Cannabidiol, a non-psychoactive component of marijuana, may help to relieve pain and joint stiffness in people with RA. Here’s what you need to know. Arthritis patients live with chronic pain—pain which can become debilitating if it goes unaddressed. One innovation in pain management is the use of cannabidiol, or CBD.
CBD For Rheumatoid Arthritis
Kimberly is a health and wellness writer with 8 years of experience in healthcare and a special passion for mental health awareness.
Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.
Scott J. Zashin, MD, specializes in the treatment of rheumatologic and musculoskeletal conditions using both traditional and alternative therapies.
As cannabidiol (CBD) has grown in popularity over the years, major organizations like the Arthritis Foundation have released guidelines pertaining to its use in the treatment of rheumatoid arthritis (RA). CBD is a non-psychoactive component of cannabis. The CBD in most products is extracted from hemp, a variety of cannabis that only has traces (up to 0.3%) of THC, the active compound that gets people high. Studies have shown CBD can help reduce chronic pain by impacting endocannabinoid receptor activity, which may also reduce inflammation.
CBD comes in different forms, including oil, vape, edible, and topical. Oils, vapes, and edibles are taken orally, while topical CBD lotions can be applied to the skin. CBD dosage varies depending on the form, the indication, and other treatments being used.
What Is Rheumatoid Arthritis?
RA is an autoimmune inflammatory disease, in which the immune system attacks healthy cells in the body and causes inflammation. RA commonly affects joints in the hands, wrists, and knees, causing the joint lining to become inflamed and damaging the tissue. This causes chronic joint pain and leads to deformity. RA can also affect other tissues throughout the body, such as the lungs, heart, and eyes.
Vera Livchak / Getty Images
Health Benefits of CBD for RA
Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties, but these effects have not been validated with quality studies in humans. Anecdotally, some people who have tried CBD for treatment of arthritis symptoms report noticeable pain relief, improved sleep improvement, and reduced anxiety.
The trials that have been conducted in humans have not yielded strong evidence for the use of CBD in managing arthritic pain.
- A randomized trial of topical CBD for treatment of knee osteoarthritis lasted only 12 weeks, and results were mixed.
- One of the largest reviews examining the health effects of cannabis and CBD concluded that there is substantial evidence that cannabis is an effective treatment for chronic pain in adults. There was, however, no specific conclusion regarding CBD, as definitive studies were not available.
- More recently, a new study showed that CBD can potentially help alleviate RA pain and inflammation by acting on immune cells that are attacking healthy cells in the body. It’s important to note that this study was also not conducted with human subjects.
Research in this area is ongoing.
If you are interested in trying CBD for RA pain management, be sure to talk to your healthcare provider first before using any CBD products.
Rising Popularity of CBD for RA
Based on a 2019 national survey of 2,600 people conducted by the Arthritis Foundation, 79% of respondents said they were using CBD, have used it in the past, or were considering using it to help with their arthritis pain.
Health Benefits Related to Arthritis
Given the lack of strong scientific evidence supporting the use of CBD, it is not recommended as the first choice for pain relief in RA.
If you have RA, you should not stop taking your prescribed medications that may be protecting your joints from future damage. You should discuss any changes you want to make to your medication regimen with your healthcare provider.
Additional Health Benefits
The strongest scientific evidence for effectiveness of CBD as a medical treatment is for seizure prevention in Dravet syndrome and Lennox-Gastaut syndrome, which are severe childhood epilepsy disorders that typically don’t respond to antiseizure medications. Several years ago, the FDA approved the first cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.
Other potential health benefits of CBD include:
- Reduce anxiety, insomnia, and depression
- Relieve cancer or cancer treatment symptoms
- Clear acne
- Slow the progress of neurologic disease like Alzheimer’s disease
Possible Side Effects
Treatment with CBD should be started slowly and under the supervision of a healthcare provider, who will oversee its effectiveness and side effects. There have been reports of mild side effects of CBD.
The most common side effects include:
It’s important to note that CBD may interact with other drugs, including some of the medications that are prescribed for the treatment of RA.
Warnings and Interactions
There are some warnings and adverse drug interactions to be aware of before beginning using CBD for management of RA-associated pain.
Do not stop taking any other treatments without consulting your healthcare provider. Additionally, CBD shouldn’t be a replacement for other therapies you are using.
Pregnant people and children should consult a healthcare provider before using CBD since there isn’t enough research on the effects of CBD on these populations. There has been concern about a possible link between inhaled cannabis and lower-birthweight babies, but it’s not clear if this applies to CBD.
Currently, the U.S. Food and Drug Administration (FDA) does not regulate the safety and purity of CBD products, so you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. The product may contain other unknown elements. The most effective therapeutic dose of CBD for any particular medical condition has not been established.
Are CBD Products Legal?
CBD products derived from hemp are no longer considered schedule I drugs under the federal Controlled Substances Act, but they still remain in a legal gray zone. There are changes underway on federal and state levels that will ultimately clarify the laws and regulations related to CBD-based products and sales. Despite that, they’re widely available in nearly every state and online. People who want to use CBD should check their own state laws.
Studies have found moderate interactions between CBD and medications commonly prescribed for treating RA.
Interactions can occur with these medications:
CBD can increase your level of coumadin, a blood thinner.
CBD may also raise levels of other medications in your blood by the same mechanism that grapefruit juice does.
Medications that interact with grapefruit juice can potentially interact with CBD, including:
- Cholesterol medications
- High blood pressure medications
- Organ-rejection medications
- Anti-anxiety medications
- Heart medications
- Some antihistamines
Preparation and Dosage
If you’ve decided to try CBD for treating your RA pain, the next step is figuring out how much to take.
Your dosage depends on a number of factors:
- Body weight
- Medical indication
- The concentration and form of CBD that you’re taking
You will likely need to start with a low dose and find what works for you. Studies have found extreme differences in dosages, with some people using 5 milligrams (mg) and others as much as 600 mg.
Your healthcare provider may direct you to start with 20-40 mg per day and increase slowly each day until you feel the relief you’re looking for.
To ensure that you are using CBD safely and effectively for pain management, you should:
- Choose an oral treatment (rather than inhaled products) and start with a low dose
- Establish initial goals of treatment within a realistic period of time. For example, a reduction in knee pain that allows you to walk around the block within two weeks of starting treatment; later, if improved, the goals can be adjusted
- Tell your healthcare provider(s) about your planned and current CBD treatment; monitor your pain and adjust medications with your medical providers, rather than with non-medical practitioners
- When preparing to take a liquid form, be aware that the CBD extract is mixed with a carrier oil, so there are two measures to know: the amount of the liquid product to take (the dose) and the amount of CBD in each dose
If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, you could consider talking to your healthcare provider about taking CBD with a very low-dose THC product. Be aware that even at low levels, THC may make you feel high, resulting in cognitive, motor, and balance impairment.
If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your healthcare provider.
What To Look For
Look for the following when choosing a CBD product:
- Look for products manufactured in the United States with ingredients grown domestically
- Choose products made by companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements or required by the state where they are manufactured
- Buy from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP), or the Association of Official Agricultural Chemists (AOAC)
- Avoid companies that claim their products have disease benefits
- Be aware that marketers and people behind retail counters are not health professionals. Your healthcare provider is your best source for guidance and monitoring when using an unregulated product
A Word From Verywell
CBD may sound like an appealing option for pain relief, but do your due diligence before jumping on the bandwagon. A lot of people say CBD can help reduce pain and inflammation for those with RA, but not a lot of strong scientific data have substantiated that claim. That said, serious effects are not commonly associated with CBD use.
If this is something you are interested in, you can work with your healthcare provider to figure out whether CBD is something you can try safely. Remember that CBD should not be used as a first-line treatment for RA pain and that it’s not advisable to stop taking disease-modifying treatments for RA.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention. Rheumatic Arthritis (RA).
Lowin T, Tingting R, Zurmahr J, Classen T, Schneider M, Pongratz G. Cannabidiol (CBD): a killer for inflammatory rheumatoid arthritis synovial fibroblasts. Cell Death Dis. 2020 Sep 1;11(8):714. doi: 10.1038/s41419-020-02892-1
Dariš B, Tancer Verboten M, Knez Ž, Ferk P. Cannabinoids in cancer treatment: Therapeutic potential and legislation. Bosn J Basic Med Sci. 2019;19(1):14-23. doi:10.17305/bjbms.2018.3532
Wilson-Morkeh H, Al-Abdulla A, Sien L, Mohamed H, Youngstein T. Important drug interactions exist between cannabidiol oil and commonly prescribed drugs in rheumatology practice. Rheumatology (Oxford). 2020 Jan 1;59(1):249-251. doi: 10.1093/rheumatology/kez304
Bergamaschi MM, Queiroz RHC, Zuardi AW, Crippa JAS. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011;6(4):237-249. doi:10.2174/157488611798280924
By Kimberly Charleson
Kimberly is a health and wellness content writer crafting well-researched content that answers your health questions.
CBD For Arthritis: Benefits, Risks And More
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Table of Contents
- What Is Arthritis?
- Why CBD Might Relieve Arthritis
- Potential Risks of Using CBD for Arthritis Relief
- Should You Use CBD for Arthritis?
- Talk to Your Doctor
Arthritis patients live with chronic pain—pain which can become debilitating if it goes unaddressed. One innovation in pain management is the use of cannabidiol, or CBD. While there is no cure for arthritis pain, early studies have shown that CBD can potentially aid in some of the discomfort, anxiety and inflammation associated with the condition.
Read on to learn more about how CBD can be used for arthritis pain, its potential benefits, risks and if it might be an option for you.
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What Is Arthritis?
Arthritis is the acute or chronic inflammation of joints. Though commonly understood to be a singular condition, arthritis is a term used to reference joint pain and joint disease. In fact, there are more than 100 different types of arthritis and related conditions, such as osteoarthritis, rheumatoid arthritis and psoriatic arthritis, among others. Symptoms include pain and stiffness in the joints, swelling, decreased range of motion, joint deformities and other related conditions.
Causes for arthritis vary depending on the individual, but can include:
- An autoimmune disease
- A previously injured joint that develops post-traumatic arthritis later in life
- Being overweight
Types of Arthritis
While there are many types of arthritis, two of the most common forms are osteoarthritis (OA) and rheumatoid arthritis (RA).
“The most common form of arthritis is osteoarthritis, which develops over time and can intensify with age,” says Thomas Lazoff, M.D., a double board certified physician at Physical Medicine Consultants in Fort Wayne, Indiana. OA affects more than 32.5 million adults in the United States, according to the Centers for Disease Control and Prevention (CDC)  Osteoarthritis (OA). Centers for Disease Control and Prevention. Accessed 5/4/2022. .
OA affects the entire joint, including the bone, cartilage, ligaments, fat, and the tissues lining the joint, says Dr. Lazoff. Symptoms of OA can include joint stiffness, redness, and decreased motion in the hands, knees, hips, lower back and neck.
“This form of arthritis causes some element of swelling and tenderness of one or more joints,” he adds, noting joint pain can be chronic and flare up at times.
Age, gender, overuse of the same joints, genetics, former injuries and suffering from obesity can all contribute to the onset of OA. The condition is more common in people over 50 years old and tends to occur in women more than men.
“Rheumatoid arthritis is an autoimmune disease which typically attacks the joints of the body,” says Dr. Lazoff. Individuals living with RA often experience stiffness, swelling and pain in the joints. Symptoms of an RA flare can last for extensive periods of time and may include:
- Low grade fever
- Joint stiffness, tenderness or swelling that lasts for six weeks or more
- Joint stiffness that occurs in the morning and lasts for longer than 30 minutes
Symptoms occurring in multiple joints in the body, or symptoms occurring in the same joints bilaterally may also be an indication of RA.
While the cause of RA is unknown, a genetic component is suspected to play a part in the disease, especially when triggered by lifestyle and environmental factors. Women are more likely to develop RA than men, and women who have never given birth are thought to be at higher risk, according to the CDC.