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Arthritis is a disorder that causes inflammation and pain of one or more joints. Studies have shown cannabis and cannabinoids have anti-arthritic effects and may be able to help manage pain and inflammation associated with the disorder.
Overview of Arthritis
Arthritis is a condition characterized by joint pain. There are 100 different types of arthritis, according to the Arthritis Foundation, but common symptoms among all the types include swelling, pain, stiffness and decreased range of motion.
The most common type of arthritis is osteoarthritis, or degenerative joint disease, which is the wearing down of the protective cartilage on the ends of bones. Another common type is rheumatoid arthritis, which is when the body’s immune system mistakenly attacks healthy cells, including the synovium that lines the joints. Other more common types of arthritis include juvenile arthritis, which develops in children; psoriatic arthritis, which affects people with psoriasis; infectious arthritis, which is an infection that spreads to a joint; and gout, which is caused by the buildup of uric acid.
The pain, swelling and stiffness associated with arthritis can fluctuate in severity and varies between individual. Severe arthritis can cause such intense chronic pain that the ability to maintain daily activities is affected.
Arthritis treatment focuses on relieving pain and swelling with medications, physical therapy, and in some cases, surgery.
Findings: Effects of Cannabis on Arthritis
Studies finding that the endocannabinoid system has receptors present in the synovium of joints have suggested to researchers that cannabinoids may be beneficial for addressing the pain and inflammation associated with osteoarthritis and rheumatoid arthritis4,7. Preclinical studies have also demonstrated cannabis’ anti-inflammatory and pain-relieving effects, supporting the idea that the endocannabinoid system is involved in alleviating pain associated with arthritis6.
Other studies have found evidence that synthetic cannabinoids offer strong anti-inflammatory and immunosuppressive properties and reduce joint damage in mice with osteoarthritis3. Most recently, cannabinoid treatments were found effective for reducing osteoarthritis-related cartilage breakdown5.
These anti-inflammatory and anti-pain effects of cannabinoids are likely due to their interactions with the endocannabinoid system’s CB1 receptors, which have been specifically found to be associated with pain sensitivity in the osteoarthritic knee joints of rats7.
States That Have Approved Medical Marijuana for Arthritis
Currently, Arkansas, California, Connecticut (severe rheumatoid arthritis), Illinois (osteoarthritis, rheumatoid arthritis), Michigan (arthritis, rheumatoid arthritis), New Mexico (inflammatory autoimmune-mediated arthritis), and North Dakota (rheumatoid arthritis) have approved medical marijuana for the treatment of arthritis. However, in Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. In addition, various other states will consider allowing medical marijuana to be used for the treatment of arthritis with the recommendation from a physician. These states include: Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Several states have approved medical marijuana specifically to treat “chronic pain,” a symptom commonly associated with arthritis. These states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New Mexico, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, and West Virginia. The states of Nevada, New Hampshire, North Dakota, Montana, Ohio and Vermont allow medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania, Washington, and West Virginia have approved cannabis for the treatment of “intractable pain.”
Recent Studies on Cannabis’ Effect on Arthritis
- Arthritis. (2014, July 15). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/arthritis/basics/definition/con-20034095.
- Arthritis. (n.d.). MedlinePlus. Retrieved from https://www.nlm.nih.gov/medlineplus/arthritis.html – cat51.
- Burston, J.J., Sagar, D.R., Shao, P., Bai, M., King, E., Brailsford, L., Turner, J.M., Hathway, G.J., Bennett, A.J., Walsh, D.A., Kendall, D.A., Lichtman, A., and Chapman, V. (2013). Cannabinoid CB2 Receptors Regulate Central Sensitization and Pain Responses Associated with Osteoarthritis of the Knee Joint. PLoS ONE, 8(11), e80440. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840025/.
- Fukada, S., Kohsaka, H., Takayasu, A., Yokoyama, W., Miyabe, C., Miyabe, Y., Harigai, M., Miyasaka, N., and Nanki, T. (2004). Cannabinoid receptor 2 as a potential therapeutic target in rheumatoid arthritis. BMC Musculoskeletal Disorders, 15, 275. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4243420/.
- Kong, Y., Wang, W., Zhang, C., Wu, Y., Liu, Y., and Zhou, X. (2016, June). Cannabinoid WIN‑55,212‑2 mesylate inhibits ADAMTS‑4 activity in human osteoarthritic articular chondrocytes by inhibiting expression of syndecan‑1. Molecular Medicine Reports, 13(6), 4569-76. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878569/.
- La Porta, C., Bura, S.A., Negrete, R., and Maldonado, R. (2014, February). Involvement of the endocannabinoid system in osteoarthritis pain. The European Journal of Neuroscience, 39(3), 485-500. Retrieved from http://onlinelibrary.wiley.com/wol1/doi/10.1111/ejn.12468/full.
- Richardson, D., Pearson, R.G., Kurian, N., Latif, M.L., Garle, M.J., Barrett, D.A., Kendall, D.A., Scammell, B.E., Reeve, A.J., and Chapman, V. (2008). Characterisation of the cannabinoid receptor system in synovial tissue and fluid in patients with osteoarthritis and rheumatoid arthritis. Arthritis Research & Therapy, 10:R43. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2453762/.
- Schuelert, N., and McDougall, J.J. (2008, January). Cannabinoid-mediated antinociception is enhanced in rat osteoarthritic knees. Arthritis and Rheumatism, 58(1), 145-53. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/art.23156/full.