Ankylosing Spondylitis and CBD: The Assessment

Also known as ankylosing spondylitis or Bechterew's disease, Ankylosing Spondylitis is a chronic inflammatory disease primarily affecting the axial skeleton and its central part; the spine, the rachis and the pelvis with the sacroiliac joints that transfer loads between the spine and the lower limbs.

It's a disease that's often diagnosed too late, several years after onset, because its first symptoms are often lumbar and back pain that may seem "normal". Little known to the general public, it nevertheless affects more than 180,000 people in France[1], and is mostly triggered by young people in their 20s and 30s.

A common factor seems to stand out in affected patients: the HLA (Human Leukocyte Antigene) B27 gene, which would explain the hereditary and predisposing nature of the disease.

Symptoms and pain of spondyloarthritis: an often misidentified disease

Some pains are fairly typical of ankylosing spondylitis, such as back pain, pelvic pain, heel pain or even severe fatigue, but medical advice is always necessary to confirm or deny the disease.

Pain occurs in attacks (flare-ups) and can last from a few hours to several weeks. Sensations of stiffness in the joints (knees, ankles...) or swelling of the fingers or toes may be encountered. Fatigue is also often an omnipresent factor in affected patients.

Everyday aches and pains often mislead sufferers, since spondyloarthritis affects parts of the body that can be painful for a variety of reasons (exertion, activity, a long day, carrying a load...).

However, there are certain signs that herald this chronic disease:

• Pain along the spine that wakes up in "spurts", mainly at night, and that rest does not relieve.
• Joint stiffness in the early morning that eases as the day progresses
• Extremely tired, not even rest can calm the nerves
• Swelling of the extremities
• Long-lasting attacks of back and pelvic pain (several months)
• Difficulty getting up and sitting down

Diseases often confused with ankylosing spondylitis

Chronic inflammatory diseases such as ankylosing spondylitis or rheumatoid arthritis are often misunderstood by the general public, and sometimes confused with more common inflammatory diseases such as osteoarthritis, arthritis or gout.

We explain all about polyarthritis in our dedicated article: Rheumatoid arthritis and CBD

Yet the inflammation associated with spondyloarthritis is very specific, with flare-ups that can last several months and a constant state of fatigue.

If you're unsure of your diagnosis but have symptoms, it's advisable to consult a treating physician or rheumatologist, so that blood tests, X-rays, scans or ultrasound scans can be performed on the various parts affected, in order to make a well-founded diagnosis and set up a suitable protocol.

A disease whose main cause is joint inflammation

As mentioned above, the main cause of spondyloarthritis is inflammation, as with 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 specifically 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 (walking, sitting, carrying loads, etc.).

CBD has been a recognized anti-inflammatory for decades, and can play an important role in the treatment of ankylosing spondylitis.

But in addition to inflammation, spondylitis can cause a thickening of the synovial membrane, which normally lubricates the cartilage in the joints. Spondylitis can lead to excess fluid in this membrane, which interferes with joint function and causes pain. In such cases, an intra-articular injection may be recommended, known as synoviorthesis.

Scientific opinion on CBD's anti-inflammatory and pain-relieving action

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.

 

American scientific study: Benefits of CBD against arthritis and inflammatory joint diseases

A study was carried out in the USA on a sample of over 400 people using CBD to treat inflammatory joint pathologies such as arthritis, osteoarthritis or rheumatoid arthritis.

The feedback has been very positive and the survey has highlighted a number of areas for improvement when it comes to taking CBD:

• Pain reduction
• Improved physical function
• Improved sleep quality

Read our summary of this study: Case study: CBD as a treatment for inflammatory diseases

 

Additional benefits of CBD: Sleep, well-being and relaxation

 In addition to its significant anti-inflammatory action, cannabidiol acts on the homeostasis of the human body. In other words, it regulates functions such as weight, mood, sleep and relaxation.

We are convinced that these benefits are complementary to the anti-inflammatory action of CBD for spondyloarthritis, as they enable the body to be in a state of complete general well-being. Joint diseases particularly affect sleep, with nocturnal awakenings due to pain, as well as mood and fatigue. The regulating action of cannabidiol enables a global synergy on these different factors for a deeper and more stable accompaniment of the pathology.

What type of CBD for spondylitis?

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 to accompany pathologies such as ankylosing spondylitis, which ones? We present them to you:

• 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 different concentrations (5%, 10%, 15%, 20%, 30% and 40%), it offers excellent background support for 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 spondylitis. Their formulation, often composed of CBD and other plants with multiple benefits, enables a global action on the organism and a deep accompaniment.
  
  
• CBD lozenges: These are also highly effective, thanks to their enhanced bioavailability via the perlingual absorption route. Like oil or capsules, they can be used to treat a wide range of medical conditions. Their cannabidiol concentration ranges from 10 to 15mg per lozenge. The only drawback is that, according to several feedbacks, they are not very convenient to consume, since you have to take several and the consistency is not very pleasant.
  
  
• CBD herbal tea: Generally composed of cannabidiol and natural plants with multiple benefits, herbal teas are generally formulated to meet specific needs (detox, sleep...). They are not sufficiently concentrated in CBD to support a pathology on their own, but they are an excellent complementary product to capsules or oil.

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)

Opinion of the cb'dé team: CBD capsules for ankylosing spondylitis

After several years' experience in the CBD market, we have received a great deal of feedback on the benefits of cannabidiol for joint diseases. CBD oil has proved to be the ideal product for these conditions, and numerous consumer reports confirm that CBD works well on a number of fronts:

• Pain reduction
• Better state of mind and mental peace of mind with regard to pathology (less stress, fewer negative thoughts)
• Improved daily life (activities, mobility) thanks to pain reduction
• Improved sleep

This feedback and our studies on the subject have enabled us to offer a product specifically formulated to support inflammatory autoimmune diseases: CBD, Turmeric and Ginger capsules for global action and in-depth support.