CBD for rheumatoid arthritis?

As with Ankylosing Spondylitis, rheumatoid arthritis is a chronic inflammatory disease of the joints, triggered by a variety of hormonal, environmental and genetic factors.

It also comes on in flare-ups lasting from a few days to several months, generally interspersed with periods of calm. The synovial membrane (which lubricates and nourishes the joints to keep them working properly) is once again at the heart of the disease, since it is directly affected by polyarthritis, which triggers excessive production of synovial fluid within the membrane, leading to thickening. This thickening can then lead to the destruction of the cartilage and other components of the joint, resulting in a significant loss of mobility: this is synovial pannus.

This autoimmune disease affects more than 380,000 people[1] and is more common in women than men, according to studies. If not diagnosed early, it can spread rapidly to all extremity joints (feet and hands), severely affecting mobility.

Diagnosing polyarthritis: Symptoms, pain and treatments

The symptoms of polyarthritis are similar to those of spondylitis, the only difference being that polyarthritis generally affects the limbs (hands, feet), while spondylitis affects the joints of the spine, spine and pelvis.

Symptoms are generally as follows:

• Stiffness of joints, generally in the wrists, hands and fingers
• Swollen joints (wrists, hands and fingers)
• Pain is more frequent at night and in the early morning, then subsides during the day.
• General fatigue

These signs are the early stages of the disease, and must be promptly diagnosed and treated (injections, NSAIDs, non-steroidal corticoids...) before the disease spreads too rapidly.

As the disease progresses, every joint in the body can be affected: fingers, toes, wrists, ankles, knees, shoulders, neck, hips... Swelling and deformations of the joints are often visible, impairing the mobility of the sufferer.

Possible treatments

There are several possible treatments for rheumatoid arthritis, depending on how the disease progresses, which will require more or less extensive and radical solutions:

• Early stage: When the disease first appears, anti-inflammatory drugs (NSAIDs) or corticosteroids may be prescribed to limit inflammation. Methotrexate is often prescribed to reduce immune system activity and inflammation.
• Advanced stage: When drugs no longer work, methotrexate can be injected subcutaneously for greater effect.
• Final stage: When the disease reaches its final stages, surgery may be required. Orthopedic surgery is called in to repair or, where necessary, replace joints with prostheses.

Of course, each case is different, and these treatments will be more or less well tolerated by the body. A healthcare professional will recommend the most appropriate solution, depending on the stage of the disease and the pain experienced.

Similar inflammatory diseases: osteoarthritis, arthritis, ankylosing spondylitis...

There is a wide variety of inflammatory joint diseases known as " autoimmune " (diseases resulting from a dysfunction of the immune system, which instead of protecting the body, attacks it in different ways). Joints are sensitive, and joint disease can quickly lead to severe rheumatism. What are these pathologies? Here's a look at the main ones and their different characteristics:

• Osteoarthritis: This is the most widespread joint disease, affecting more than 528 million people worldwide[2]. The most common forms affect the knee, hand and hip joints. It is characterized by the destruction of cartilage, leading in the long term to bone friction and daily pain.
  
  Read our article to find out more about CBD's action against osteoarthritis and inflammatory diseases.
  
  
• Arthritis: Characterized by pain, stiffness and fatigue, arthritis results from inflammation, mainly of the joints, and impairs mobility. Various treatments are available, including anti-inflammatories and injections.
• Ankylosing Spondylitis: Chronic inflammatory disease mainly affecting the axial skeleton and its central part; the spine, the rachis and the pelvis with the sacroiliac joints. Once again, treatment is often based on anti-inflammatories, injections or, in the most advanced stages, orthopedic surgery and joint prostheses.

These diseases can affect older and younger people alike. Spondylitis generally affects people in their 20s and 30s, while osteoarthritis often occurs in people over 45.

As osteoarthritis is the most widespread and well-known to the general public, it is sometimes "diagnosed" prematurely, either by the patient telling himself he has osteoarthritis, or by a health professional unaccustomed to other related pathologies. Diseases such as spondyloarthritis are sometimes diagnosed several years after their onset, making treatment very difficult.

 

Inflamed joints at the heart of the problem

The inflammatory mechanism is very similar to that of spondyloarthritis, with inflammation as the main cause, as in Crohn's disease or ulcerative colitis, which result from inflammation of the intestine, except that in our case it's inflammation of the joints and more particularly of the enthesis, the part of the bone where tendons, ligaments and capsules are inserted and bound.

Over time, this inflammation will subside, giving way to an ossification of the enthesis, also known as an " enthesophyte ". This bony outgrowth resulting from the healing of the inflammation will obstruct the joints, creating discomfort and pain during movement. In the case of polyarthritis, the joints affected are mainly those of the extremities: wrists and fingers, ankles and toes.

We'll now look at how CBD has been a recognized anti-inflammatory for decades, and how it can play an important role in the treatment of rheumatoid arthritis.

 

CBD, an effective natural anti-inflammatory for joints

Mechanism of action

CBD is a cannabinoid that acts on the body via the central endocannabinoid system (CES) and CB1 and CB2 receptors. The CB2 receptors are of particular interest to us in terms of cannabidiol's anti-inflammatory action, as they are present almost everywhere in the human body (joints, muscles, organs, skin...). Here's a simple explanation of how CBD interacts with various enzymes and receptors to reduce inflammation:

• CBD is an inverse agonist of CB2 receptors and plays a role in inhibiting immune cell migration and reducing inflammation.
• It activates TRPV1 receptors responsible for regulating several inflammatory agents
• Inhibits the activity of COX1 and COX2 enzymes, which produce prostaglandins (a mediator of inflammation)
• Antagonizes the GPR55 receptor, thereby reducing IL12 production, which is pro-inflammatory

In short, CBD reduces the feeling of pain and limits the development and spread of inflammation via its interaction with various receptors.

A scientific study on the benefits of CBD on joint inflammation was carried out on a sample of over 400 people with inflammatory joint diseases. We have analyzed the results and highlighted the main improvements felt by patients.

To find out more, read our dedicated article: Case study on the action of CBD on osteoarthritis.

CBD, regulator of the human body's homeostasis

Cannabidiol's anti-inflammatory action isn't the only one we're interested in when it comes to autoimmune diseases. In fact, CBD regulates various bodily functions via its global action on the central nervous system (CNS).

It regulates sleep, weight, mood and anxiety through its interaction with various receptors and body enzymes, resulting in overall improvements in well-being and mental health.

In a way, its anti-inflammatory action will respond to the main problem caused by the pathology, but its various regulatory actions will enhance these benefits.

To find out more, read our article on a Case Study of CBD as a treatment for inflammatory diseases.

What form of CBD for rheumatoid arthritis?

CBD comes in various forms (oil, capsules, lozenges...) and can be more or less concentrated. Each type of CBD product has its advantages and disadvantages, but only a few are really interesting for accompanying inflammatory pathologies:

• CBD oil: This is the best-known cannabidiol-based wellness product. Its sublingual absorption route ensures one of the best bioavailabilities of CBD. Available in various concentrations (5%, 10%, 15%, 20%, 30% and 40%), it offers excellent support for both light and heavy pathologies.
  
  Find out more: CBD Oil: Uses and Benefits
  
  
• CBD capsules: Capsules are also highly prized for their support of multiple pathologies. From anxiety to sleep and migraines, capsules are also highly effective for chronic inflammatory diseases such as polyarthritis. Their formulation, often composed of CBD and other plants with multiple benefits, enables a global action on the body and a deep accompaniment.
  
  
• CBD lozenges: Less recommended than oil or capsules, lozenges are very effective but complicated to take for high doses (>80mg) since each lozenge is 10 or 15mg, you have to take several a day and this can be "painful" given their texture.
  
  
• CBD herbal tea: Not high enough in cannabidiol to support an autoimmune pathology, they are nevertheless recommended as a CBD supplement when taken alongside another product: oil, capsules.

Attention

These products are not intended to be used as a substitute for medication (NSAIDs, cortisone, paracetamol, aspirin, etc.). If you have been diagnosed with ankylosing spondylitis and prescribed medication, you should consult your treating physician before taking CBD.

Find out more: Drug interactions and CBD (Part 7)

Find our CBD Joint Capsules for joint pathologies such as osteoarthritis, polyarthritis, ankylosing spondylitis or arthritis.

 

Sources :

[1] Data on rheumatoid arthritis: https: //www.ameli.fr/assure/sante/themes/polyarthrite-rhumatoide/comprendre-polyarthrite-rhumatoide#:~:text=La%20polyarthrite%20rhumato%C3%AFde%20est%20une%20maladie%20articulaire%20inflammatoire%20et%20chronique,et%20des%20p%C3%A9riodes%20d.

[2] Data on osteoarthritis: https: //www.who.int/fr/news-room/fact-sheets/detail/osteoarthritis