Since U.S. states began to legalize cannabis for medicinal use, much of the debate about medical marijuana has shifted from questions about whether cannabis use has genuine medicinal value to what uses of cannabis provide legitimate medicinal benefits. A majority of U.S. states have enacted legislation legalizing the use of medical marijuana, but the medical conditions for which cannabis can be used vary by state. The Oregon Medical Marijuana Program (OMMP) lists a wide variety of chronic pain conditions for which cannabis is approved, many of which involve inflammation, including osteoarthritis, psoriatic arthritis, plantar fasciitis, rheumatoid arthritis and severe joint pain. These can be serious medical conditions that affect quality of life, and the chronic pain they produce leads to depression in up to half of affected individuals.
Oregon and other states have legalized the use of cannabis products to treat joint pain and inflammation, but federal prohibitions on medical marijuana have limited legitimate research into the use of cannabis for treating these conditions. Given the debilitating effects of chronic joint pain, medical marijuana patients need good information to make informed decisions about treating their pain with cannabis products.
Opioids, formerly classified as “narcotics,” have set the standard for pain management in U.S. health care. Common opioids are morphine, codeine, hydromorphone, fentanyl, tramadol, oxycodone and meperidine. While effective in suppressing pain, these opioids often produce serious side effects like nausea, vomiting, constipation, respiratory issues, confusion and sedation, not to mention the risks of addiction and overdose, which often causes death. A strong argument for cannabis use is milder side effects, including no risk of physical addiction and no deaths directly attributable to cannabis use. (Of course, cannabis aficionado Willie Nelson claims to have known a man who died when a large bale of cannabis fell on him).
Active Ingredients in Cannabis
Medicinal benefits of cannabis are derived from cannabinoids. Cannabis plants produce hundreds of cannabinoids in different quantities and ratios, depending on the strain of cannabis. The cannabinoids produced most abundantly tend to be delta-9-tetrahydrocannabinol (THC), which produces the psychoactive “high” sought by recreational users of cannabis, and cannabidiol (CBD), which shows promise in treating pain, inflammation, seizures, epilepsy, mental illness and addiction.
Cannabinoids act through cannabinoid receptors in the body’s endocannabinoid system, and several studies have shown that elements of this interaction suppress inflammation, which is often the source of chronic joint pain. Inflammation is a defense mechanism that results from the activation of immune cells in response to foreign substances entering the human body. Chronic joint pain typically involves an autoimmune disease, like rheumatoid arthritis, in which the immune system mistakenly recognizes an individual’s own cells as foreign. The body’s reaction leads to inflammation, tissue damage and pain.
While CBD is gaining popularity for medicinal benefits without THC’s psychoactive effects, THC possesses strong anti-inflammatory and pain relief properties and have been shown to assist patients suffering from arthritis. THC is also an antispasmodic, bronchodilator and muscle relaxer. Anecdotal evidence as well as limited research supports the belief that the natural mix of cannabinoids in cannabis plants provides a synergistic efficacy that cannot be duplicated by CBD alone.
Research Findings on its Effectiveness
An article published in the London-based research journal “Future Medicinal Chemistry” reviews the scientific findings about using cannabinoids to treat inflammation. The authors conclude that cannabinoid use “can constitute a potent treatment modality against inflammatory disorders. … Cannabinoids suppress inflammatory response and subsequently attenuate disease symptoms. This property of cannabinoids is mediated through multiple pathways.” In plain English, scientific research confirms the effectiveness of cannabinoids for treating inflammation and pain. The authors also verify the beneficial effects of cannabinoids for multiple autoimmune disorders, including rheumatoid arthritis.
Rheumatoid arthritis, a chronic inflammatory disease that wreaks havoc with human joints, is a fairly common source of chronic joint pain. Researchers report that studies of cannabinoids and their anti-inflammatory properties demonstrate “the anti-arthritic properties of these natural plant compounds. Interestingly, most of the studies on rheumatoid arthritis and cannabinoids focus on the use of nonpsychoactive cannabinoids.”
One study shows that daily doses of oral CBD “inhibited disease progression” of arthritis, while another study shows that the nonpsychoactive cannabinoid HU-320 improved arthritis in mice. Yet another study demonstrates the effectiveness of the cannabinoid ajulemic acid (AjA) in modulating inflammation-inducing immune responses.
More recently, a study published in the Oxford University Press journal “Rheumatology” confirms the efficacy of cannabinoids for fighting inflammation in joints. A new Canadian study supported by the Arthritis Society is further examining the ability of cannabis to relieve pain as well as repair arthritic joints. Preliminary results indicate that cannabinoids taken orally or topically can interact with the endocannabinoid system to modulate pain signals in arthritic joints.
While scientific research remains sparse, plenty of anecdotal evidence shows the effectiveness of cannabis for treating joint inflammation and pain. For example, Katie Marsh of Madawaska, Maine, suffered from rheumatoid arthritis, for which she took prednisone, opioids and antibiotics. She even tried “disease-modifying anti-rheumatic drugs” but experienced severe side effects. After consulting with Dr. William Courtney, Marsh started juicing cannabis, consuming the whole raw plant. Marsh was able to stop taking all other medications, and after 11 months of consuming cannabis smoothies, her arthritis is in remission.
Finding The Right Cannabis Strain
Generally speaking, indica-dominant Kush strains tend to be good for joint pain and inflammation, but doctors and patients alike recommend finding strains with relatively high levels of CBD (5-12 percent) along with decent THC levels (7-18 percent). Those who prefer to avoid the THC high should look for strains with lower THC levels (less than 12 percent).
MarijuanaBreak.com’s “5 Best Marijuana Strains for Arthritis Pain Relief” recommends strains like Girl Scout Cookies, Cannatonic, ACDC, Harlequin and Canna Tsu. For treating arthritis, Leafly recommendations encompass multiple strains, including Harlequin, G13, God Bud, Gorilla Glue and Bubblegum Kush. Here at Grown Rogue, we recommend our CBD Therapy, Obie 1:1, or Medi-haze for the sativa lover that still needs a CBD rich strain.
Ultimately, finding the best cannabis strain for joint pain and inflammation will involve trying various strains to determine which ones interact most effectively with an individual’s physiology. And until additional scientific research is completed, anecdotal evidence can be a useful guide to finding a strain with the cannabinoid synergy not only to alleviate pain but actually to heal underlying health conditions. So if you need relief from joint pain and inflammation, visit your local cannabis dispensary and ask your budtenders what they recommend.