resources

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