Arthritis is a bone disease characterized by the inflammation of the joints. Symptoms include a wide range of pain, stiffness, swelling and decreased range of motion. Severe cases of arthritis impair the quality of life of the sufferer drastically, including bouts with significant fatigue and the development of physical deformities.
Over 50 million Americans have arthritis, making it the number one cause of disability in the country. That means 1 in every 5 adults, 300,000 children and countless families.
The main symptoms of arthritis are joint pain and stiffness, which typically worsen with age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.
Osteoarthritis causes cartilage — the hard, slippery tissue that covers the ends of bones where they form a joint — to break down. Rheumatoid arthritis is an autoimmune disorder that first targets the lining of joints (synovium).
Uric acid crystals, infections or underlying disease, such as psoriasis or lupus, can cause other types of arthritis.
Treatments vary depending on the type of arthritis. The main goals of arthritis treatments are to reduce symptoms and improve quality of life.
Right now, because scientists don’t fully understand the causes or mechanisms behind these diseases, true prevention seems to be impossible. However, there is real hope that someday some or all types of arthritis and related conditions can be prevented.
The medications used to treat arthritis vary depending on the type of arthritis. Commonly used arthritis medications include:
- Analgesics. These types of medications help reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol, others), tramadol (Ultram, others) and narcotics containing oxycodone (Percocet, Oxycontin, others) or hydrocodone (Vicodin, Lortab, others).
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce both pain and inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Some types of NSAIDs are available only by prescription. Oral NSAIDs can cause stomach irritation, and some may increase your risk of heart attack or stroke. Some NSAIDs are also available as creams or gels, which can be rubbed on joints.
- Counterirritants. Some varieties of creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over your aching joint may interfere with the transmission of pain signals from the joint itself.
- Disease-modifying antirheumatic drugs (DMARDs). Often used to treat rheumatoid arthritis, DMARDs slow or stop your immune system from attacking your joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
- Biologics. Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules that are involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
- Corticosteroids. This class of drug, which includes prednisone and cortisone, reduces inflammation and suppresses the immune system. Corticosteroids can be taken orally or be injected directly into the painful joint.
There are numerous strains known to be effective in combating the pain and suffering of arthritis. The indica dominant strain Afgoo, the hybrid Sour OG, and the sativa Harlequin, have all been noted by patients to be effective in the treatment of symptoms.
What are indicas, sativas and hybrids in Medical Marijuana
Cannabis is one of the oldest crops known to mankind, with records of its cultivation dating back thousands of years.
Today, it is widely accepted that marijuana has two different species: Cannabis indica and Cannabis sativa. Cross-breeding of the two types has led to a wide variety of hybrid strains with unique characteristics.
The differences between indica and sativa remain a subject of much debate, especially among scientists who study the plant. However, most agree that indica and sativa plants are distinct in a number of ways.
The most accepted way of distinguishing indica versus sativa is by appearance, or what scientists refer to as morphology.
Indica plants are short, densely branched and have wider leaves. They are better suited for growing indoors.
Sativa plants are tall, loosely branched and have long, narrow leaves. They are usually grown outdoors and can reach heights of up to 20 feet.
Besides appearance, indica and sativa plants have different effects on their user. These effects include:
- relaxing and calming
- body buzz or ‘couch lock’
- best suited for night use
- uplifting and energetic
- cerebral, spacey or hallucinogenic
- best suited for day use
Patients are accessing cannabinoids for arthritis pain through a variety of sources: they’re smoking or vaporizing raw cannabis flowers high in THC and CBD to get fast-acting, body-wide relief from arthritis pain. They’re also ingesting cannabinoids in the form of infused foods and tinctures. This method is slower-acting than smoking, but longer-lasting with more intense physical rather than psychological effects. They’re also using topical ointments rich in a broad spectrum of cannabinoids that are rubbed directly onto sore joints for relief.
There is a large body of both pre-clinical and patient-reported support for the use of cannabinoid therapy for both rheumatoid arthritis and osteoarthritis. A few clinical trials also exist. The active ingredients in marijuana —“cannabinoids” like THC and CBD — work to suppress immune system over-activity, and this type of over-activity causes the inflammation and pain of rheumatoid arthritis.
Cannabis oils, edibles, tinctures and topicals are also known to be effective.
The application of cannabis topicals to affected areas of the body has been known to produce dramatic relief from inflammation, pain and stiffness. Vaporizing, smoking and ingesting cannabis edibles and tinctures are also known to alleviate symptoms and pain.
What are edibles, tinctures and topicals?
Edibles are food items made with marijuana or infused with marijuana oils. Edibles may be an alternative to smoking or vaporizing marijuana. Edibles come in many forms, e.g. brownies, cookies, candies, including animal or fruit-shaped gummies, suckers and chocolates, and as beverages. Unlike smoking marijuana, where the effects can be felt almost immediately, effects from edibles can take from 30 minutes to 2 hours to take effect, and may last longer than expected, depending on the dose, when your last meal was consumed, and/or any medications or alcohol used at the same time.
Tinctures are essentially alcohol extractions of whole cannabis (usually the flowers and trim leaves). The best way to use tinctures is by placing a few drops under the tongue. Dose control is easily achieved by the number of drops a patient places under the tongue where the medicine is rapidly absorbed into the arterial system and is quickly transported to the brain and body. All a patient need do with tincture is use a few drops, wait for the desired medical effects, and either use more or stop as the situation indicates. Tinctures can be flavored for better taste. They are best stored in dark bottles in the refrigerator.
Topicals are external applications of cannabis that can be used to treat body pain or skin conditions, infused with THC and other cannabinoids. These can include lotions, creams, balms — pretty much anything you can rub on your skin. They generally don’t give you any kind of head or body high, so they’re a favorite of patients who are wanting localized pain relief.
Recent surveys have estimated as many as 20% of arthritis sufferers treat the disease with cannabis. While little scientific research exists, anecdotal evidence is overwhelming and continues to emerge. Patients have reported having a level ten pain reduced to approximately a level six upon the ingestion of cannabis.
A January 2006 study published by the British Royal National Hospital for Rheumatic Disease concluded that the administration of cannabis extracts over a five week span of time led to statistically significant improvements relating to a wide variety of symptoms. This included relief in pain on movement, pain at rest, intensity of pain, quality of sleep, and inflammation. It was the first ever study of its kind, and no adverse effects on the patients were reported.
Preclinical data has revealed CBD administration in animal models to slow the progression of arthritis while protecting the joints from the damage that defines arthritis. More clinical research on the intersection of cannabis and arthritis is needed to further understand the dynamic interaction of the plant with the disease.