Rheumatologic Disorders (Rheumatoid Arthritis, Systemic Sclerosis, Osteoarthritis, Fibromyalgia) and Medical Marijuana (Cannabis)
Rheumatologic Disorders (Rheumatoid Arthritis, Systemic Sclerosis, Osteoarthritis, Fibromyalgia) and Cannabis
Summary. Rheumatologic disorders are a common cause of chronic pain and current pharmacological interventions are not always useful or safe for chronic use. Treatment with Medical Grade Cannabis has proven very helpful for management of Pain, Anxiety, Depression, Insomnia and has the additional benefit of reducing inflammation and improving immune system function.
Cannabis is a natural product containing over 450 compounds that work by activating the Endocannabinoid System (ECS). This system exists in the body to help restore balance and homeostasis. This is not a simple on/off process, but rather a complex phenomenon involving endogenous and exogenous ligands, cross-reactions with non-cannabinoid receptors, and plasticity of response dependent upon local tissue characteristics.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000161/
This highly complex system is made up of 3 main components.
-
- Cannabinoids. Our body only makes 2 different Endocannabinoids, Anandamide and 2-AG). Cannabis contains over 100 Phytocannabinoids along with Terpenes/Terpenoids, Flavonoids and other chemicals that activate the Endocannabinoid System.
- Cannabinoid receptors. Receptors that engage cannabinoid molecules are ubiquitous throughout the human body.
CB1 receptors are located mostly in the brain.
CB2 receptors exist primarily in the immune system, bone, synovial cells and the peripheral nervous system. - Enzymes to both create and break down Cannabinoids.
Rheumatoid Arthritis, Systemic Sclerosis and Osteoarthritis. Studies have demonstrated that cannabinoids have an inflammatory-modulating effect in the body. It has been postulated that they may also have a disease modifying quality based on animal model studies for rheumatoid arthritis and systemic sclerosis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000161/#b9-rmmj-11-1-e0007
Fibromyalgia. Studies have shown a positive treatment response to cannabis in over 80% of patients treated. Patients enjoyed a significant reduction of pain and stiffness along with an increase in relaxation and a perception of well-being.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000161/#b24-rmmj-11-1-e0007
Esteemed researcher, Dr. Ethan Russo, has proposed that Autoimmune diseases, Complex Regional Pain Syndrome, Fibromyalgia, Anxiety and Depression represent a Clinical Endocannabinoid Deficiency.
https://pubmed.ncbi.nlm.nih.gov/18404144/
https://boorasmd.com/education/articles/clinical-endocannabinoid-deficiency/
“In conclusion, we believe that the use of cannabis and cannabinoids for pain relief in rheumatic diseases (and fibromyalgia in particular) shows great potential and may be a source of hope for those suffering from chronic pain associated with those conditions, and for the physicians treating them. More research into this question should be conducted, especially among larger cohorts of patients and for longer periods of time, to assess for long-term efficacy and adverse effects.
At this point, the data suggest that the use of cannabinoids and cannabis carries limited side effects in the treatment of rheumatic disease, although drug interactions should always be kept in mind.
Research also suggests that cannabis and cannabinoids can improve some common and debilitating symptoms of rheumatic disease, thus making them an adequate potential treatment option in our opinion, when other treatment lines have been exhausted.”
***(Editors note: Based on the very positive subjective reports from clients I have been seeing, I feel the use of medicinal cannabis should be introduced well before exhausting “other treatment lines”. Proper use of cannabis is safe, effective and with very few adverse effects. I have seen no significant evidence for excessive psychoactivity or dependency by combining CBD with THC and gradually titrating the dose as needed.)***
https://pubmed.ncbi.nlm.nih.gov/29847473/
https://pubmed.ncbi.nlm.nih.gov/26767993/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000161/#b33-rmmj-11-1-e0007
Additional reading:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000161/
Written by Charlie Booras, MD on November 4, 2020
