When it comes to chronic disease, arthritis isn’t so much a novelty as it is an inevitability. Aging, injuries and a host of other lifestyle factors add to the risk of osteoarthritis. The wear-and-tear on the joint leads to the eventual degradation of cartilage, the shock absorbing tissue that allows for friction-free movement in the joint space. The inflammation leads to early morning stiffness in the area accompanied by muscle spasm and decreased range of motion. As the cartilage declines, symptoms such as restricted movement, deformity of the joint, instability, weakness and pain increase.
Statistics Canada estimates that 37 per cent of Canadians over the age of 19 have been diagnosed with osteoarthritis. Osteoarthritis is not a disease of the elderly. It is increasingly a disease of the young. Traumatic injury and obesity put people from all walks of life at risk.
Preventative measures such as low-impact activities and weight loss help to reduce the stress on joints. Treatments usually involve pain medication and anti-inflammatories. These symptomatic treatments, while effective, have side effects. The risk of dependency for opioid medication has made patients reluctant to try them, and the Non-Steroidal Anti-inflammatory drugs (NSAIDs) increase the risk of ulcers, heartburn and liver issues.
Medical cannabis provides a two-pronged approach to treating the symptoms of osteoarthritis using THC (tetrahydrocannabinol) and CBD (cannabidiol). The pain and inflammation are addressed through these two active ingredients. CBD inhibits the inflammatory (cyclo-oxygenase) pathways that lead to redness, swelling and stiffness while providing relief from muscle spasm. Concerns of impairment from cannabis use are not a factor as CBD doesn’t cause intoxication, unlike THC. The effects are felt in the body and are non-euphoric.
THC still has an important place in the treatment of osteoarthritis. As the disease progresses and the joint space narrows, nerve involvement is a frequent complication. THC has receptors in areas of the brain, including the thalamus, which manage the perception of pain (particularly nerve pain). Pain that doesn’t stay localized to the joint and shoots down the legs, arms, or back is best controlled with THC.
THC’s intoxicating effects could be intimidating, but THC is also sedating and used for the induction and maintenance of sleep. Osteoarthritis and sleep disturbance are strongly associated. Lying supine (face and torso up) or prone (face down), or even simple movement can be excruciating and lead to frequent wakes and difficulty falling asleep. THC can assist in reducing wakes and reducing sleep latency. If the intoxication can be tolerated THC has incredible benefits.
The best option is a combination of the two active ingredients. Dried cannabis flower and oils are available in balanced (1-to-1 ratios) of THC and CBD providing all of the aforementioned benefits. Furthermore, the use of CBD with THC lowers the negative side effects of THC such as the euphoria and paranoia. Those requiring help with appropriate dosing for their ailments should seek the guidance of a physician or specialist, but CBD and THC can be used as needed for patients without complications or risk of drug interactions. Medical cannabis gives patients a valuable option. Medical and recreational avenues have pushed these possibilities to the forefront. Most people with osteoarthritis are not aware that cannabis can help. Our clinic staff and online information are available for medical cannabis users seeking a safe and legal way replace persistent pain with relief.
DR. IFEOLUWA ABIOLA, B.SC, MD.
MEDICAL DIRECTOR – 420 CLINIC LTD.