More and more of my patients bothered by joint pain related to osteoarthritis are asking for my opinion on the benefits of CBD (cannabidiol) for relieving their pain.
Is CBD an analgesic for osteoarthritis? Are there any evidence of its effectiveness? If yes, is the effect truly significant?
What about potential complications? And what dosage should be taken, in what form?
When searching for information online on the subject, one is confronted with an issue: most of the websites that come up are CBD-selling sites. Many present CBD as highly effective:
However, they do not mention:
- how much to take precisely for a hopeful effect;
- in what form CBD is best taken for a hopeful effect;
- whether there are potential side effects;
- whether the effects are very significant or not, especially compared to other substances, medications, or practices.
I have explored data from international scientific literature to address these questions. My aim is to provide you with clear and accurate information so that you can decide for yourself whether or not to take CBD, based on the current state of our knowledge.
In this article, I focus on CBD taken for joint pain, often associated with osteoarthritis. Indeed, CBD can be effective for certain types of pain and not for others. That’s why its effect needs to be evaluated on a case-by-case basis.
Any questions? I am happy to answer them in the comments section, and you can leave your questions at the end of the article.
Happy reading 🙂!
PS: I published this article in October 2022 in French, and it has been read by tens of thousands of people. I hope it will satisfy just as many readers in English!
PPS: I would like to thank researcher Dr Jeremy Henson from the University of New South Wales (Australia, here) for kindly reviewing this article and for reminding me of the existence of interactions.
Last update: September 2023
Disclaimer: Amazon affiliate links. Complete disclosure in legal notices.
Written by Nelly Darbois, physical therapist and scientific writer
Summary
What kind of joint pain are we talking about?
Joint pain can occur for various reasons. Here are the three most common causes:
- Osteoarthritis arthritis;
- Rheumatic diseases;
- Unknown or various causes.
Joint pain due to osteoarthritis
Joint pain is often caused by osteoarthritis. Osteoarthritis is the wearing down of the cartilage present in each joint. Cartilage loses quality and thickness over the years, particularly in cases of obesity, significant fractures, or intense physical activity.
Some people may have a lot of osteoarthritis without experiencing pain – that’s fortunate!
Osteoarthritis is often predominant in:
- Knees. Osteoarthritis in the knee is known as gonarthrosis. It can sometimes lead to knee replacement surgery, although other therapeutic options exist;
- Hips (referred to as coxarthrosis);
- Neck: cervical osteoarthritis.
It can truly affect all joints in the body.
This article specifically focuses on the use of CBD for joint pain associated with osteoarthritis.
If your pain is more related to a neurological issue, my article on CBD and neuropathic pain might be more relevant for you (coming soon in Ennglish).
This article concentrates on CBD and pain related to osteoarthritis, especially in the knees, neck, and hips.
Joint pain due to inflammatory rheumatic disease
Perhaps you have joint pain due to an inflammatory rheumatic condition?
- Rheumatoid arthritis
- Spondyloarthritis
- Lupus
- Another form of arthritis
- Fibromyalgia (sometimes classified under inflammatory rheumatism)
There are more studies testing the effectiveness of CBD for these conditions than for osteoarthritis.
You can subscribe to my website to stay informed about the publication of a future article on this topic.
In the meantime, I can simply tell you that there is currently no evidence of superior effectiveness of CBD against pain compared to other available treatments.
Joint pain of unknown cause
Sometimes, joint pain can occur even when there is neither osteoarthritis nor rheumatic disease.
This could be related to trauma, tendon or muscle injuries (like runner’s knee), or illnesses (such as the flu or gout).
Joint pain is often due to osteoarthritis, and sometimes to an inflammatory rheumatic disease. This article focuses on the effect of CBD for pain related to osteoarthritis.
A quick reminder about CBD (cannabidiol) and hemp oil
CBD (cannabidiol) is: one of the components of cannabis that can reduce pain and have other beneficial effects. It generates fewer side effects than another component of cannabis, THC.
What is CBD?
When we talk about therapeutic cannabis, we are referring to:
- either products containing only CBD;
- or products containing both CBD and THC.
In lot of countries (like France), only products containing exclusively CBD are allowed (the amount of THC allowed in them is so minimal that it is negligible).
In United States, CBD (cannabidiol) with a low THC content (usually less than 0.3%) is legal at the federal level thanks to the 2018 Farm Bill.
Some states have legalized both medical and recreational use of marijuana, which contains THC, while others have only legalized medical use or have maintained stricter regulations.
Therefore, this article only focuses on the benefits of CBD.
What is hemp?
CBD and hemp oil are sometimes confused. Hemp is a plant that indeed belongs to the same species as cannabis. However, hemp contains almost no cannabidiol or THC.
Does hemp oil help arthritis? No.
Here on Amazon are products based on hemp oil. They do NOT contain CBD and are not effective against pain.
CBD (cannabidiol) is a potentially effective substance for pain relief, with far fewer side effects than cannabis. However, hemp oil does not provide relief from joint pain (or other types of pain).
Does CBD work for arthritis and joint pain?
There are several ways to assess the effectiveness of CBD against osteoarthritis, each with its own advantages and disadvantages:
- Seeking opinions from family, friends, or a physician, or consulting online user reviews;
- Trying it out on yourself for a period and seeing if it works or not;
- Considering the findings of research teams that evaluate the properties of cannabis and CBD daily over the course of years.
Why I Rely on Scientific Publications?
My goal is to shed light on this last point. For me, it’s crucial, and it will save you valuable time: there’s no need to test CBD at very low doses, for example, if we know that there’s a chance it might only work with significant doses!
Furthermore, I have more confidence in the opinions of research teams who have worked on the subject for years and have gathered results from dozens, hundreds, or even thousands of individuals. This is in contrast to the opinions of just 1 or 2 individuals in my circle (whether they are medical professionals or not) or online users whose testimonies’ credibility I can’t verify.
What Studies and Pubmed Say on does CBD work for arthritis?
In the table, you’ll find a summary of the conclusions that individuals publishing information on CBD and osteoarthritis in international peer-reviewed journals have reached, which have been reviewed and improved by other researchers.
| Author, Year | Research Topic | CBD Efficacy and Risk | Specific Efficacy on Osteoarthritis |
|---|---|---|---|
| Sarzi 2019 | CBD & Rheumatic Conditions [Narrative Review] | Lack of clinical trials, but strong theoretical reasons to believe it may work through its anti-inflammatory and analgesic actions | |
| Johal 2020 | CBD and Non-Cancer Chronic Pain [Meta-analysis] | – Effective if taken for 2 to 8 weeks – Oral form more effective – On a scale of 0 to 10, CBD patients rate their pain an average of 0.7 points lower than placebo | No high-quality studies assessing its effect on osteoarthritis |
| Stockings 2018 | CBD and Non-Cancer Chronic Pain [Meta-analysis] | – On a scale of 0 to 100, CBD patients rate their pain an average of 3 points lower than placebo – 1 in 24 people experience better relief than with placebo, and 1 in 6 experience (mild) side effects | No studies specifically and solely targeting osteoarthritis |
| Fitzcharles 2020 | CBD in Rheumatology [Narrative Review] | – Commercial products contain much less CBD than products used in studies – 20 mg/kg/day, possible side effects: drowsiness, diarrhea, vomiting, fatigue. Mild to moderate severity | Potentially effective in theory. Only one study on knee osteoarthritis: 1/ shows no superior efficacy of CBD gel compared to placebo; 2/ being physically active reduces pain more than CBD. |
| Deckey 2021 | CBD & Hip and Knee Osteoarthritis [Narrative Review] | 24% of these patients use CBD | |
| They, on average, don’t experience less pain than those not using it | |||
| Vela 2021 | CBD & Hand Osteoarthritis [Randomized Controlled Trial] | – 20-30 mg/day of CBD for 3 months | |
| – Those taking CBD don’t experience less pain than those taking a placebo | |||
| Gusho 2020 | CBD and Joint-related Conditions [Narrative Review] | – Preventive effect on rat osteoarthritis (small studies) – Probable biochemical and pharmacological efficacy – Lack of high-quality studies on efficacy – Not recommended in current state | |
| Vannabouathong 2021 | CBD and Chronic Knee Pain [Cost-effectiveness] | – 0.5 to 1.25g per day – Price: $6.53 for a 15g container in Canada! – Cost-effectiveness ratio superior to osteoarthritis medications, but efficacy studies are unreliable |
Here are the three major conclusions that can be drawn from the work of these rheumatology research teams:
- CBD may theoretically be effective against osteoarthritis pain and possibly even slow down degeneration. However, it does not promote cartilage regeneration;
- The few instances where CBD efficacy was tested in osteoarthritis patients did not demonstrate superior effectiveness compared to those taking a placebo. Nevertheless, there are still limited studies. On the other hand, the doses used are significant (250 to 500 mg per day). Considering the average cost of 40 euros per mg, imagine the expense!;
- Possible side effects exist.
In theory, CBD should provide some relief for joint pain. However, the limited studies available do not show superior efficacy over a placebo.
Ointment, gel, cream, pill, CBD oil… Are they all equally effective?
Not everything is equal: the concentration and distribution in the body depend greatly on the type of CBD taken.
Two forms are more recommended for chronic pain (including osteoarthritis):
- CBD that is ingested (pill, oil, capsule, gelcap, CBD flowers or crystals);
- CBD that is absorbed through the mucous membranes (spray).
The less recommended forms are inhaled and vaped forms.(Haüser 2018)
It is better to take CBD that is ingested (capsule, pill, flower) for osteoarthritis.
What CBD Dosage for Osteoarthritis and Joint Pain?
It’s entirely reasonable to question the percentage of CBD contained in the product you acquire. A certain quantity is necessary to hope for an effect.
Here are recommendations drawn from consumption habits in Canada:
However, these data pertain to quantities for general chronic pain. What is the ideal CBD dosage per day for osteoarthritis? To find out, let’s refer to this study conducted on 320 individuals who took 250 to 500 mg/day of CBD for 3 months or a placebo.
Those who received CBD did not experience less pain after 3 months compared to those who received the placebo. (Fitzcharles 2020)
Therefore, there are good reasons to believe that one should never take less than 250 to 500 mg of CBD per day to hope for an effect. The recommended dosages for neuropathic pain are more precise: from 2.85 mg/kg per day to 50 mg/kg per day.
Some individuals have anecdotally reported a positive effect at very low doses (1 to 20 mg/day). This is likely due to a placebo effect (also known as contextual effect).
Considering Interactions
When consuming CBD at high doses and over an extended period, it is advisable to take into account potential interactions with other substances.
In such situations, it is recommended to discuss CBD usage with a knowledgeable physician familiar with your medication regimen and potential CBD-related interactions.
It is particularly important to exercise caution if you are taking:
- Medications containing estrogens, such as oral contraceptive pills:
- Consuming high amounts of CBD may reduce or even negate the effectiveness of the contraceptive pill.
- An anticoagulant called warfarin (a vitamin K inhibitor):
- Regular monitoring of the International Normalized Ratio (INR) is advised when starting to consume CBD simultaneously with warfarin.
- Anti-cancer immunotherapies: There is a potential risk of decreased effectiveness due to CBD consumption, which may diminish the immune response.
Source: Henson 2022, Grayson 2018.
Best CBD Oil for Osteoarthritis: Review
Numerous establishments and websites sell CBD products.
The most challenging aspect is identifying products containing a sufficiently substantial amount of CBD. Here is the result of my research.
CBD Oil for Osteoarthritis if you reside in America, Oceania, Africa, or Asia
Here is the oil that I found on a website for which I found:
- the most reliable feedback
- the most detailed information on the quantity and nature of the products.
I am not being compensated to speak about them, but by clicking the link, if you make a purchase, I may receive a small commission.
Additionally, it becomes 10% cheaper for you if you use the code CONC10 on purchases for CBD CONCENTRATES products.
Size = 15-30-60-120 mL
⭐⭐⭐⭐ 4- 65 ratings (knoji.com)
✅ Vegan
✅ THC free
CBD Oil for Osteoarthritis if you reside in Europe (UK, etc.)
After several years of attempting to find a manufacturer that clearly communicated on this matter, I discovered the CBD brand Sensilia. They provide clear information about the quantity of CBD contained in their products and in each serving, which I find highly commendable. Moreover, the prices are quite reasonable considering the CBD content.
I am not being compensated to speak about them, but by clicking the link, if you make a purchase, I may receive a small commission.
Additionally, it becomes 10% cheaper for you if you use the code NDB10 on purchases over 50 euros.
Size = 30 mL
⭐⭐⭐⭐⭐ 4,6/5 – 318 reviews
78 mg of CBD per serving and quantity for 1 month of daily intake
Also available in 6720 mg – 156 mg per serving
✅ Vegan
✅ Made in France
✅ THC-free
CBD Oil in a non-online store near you
You will likely be able to find similar products in a store near you. Remember to inquire about the exact amount of CBD per serving. If the seller cannot provide you with an answer (which is already honest of them!), I recommend finding another shop.
The ideal daily CBD dosage for osteoarthritis is a minimum of 250 to 500 mg. Always inquire about the CBD content in the product you are purchasing!
What’s Effective Against Joint Pain from Osteoarthritis?
Are you seeking non-drug or non-surgical therapies other than CBD to alleviate your osteoarthritis-related pain? While I prepare a dedicated article on this subject, let me introduce you to one of the most effective treatments: physical activity.
What do we mean by physical activity? It involves engaging in any activity that causes mild breathlessness, 2 to 3 times a week:
- Fast walking;
- Indoor or outdoor cycling;
- Home or gym fitness, cardio, and muscle-strengthening exercises;
- Aquagym, swimming;
- And more.
Walking 7000 steps per day (about 2 to 3 miles) doesn’t lead to additional cartilage damage, even in individuals with existing knee osteoarthritis.
The effect of physical activity against knee osteoarthritis pain is as effective as that of anti-inflammatory drugs (NSAIDs). The benefits of physical activity persist for 2 to 6 months after cessation.
Physical activity is an intriguing pain therapy compared to more passive approaches (TENS, massage therapy, etc.). Why? Because it comes with additional benefits: reduced cardiovascular risk, improved well-being and mental health, weight management, and more.
Furthermore, it’s often equally or even more effective than some passive therapies. For instance, patients with knee osteoarthritis have found relief through physical activity (Hunter 2018).
Physical activity stands as one of the best means to alleviate joint pain caused by osteoarthritis!
CBD and Arthritis in Dogs
Some individuals are interested in its efficacy for canine pain relief. Two studies to date have focused on this subject.
Dogs suffering from arthritis and given CBD for 4 weeks experienced less pain and improved mobility compared to those receiving a placebo. They were given doses of 20 to 50 mg/day.
However, the other study found no differences between the two groups on indicators other than pain.
***
Here’s what I wanted to tell you about this! Do you have any comments or questions? Your comments are welcome 🙂 !
You may also like:
- PRP Knee Injection: My Review
- Knee Replacement: How Long Does Physical Therapy Last?
- How walking with knee arthritis?
- Rheumatoid Arthritis, Diet & Fasting
📚 SOURCES
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+++ Stockings E, Campbell G, Hall WD, Nielsen S, Zagic D, Rahman R, Murnion B, Farrell M, Weier M, Degenhardt L. Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain. 2018 Oct;159(10):1932-1954. doi: 10.1097/j.pain.0000000000001293. PMID: 29847469.
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Marketing & CBD
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Chez le chien
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Written by Nelly Darbois
I love writing articles based on my experience as a physiotherapist (since 2012), scientific writer, and extensive researcher in international scientific literature.
I live in the French Alps 🌞❄️, where I work as a scientific editor for my own website, which is where you are right now.