Ultimate Guide to Marijuana for Arthritis
What is arthritis?
Generally, joints in the human body have a lining around the bones called the synovial membrane, which protects and lubricates the joint, allowing easy movement. There is also cartilage and fluid to cushion the joints. Arthritis occurs when there is swelling and inflammation in one of these joints. These commonly affect the knees, fingers, and wrists.
There are many causes of arthritis, including certain infections, autoimmune diseases (when the immune system attacks its own body), injuries, old age, and uric acid crystal build-up.
The main symptoms are joint pain, swelling, redness, and stiffness, which limit the activities of those affected.
For example, those with arthritis in their knees find it painful and difficult to walk. Even if there is arthritis in a small joint like a finger, it is common for other fingers and joints to become affected, and thus, impair daily tasks.
Types of arthritis
There are more than 100 types of arthritis related conditions, but the two most common types are rheumatoid arthritis and osteoarthritis.
Rheumatoid arthritis is an autoimmune disease where the body’s immune system attacks the lining of the joint, causing inflammation and eventual cartilage destruction. The synovial membrane itself becomes inflamed and the joint can become eroded if not treated.
Osteoarthritis is the most common type and is a degenerative disease due to wear and tear on the joint, affecting the cartilage over time. The loss and damage of cartilage around a joint reduces the cushioning, and thus pain is felt when the bones of the joint grind together. This type of arthritis often occurs with an increase in age, but it can be sped up by infection or a joint injury.
Other common types of arthritis include:
- Gout: severe attacks of pain and swelling usually in the big toes
- Reactive arthritis: triggered by an infection
- Arthritis in the intestines, genitals, or urinary tract
- Juvenile idiopathic arthritis: inflammation and swelling of joints in children under 16
What are the Factors That Increases Ones Risk of Arthritis?
Women have a higher chance of having rheumatoid arthritis, whereas men have an increased risk of gout and other types of arthritis.
Generally, here are some factors that influence ones chances of getting arthritis
- Family history
- Genetic predisposition
- Previous joint injury
- Obesity (which causes increased stress on joints).
Diagnosis of arthritis is usually done by medical professionals who may conduct a physical exam, check imaging scans such as X-rays, CT scans, MRIs, and aspirations of the joint to determine the cause of arthritis.
What is CBD?
There are two major compounds in cannabis. They are; CBD (which is short for cannabidiol) and THC (which is short for tetrahydrocannabinol). CBD itself was discovered in the 1940s and since then it has become popular as a means of treating many medical conditions.
Unlike THC, which causes the ‘high’ effect in marijuana, CBD doesn’t cause these feelings and is therefore classified as non-psychoactive.
CBD can be extracted from hemp - A variety of cannabis with small traces of THC, (around 0.3%). There is also marijuana-derived CBD, but this is less common as it contains more THC.
How does CBD affect arthritis
CBD is considered to have pain-relief and anti-inflammatory properties, which are especially useful for inflammatory and pain related diseases.
Nevertheless, research is still being conducted to find out if CBD can ease symptoms specific to osteoarthritis arthritis and rheumatoid.
So far, a small number of studies have shown that CBD can help curb morning pain due to arthritis, improve sleep and lower inflammation in joints (but not joint stiffness).
A woman in 2016 named April shared her experience with CBD ointment:
"I started with a low-strength 100mg CBD salve, and only noticed a slight difference at first. But when I combined it with trigger massage, the pain was noticeably less"
Dr. Jordan Tishler, a Harvard emergency physician, reported that when his patients tried CBD as a therapeutic for arthritis, they saw tremendous improvements in pain control, stiffness, and increased mobility.
As stated earlier, there are more than 100 types of arthritis and these conditions are not all alike. Thus, CBD may show improvements for some type of arthritis and not for other types. This also means that conventional pain medications are better suited to some types of arthritis over others.
It is important to note that CBD in therapeutic uses is in its early days, and due to the FDA warning about the lack of studies and risk of side-effects, it is important to consult a health professional before considering the use of CBD to treat arthritis.
Related Article: Cannabis Pain Relief Products | Uses | Risks | Examples
What Are The Side Effects of Using CBD To Treat Arthritis?
1. CBD can alleviate symptoms of anxiety, depression, migraines, PTSD and seizures. However, smoking or vaping marijuana as a whole can cause lung and respiratory system damage.
2. There is also a chance of allergic reactions when CBD oil is applied directly to the skin.
3. CBD causes a series of safety concerns with drug interactions, especially with other drugs commonly taken by people with arthritis, such as corticosteroids (e.g. prednisone), tofacitinib, naproxen, certain antidepressants, certain medications for fibromyalgia, and fluoxetine.
4. Another risk of using CBD in the long-term is that it interacts with the cytochrome P450 complex, which is an enzyme that supports the liver’s ability to break down toxins. CBD could thus increase the risk of a rise in liver toxicity.
5. The dosage of CBD can also drastically change the intended effects and benefits. When starting with CBD, it is important to start at low doses, around a few milligrams twice a day, to see what dose is right for you in terms of pain relief and reducing the side-effects.
Other side-effects of excessive intake of CBD include
- dry mouth
- loss of appetite
Overall, CBD may work for some people, but for others, the side-effects may outweigh the benefits, and other therapies, or prescription drugs, are better suited.
What is THC and How Does it Affect Arthritis?
THC is the main psychoactive ingredient in cannabis. This is the extract of marijuana tagged for recreational use
There is a family of cannabinoid receptors in the body, called the endocannabinoid system. Both CBD and THC have chemical structures that are like endocannabinoids. By mimicking the structure of endocannabinoids, they can bind to similar receptors but cause different effects on the body.
THC activates a different cannabinoid receptor than CBD. One of these receptors are in the nerve cells concentrated in the brain and central nervous system, which reduces the pain from arthritis; and the other is in immune cells usually in peripheral organs, which may target the symptoms of rheumatoid arthritis specifically, as it’s an autoimmune disease.
In plain English, THC blocks the pain receptors in the body and causes euphoria, which by itself makes it easier for the patients to deal with arthritic pain.
Angela D. Bryan a PhD professor of psychology and neuroscience states that:
"A little bit of euphoria can help us not care that we’re experiencing quite as much pain in the same way that other pain medications work."
What Are The Side Effects THC have on People?
1. Marijuana itself has short and long-term side-effects, including impaired short-term memory, altered judgement, and impaired coordination. More seriously, research into the long-term health effects of marijuana use shows that marijuana can alter brain development, leading to cognitive impairment.
2. THC as a component of marijuana can alter the function of the hippocampus and orbitofrontal cortex. These areas of the brain are important for forming new memories, and the ability to shift attention from one thing to another.
3. Side effects of THC include: increased heart rate, dry mouth, increased appetite, coordination problems, red eyes, slower reaction times, mood changes, anxiety and memory loss.
4. There is also the point of view that the placebo effect does wonders for chronic pain patients, and that simply using a therapy that has little to no medical effect can trick the brain into believing that it is working. This is backed up by scientific evidence in cases other than arthritis, but it is applicable, and could mean that even though THC treatments don’t medically benefit the patient, their mental perception about it is enough to reduce their pain.
How many people suffering from arthritis use cannabis as medicine?
In a CreakyJoints study in 2019, it was reported that out of 1059 patients in Madrid, Spain, "57% of them have tried marijuana or CBD for medical reasons – and more than 90% say it helped". Among these statistics, 62% of people who regularly used marijuana did so at least once daily and 93% of people who tried CBD said that it improved their symptoms. In this study, 46% had rheumatoid arthritis, and 22% had osteoarthritis.
When did cannabis start being used to treat arthritis?
In Canada, medical cannabis has been a legal treatment option for certain health conditions since 2001. However, the use of medical cannabis should not be used to treat rheumatology patients under the age of 25.
What places have legalized medical marijuana?
There are many countries that have legalized medical marijuana in some capacity. These countries are: Argentina, Australia, Barbados, Brazil, Canada, Chile, Colombia, Croatia, Cyprus, Czech Republic, Denmark, Ecuador, Finland, Germany, Greece, Ireland, Israel, Italy, Jamaica, Lebanese, Lithuania, Luxemborg, Malawi, Malta, the Netherlands, New Zealand, North Macedonia, Norway, Peru, Poland, Portugal, Saint Vincent and the Grenadines, San Marino, Sri Lanka, Switzerland, Thailand, the United Kingdom, Uruguay, Vanuatu, Zambia and Zimbabwe.
Other countries may have more restrictive laws allowing only the use of cannabis-derived drugs such as Sativex, Marinol, or Epidiolex. Generally, Europe was the leader and the most progressive in its legalization of medical marijuana.
While in the United States, 36 states and 4 territories have legalized the medical use of cannabis, at the federal level, its use remains prohibited.
Methods of administration when using cannabis for arthritis
Generally, the type of arthritis, how an individual deals with pain, what treatment options are legalized in that particular country, pricing and efficiency, personal preference, and side-effects are all important things to consider when weighing the pros and cons of each treatment option for cannabis.
Higher doses tend to have greater side-effects, so when an individual is beginning administration, low doses should be started with, and higher doses may or may not be administered due to personal preference and tolerance of the side-effects.
In relation to rheumatoid arthritis, here some ways in which cannabis can be administered.
1. By mouth
A. Pills and capsules:
These can be bought from stores, but it is important to be aware that some labels do not disclose accurate information about the amount of CBD and THC.
Since cannabis medication isn’t FDA regulated, there is lots of room for inaccuracies in manufacturing, which may cause dosage problems and the risk of more side-effects.
The pros of pills and capsules is that if dosage is consistent, the pain relief can last for up to eight hours, which is generally longer than some other treatments.
The cons are that they can be very expensive, and the medicinal effects are delayed due to going through the digestive system and then being absorbed (1-2 hours). Cannabis is fat soluble, so it may be absorbed more quickly if you ingest it with fatty foods. However, this means that diet has a role to play in the effectiveness of these pills, which people need to be aware of.
These refer to cannabis included in edible foods, usually sweets and baked goods. The cannabis is odorless and usually doesn’t taste bad.
The pros are that they are easy to administer and the medicinal effects can last up to eight hours. They can be bought as medical marijuana candy, such as gummy chews.
The cons are that edibles can affect people differently and the THC isn’t usually evenly distributed throughout the product. This can lead to improper dosing and possible greater side-effects. If you ate the same sized piece of an edible two days in a row, you could have very different effects, both positive and negative! For some people, the additional calories may also be a concern.
These are liquids that are ingested, usually administered via a dropper to place the tincture underneath the tongue.
The pros are an easy method of administration, flexibility in the dosage for the person’s needs (e.g. severe pain vs moderate pain, concerns about side-effects, diet, lifestyle etc.). It also means the person can experiment with dosage. The pain-relief effects last twice as long as inhalation, and the lungs have no risk of being irritated.
The cons are the delay in pain relief, as it can take as long as 45 minutes to feel it. Tinctures are also quite expensive and reportedly less reliable than other treatment methods.
2. On the skin
A. Topical ointments:
Usually placed directly on the skin, on the affected joint.
The pros are that topical ointments don’t make you euphoric or ‘high’ because they aren’t going through the digestive system. This means the side-effects are also much less than ingested or inhaled products.
They provide relative immediate pain relief in the targeted area for, on average, a couple of hours. However, this does mean the time frame of effectiveness is relatively short. With these topical ointments, it also gives people a chance to incorporate massage and physical therapy as a combination therapy for arthritic pain relief.
The cons are generally an odor that some people don’t like, and the relative inconvenience of having to reapply the ointment once it has worn off. Some people don’t have time to do this multiple times a day. The ointment is also expensive.
B. Transdermal patches:
These are adhesive patches placed on the skin (not necessarily on the affected joint) and the products are absorbed into the skin, then into the bloodstream and affect the entire body.
The pros of these patches are that their effects last a long time, and they are delivered in a slow-release (meaning less risk of side-effects). The cannabinoids in the patches are absorbed within half an hour, and they can be quickly removed. If you remove the patch, the effects will dissipate. Furthermore, if you only have the patch on for a short period of time, you can re-use it once more in the future.
The cons are, these transdermal patches are one of the most expensive delivery systems and are reported to not be as effective for severe pain, compared to other treatment options.
Vaporizers are like mini ovens that heat up the cannabis plant inside (usually to around 375 degrees) and you inhale the vapor produced.
The pros are that it is nearly odorless and easier on the lungs than smoking. It has an immediate medicinal effect, providing relief within 2-3 minutes.
The cons are an expensive price for good quality vaporizing machines (between $250-$300).
The oil cartridges may get extremely hot, and this can be irritating to the throat and lungs.
If cannabis concentrates are inhaled, there may be dangers in relation to the chemicals associated with tobacco smoke. However, if cannabis flowers are vaporized, there are little to none of the dangerous chemicals associated with tobacco smoke, so it is likely safer than smoking.
This is actually the most popular delivery system. This is done with either a joint or pipe.
The pros are easy access to these materials, and they are relatively less expensive than other delivery systems mentioned above. There is an immediate pain-relieving effect.
The cons are mainly smoking as the most unhealthy method of administration due to the irritation of the respiratory tract whereby smoke contains toxins that contribute to more inflammation throughout the body. Since medical cannabis aims to provide pain-relief and reduce inflammation, there are some counteracting side-effects to smoking.
There is also a general health concern due to smoking. Smoking poses a greater risk for many diseases, including heart disease, diabetes, lung disease, tongue cancer, lung cancer, and addiction.
Since women with rheumatoid arthritis already face an increased risk for progressive lung diseases such as emphysema (lung disease that causes shortness of breath where alveoli are damaged, and overtime can weaken and rupture), smoking poses many negative health effects.
Another con is that the pain-relief only lasts 2-3 hours.
There are secondary concerns about the risks of hand grinding, which is required to make the cannabis inhalable. Since many people with arthritis have affected hand and wrist joints, and are generally older, there is a risk of injury from repetitive twisting motions required to hand grind cannabis before smoking.
Marijuana Grinders for those with disabilities
Herb grinders are especially important for those with arthritis, carpel tunnel syndrome or other disabilities that affect the physical motion of their hands and wrists. For those wanting to inhale medical marijuana products, grinding is important for the administration.
Related Article: 10 Awesome Fact About Weed Grinders
Herb grinding is defined as: Grinding weed (cannabis) that breaks down the cannabis flowers into smaller pieces for joints, blunts and bowls. A twisting motion from one hand to use the marijuana grinder, and the other hand to hold it steady is required to complete the process. These are manual grinders.
Why are Electric Grinders Important For Treating Arthritis?
The main positive about electric grinders is the convenience and also the reduced risk of error that comes with manual grinding. There aren’t many options, but three crucial facts must be kept in mind when deciding which electric grinder to use:
its energy source, its storage capacity, and its shape.
Good electric grinders will be efficient and effective at these three features. An example is a chewy battery grinder, which is inexpensive and able to be operated with one hand. It slices and finely dices the weed, dispensing it neatly and storing the extra for future sessions. It is technically portable, but the 9V battery and slightly awkward shape detract from its overall portability.
Another example is the electric tobacco shredder, which can be used for shredding medical marijuana as well. It is plugged into the wall and it works like a small coffee grinder.
The four reasons why electric grinders are superior to manual grinders are as follows: 1. Electric grinders are faster
- Electric grinders grin more consistently
- Electric grinders are easier to use
- Electric grinders are less wasteful
The mamba electric grinder is a small, battery-powered gear grinder that also automatically dispenses correctly ground herbs as it is grinding. It is easily hand-held and people only need to place the nozzle over a bowl to collect the ground cannabis.
What are hand crank grinders?
A hand crank grinder has a handle on the top lid of the grinder that you gently spin, taking pressure off your hands that a normal grinder would require. Twirling the handle gently shreds the cannabis into a fluffy material and the end result should be a light and crumbly texture. It is great for people with arthritis because, even though it is still manual, it is much easier on the joints. There is also a clear top which you can see and determine how ground up you would like your cannabis to be. The sharp precision blades allow for a crumbly texture, but do not make fine dust or powder. An example is the SharpStone Hand Crank Herb Grinder
Related Article: Signs You Need a New Grinder
Other grinder innovations
Another innovative tool is made by the company 7pipe release grinders, made specifically for people with disabilities. These grinders can be used with one hand. They have traction bars that assist people with arthritis and weakened grip. Their four-piece grinder has a kief collector, screen and premium grinding teeth that make the grinding much easier.
More information can be found in this article: Herb grinders for those suffering from arthritis and hand injuries
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