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Rheumatoid arthritis (RA)

Cannabis for Rheumatoid arthritis (RA)

chronic pain diagnosis

Rheumatoid arthritis (RA) is an autoimmune condition in which the body’s immune system mistakenly attacks its own tissues, specifically the synovium—the lining of the joints. This immune response leads to chronic inflammation, causing joint damage over time. RA is the second-most common type of arthritis, after osteoarthritis. Around 1.5 million people in the U.S. and 18 million people worldwide have RA.

Compounds in cannabis, including cannabinoids and terpenes like tetrahydrocannabinol (THC), cannabidiol (CBD), cannabigerol (CBG), beta-caryophyllene (BCP), myrcene, and linalool, may help manage some of the symptoms, effects, and triggers of RA and RA flare-ups. This includes common symptoms like pain, inflammation, fatigue, insomnia, anxiety, and depression.

Rheumatoid arthritis causes

Factors contributing to RA include:

  • Age: RA typically develops between the ages of 30 and 60, though it can occur at any age
  • Comorbidities: Having another autoimmune disease such as lupus, type-1 diabetes, or Crohn’s disease can increase susceptibility to RA
  • Environmental triggers: Smoking, pollution, or infections may act as triggers
  • Genetics: Certain genes, such as HLA-DR4, can increase susceptibility
  • Hormonal factors: RA is more common in women, suggesting hormonal involvement

Rheumatoid arthritis symptoms & health effects

RA symptoms can vary from mild to severe and often include:

  • Joint pain and stiffness: Especially in the morning or after periods of inactivity
  • Swelling: Inflammation leads to swollen, warm, and tender joints
  • Fatigue: Chronic inflammation can cause exhaustion and reduced energy levels
  • Systemic symptoms: Fever, weight loss, and overall malaise are common
  • Joint deformities: Advanced RA can cause permanent joint damage and visible deformities

RA can also affect other parts of the body, including the eyes, lungs, heart, and blood vessels, leading to complications such as dry eyes, lung scarring, and increased cardiovascular risk.

Common comorbidities alongside RA include anxiety, depression, chronic fatigue, asthma, osteoporosis, and cardiovascular events like myocardial infarction or stroke.

Rheumatoid arthritis diagnosis

Diagnosing RA involves:

  • Medical history and physical examination: Checking for characteristic symptoms and joint abnormalities
  • Blood tests:
    • Rheumatoid factor (RF) and anti-CCP antibodies.
    • Elevated inflammatory markers like ESR and CRP
  • Imaging tests: X-rays, MRIs, or ultrasounds may be used to detect joint damage and inflammation

Early diagnosis is crucial to prevent irreversible joint damage.

Rheumatoid arthritis prognosis

The prognosis for RA varies depending on how early it is diagnosed and treated. While there is no cure, early and aggressive treatment can:

  • Reduce symptoms
  • Slow disease progression
  • Prevent joint damage and disability

Untreated RA can lead to significant physical limitations and systemic complications.

old woman holding and pinching her palm

Rheumatoid arthritis treatments

First-line treatments

  • Disease-modifying antirheumatic drugs (DMARDs):
    • Methotrexate, hydroxychloroquine, and sulfasalazine are commonly prescribed. These drugs help slow disease progression.
  • Biologic DMARDs: Target specific components of the immune system (e.g., tumor necrosis factor (TNF) inhibitors like adalimumab and etanercept)
  • Corticosteroids: Provide rapid relief from inflammation but are not ideal for long-term use due to side effects such as bone thinning (osteoporosis)

Other treatments

  • NSAIDs: Non-steroidal anti-inflammatory drugs, like ibuprofen or naproxen, reduce pain and inflammation
  • JAK inhibitors: Newer oral medications that interfere with immune signaling pathways.

Adjunctive therapy & alternative treatments

  • Physical and occupational therapy (OT): Improves joint function and reduces pain
  • Exercise and weight management: Low-impact activities like swimming or yoga can strengthen muscles and alleviate joint strain
  • Dietary changes:
    • Anti-inflammatory diets rich in omega-3 fatty acids (e.g., fish, flaxseeds)
    • Avoiding processed foods and added sugars
  • Mind-body therapies: Practices such as meditation, acupuncture, and tai chi can help manage pain and stress

Cannabis for rheumatoid arthritis

Medical cannabis is emerging as a potential adjunctive treatment for RA. Key benefits include:

  • Pain relief: Cannabinoids like THC and CBD interact with the endocannabinoid system (ECS) to reduce pain perception
  • Anti-inflammatory effects: Studies suggest CBD and other cannabinoids can modulate immune responses, potentially reducing joint inflammation
  • Improved sleep: RA patients often experience disrupted sleep (insomnia) due to pain, which in turn increases pain and inflammation. Cannabis may aid in better rest and prevent further pain and inflammation
  • Managing comorbidities: Anxiety, depression, and irritable bowel syndrome (IBS) are common comorbidities with RA, and can trigger flare-ups of RA symptoms, too. Medical cannabis may help reduce stress, anxiety, and inflammation associated with these conditions.
  • Terpenes: Beta-caryophyllene, myrcene, and linalool have been shown to have analgesic, anti-inflammatory, and possibly anti-arthritic properties that can help reduce the symptoms and slow the progression of RA
  • Bone growth: Cannabinoids like CBD and CBG may help repair and regenerate bones

Forms and methods of use

  • Cannabis tincture/CBD oil: Taken sublingually or added to food
  • Inhalation: Vaporized cannabis for rapid relief
  • Topical applications: CBD creams or balms applied directly to inflamed joints

Considerations

  • Consult a healthcare provider before using medical cannabis
  • Start with low doses and monitor for side effects like dizziness or dry mouth
  • Be aware of cannabis-related legal regulations in your area

medical cannabis

Additional information for patients

Rheumatoid arthritis FAQs

Is RA the same as osteoarthritis?

No. RA is an autoimmune condition, whereas osteoarthritis is caused by wear and tear on joints.

Can diet help with RA symptoms?

Yes, an anti-inflammatory diet rich in fruits, vegetables, and omega-3 fatty acids may help reduce inflammation.

Is medical cannabis safe for RA patients?

Medical cannabis is generally considered safe when used responsibly, but always consult your doctor before starting any new treatment.

Can RA go into remission?

Yes. With early and aggressive treatment, many patients achieve remission or low disease activity.

This guide is for informational purposes. Always consult a healthcare professional for personalized advice.

Resources

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Animal Study

9

Animal Study -

1

Clinical Meta-analysis

5

Clinical Trial

4

Double Blind Clinical Trial

2

Laboratory Study

10

Meta-analysis

50

Meta-analysis -

1

Total studies

Rheumatoid arthritis (RA)

82

Positive

72 studies

88%

Inconclusive

8 studies

10%

Negative

2 studies

2%

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