Cannabis in the treatment of rheumatic diseases

The term rheumatic diseases is used for a set of multiple diseases of differing origin and gravity that affect the osteoarticular and muscle-tendon system, and which are manifested by pain, progressive deformation and functional limitation. Some of these conditions can also compromise internal organs such as the heart and other viscera.

As for the cause, in some the autoimmune component is particularly important, whereas others are secondary to some other type of degenerative or infectious process.

These ailments include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Systemic lupus erythematosus (Lupus)
  • Scleroderma
  • Ankylosing spondylitis
  • Fibromyalgia
  • Gout
  • Polymyositis
  • Bursitis
  • Tendinitis
  • Behçet's disease
  • Crohn's disease
  • Sjögren's syndrome
  • Diabetes mellitus
  • Thyroiditis

The most common articular symptoms and signs are:

  • Inflammation and chronic articular pain (in one or more joints), which may be continuous or stabbing
  • Difficulty in moving joints on beginning movement, predominantly in the morning, which improves with movement
  • Functional joint limitation

Conventional treatment tends not to be very effective and have multiple adverse effects due to the toxicity of the pharmaceuticals at different levels: renal, digestive, hepatic, etc.

Effects of cannabis in rheumatic diseases

Apart from their definition, what characterises all of these conditions is their chronic nature, the presence of pain and the inflammatory component.

It is well known that cannabinoids and particularly THC and CBD have an anti-inflammatory and analgesic effect, hence their application in all these processes. At the same time, the osteoarticular system has few sites of action (receptors) for most compounds, which explains the ineffectiveness of most drugs. However, the presence of sites of action for cannabinoids in joints has been demonstrated, even in the case of degenerative processes such as osteoarthritis.

Moreover, cannabinoids act on the modulation of immunity and as mentioned, many of these diseases have an autoimmune cause. In this regard, CBD, unlike conventional immunosuppressants, is capable of reducing the immune response against the organism itself (auto-immunity) without affecting the response to infections or tumours.

Although THC has a significant analgesic effect, because of its psychoactive and cardiovascular effects, doses of this composite should be restricted, especially among elderly people, to prevent affecting cognitive processes and blood pressure, and its use must be accompanied by effective doses of CBD to neutralise the psychoactive effects.

As well as pain relief and reduction in inflammation, cannabis and cannabinoids in rheumatic diseases can offer other benefits for the general state of the patient, improving the quality of sleep, appetite, mood, and in short, quality of life.

Administering cannabis and cannabinoids in rheumatic diseases

It is recommended that the route of administration in these pathologies should be both local and general. This means applying creams or lotions to pain points, as well as ingesting oils or tinctures. In this way, while treating the painful and inflammatory symptoms of rheumatic disease by the general route of administration and seeking to modulate auto-immunity, it is possible at the same time to be more effective in relieving pain without having to resort to high doses of THC. In principle, creams containing THC do not have psychoactive effects when used locally, although it is important to be alert to possible allergic reactions to the THC.