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Arthritis

03 June 2020

More patients turning to medical marijuana for arthritis pain

According to a recent Canadian study, people using cannabis generally had high praise for the products.

Lots of people are using medical marijuana to treat their arthritis and other muscle aches and pains, often without consulting their doctor, a new study reports.

As many as one in five patients who consult an orthopaedic surgeon for chronic musculoskeletal pain is using a cannabis product to treat them, Canadian researchers found.

"We found 20% had reported past or current use of cannabis with the specific intention to manage pain," said study author Dr Timothy Leroux, an orthopaedic surgeon at the University of Toronto. "Not just recreational users, but patients who said, 'I'm using cannabis because I want to improve pain with this condition.'"

There's also a lot of interest in medical marijuana among arthritis sufferers who haven't yet tried it, Leroux and his team found.

A lack of knowledge

Two-thirds of non-users are interested in trying a cannabis product to treat their muscle and joint pain, the researchers reported.

"A lot of patients feel they have a lack of knowledge and are staying on the sidelines while we gather more science," Leroux said.

For this study, he and his colleagues surveyed more than 600 patients who visited a Toronto orthopaedic clinic.

People using cannabis generally had high praise for the products. Nine out of 10 said it was effective in managing their pain, and four in 10 said it decreased their reliance on other pain medications. Nearly six in 10 said cannabis products were more effective than other drugs.

"This is encouraging in the face of the ongoing opioid epidemic, as we look to find safe alternatives to opioids for pain control," said Dr Yili Huang, director of the Pain Management Center at Northwell Phelps Hospital in Sleepy Hollow, New York.

"Cannabis may help decrease, or in some cases completely replace, the amount of opioid medication necessary to control pain," said Huang, who wasn't part of the study. "This may be because cannabis works on many different pain pathways in our body and can even interact with the separate chemical pathways opioids work on."

Cannabidiol does not cause intoxication

Pain patients using medical cannabis in the study were more likely to have multiple conditions, report a greater burden of pain and a greater number of painful areas on their bodies. They were also more likely to have a history of pain clinic visits, a longer time with a painful condition and a higher rate of pain medication use, researchers found. They also were more likely to use or have used pot for recreation.

While people are seeking pain relief, however, they aren't necessarily looking to get high.

The most common cannabinoid used was cannabidiol, or CBD, a marijuana compound that does not cause intoxication, researchers said.

Only about a quarter of people reported using a product with THC, which gets you high. Distressingly, the remainder of people "had no idea what they were taking", Leroux said.

The most common way people took a cannabis product was by ingesting an oil, with 60% saying they used a marijuana-derived oil, researchers said.

"We found a general trend toward more edible products and products that were non-hallucinogenic," Leroux said.

Without physician oversight

The study did reveal some concerning trends, however. Only a quarter of marijuana users said they'd talked with a physician first.

"Most people were not taking cannabis on the recommendation of a physician or seeking advice from a physician in order to take cannabis," Leroux said. "They were using it in the way they would use a drug, but without physician oversight."

That's a problem because cannabis products can have side effects and might interact with other medications, he said.

While patients might benefit from a doctor's advice, Leroux said unfortunately, many doctors shy away from conversations about medical marijuana.

"For the time being, I would suggest that you go about this with caution, and if you choose to use the product that you talk to someone more familiar with those products," he said.

Leroux presented these findings at a virtual exhibition by the American Academy of Orthopedic Surgeons. Such research is typically considered preliminary until published in a peer-reviewed journal.

Image credit: iStock

 

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Arthritis expert

Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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