CBD for Arthritis Pain | Arthritis Foundation

Should I give CBD a try? Without quality clinical studies on CBD and arthritis, doctors have not been able to say who might benefit from CBD, at what dose and in which form, who likely won’t benefit, and who should avoid it. Still, there is agreement on several points:

• CBD is not a substitute for disease-modifying treatment for inflammatory arthritis.
• Patients who are interested in trying CBD should first talk to the health care provider who treats their arthritis before trying CBD. Together, they can review what has worked or not worked in the past, whether there are other options to try first, how to do a trial run, what to watch for and when to return for a follow-up visit to evaluate the results. Keep a symptom and dose diary to track effects.
• Quality CBD products can be expensive, especially when used for prolonged periods. To avoid wasting money, be completely sure that the product is truly having a positive effect on symptoms.

What type of product should I consider? CBD-based products can be taken orally, applied to the skin or inhaled. There are pros and cons for each.

By mouth. CBD that is swallowed, whether in capsules, food or liquid, is absorbed through the digestive tract. Absorption is slow and dosing is tricky due to the delayed onset of effect (one to three hours), unknown effects of stomach acids, recent meals and other factors.

Capsules can work for daily use after a safe, effective dose has been established. Experts discourage taking CBD via edibles, like gummies and cookies, because dosing is unreliable, sugar can be inflammatory, and they are appealing to children but do not come in childproof containers. Like any medicine, edibles should be secured out of sight and reach of children.

CBD can also be absorbed directly into the bloodstream by holding liquid from a spray or tincture (a liquid dosed by a dropper) under the tongue (sublingual) for 60 to 120 seconds. The taste may not be pleasant. Effects may be felt within 15 to 45 minutes. If sprays or tinctures are swallowed, their effects tend to be similar to capsules or edibles.

On the skin. Topical products, like lotions and balms, are applied to the skin over a painful joint. Whether these products deliver CBD below the skin is unknown. Topical products may also include common over-the-counter ingredients such as menthol, capsaicin or camphor, making it difficult to determine if a positive effect is due to the CBD or another ingredient.

Inhaled. CBD can be inhaled via a vaporizing, or vape, pen. However, inhalation of vapor oils and chemical byproducts carry unknown risks, particularly for people with inflammatory arthritis. Some vaping products, especially those purchased online rather than from state-licensed dispensaries, may also contain chemicals (such as Vitamin E acetate) that may cause severe pulmonary disease. As such, vaping should be approached with caution and is typically not recommended.

How much CBD should I use? While there are no established clinical guidelines, the medical experts consulted by the Arthritis Foundation recommend the following for adults:

• When preparing to take a liquid form, be aware that the CBD extract is mixed with a carrier oil, so there are two measures to know: the amount of the liquid product to take (the dose) and the amount of CBD in each dose. (For example, if your product contains 50 milligrams of CBD per milliliter, taking 0.5 milliliters would be a dose of 25 milligrams.)
• Go low and slow. Start with just a few milligrams of CBD in sublingual form twice a day. If relief is inadequate after three or four days, increase the dose by that same amount. If needed, go up in small increments over several weeks. If you find relief, continue taking that dose twice or more daily to maintain a stable level of CBD in your body.
• If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, talk to your doctor about taking CBD with a very low-dose THC product. Be aware that THC, even at low levels, may get you high, creating cognitive, motor and balance issues. Try THC-containing products at home or at night first, so you can sleep off any unwanted effects.
• After several weeks, if you don’t find relief with CBD alone or with a combination of CBD and very low THC, CBD may not be right for you.

• If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your doctor.