Arthritis Association CBD GUIDELINES

Arthritis Association Guidelines


ATLANTA, SEPTEMBER 24, 2019 – As the leading organization for people with arthritis, the Arthritis Foundation has just released the first CBD guidance for adults with arthritis. CBD, or cannabidiol, a plant-based compound, has become popular among people with arthritis seeking to ease chronic joint pain. With no federal oversight of CBD products, a lack of scientific evidence for safety or effectiveness, and even uncertainty about its legality, there has been vast confusion for patients with arthritis and health care providers too.

“While CBD is controversial and its effectiveness inconclusive, people with arthritis aren’t waiting to try it to treat their pain,” said Cindy McDaniel, Arthritis Foundation senior vice president of consumer health and impact. “To help gain a deeper understanding about how people with arthritis feel about using CBD, we conducted a national survey in July. Our survey results confirmed the need to push for more regulation and provide useful CBD guidance.”  

Of the 2,600 people who responded to the survey*, 79% are currently using CBD, have used it in the past or are considering using it as an alternative therapy to help manage their arthritis pain.  

To develop the CBD guidance for adults with arthritis, the Arthritis Foundation partnered with leading CBD and arthritis pain experts – Daniel Clauw, MD, Mary-Ann Fitzcharles, MD, and Kevin Boehnke, PhD – to develop practical guidance that addresses top questions.

“Millions of people in the U.S. are likely trying to use cannabinoids to treat pain, and many are doing this in ways that might cause more harm than good, especially when they use high doses of THC,” said Daniel Clauw, MD, a professor of anesthesiology, rheumatology and psychiatry at the University of Michigan and director of the Chronic Pain and Fatigue Research Center. (CBD is one of the more than 100 cannabinoids, or active compounds, in cannabis. THC, another compound, is the chemical in marijuana that gets users high. CBD is not intoxicating.)

“It’s important that the Arthritis Foundation has taken a stand on CBD,” Dr. Clauw said. “Right now, it appears to be fairly safe and might help certain types of pain. It’s far better to give this guidance, even if preliminary, because otherwise people will have no guidance whatsoever.”  

The Arthritis Foundation also sent a formal comment to the U.S. Food and Drug Administration (FDA) in July urging the agency to expedite the study and regulation of CBD products to help make them a safe option for the 54 million people with arthritis.  

The official statement from the Arthritis Foundation reads:

As the largest organization representing the voice and needs of people with arthritis, the Arthritis Foundation has always welcomed new treatment options because no single drug, supplement or therapy works for everyone. We believe patients should be empowered to find safe management strategies that are appropriate for them. The more options available, the likelier it is that more people will benefit.

We are intrigued by the potential of CBD to help people find pain relief and are on record urging the FDA to expedite the study and regulation of these products. While currently there is limited scientific evidence about CBD’s ability to help ease arthritis symptoms, and no universal quality standards or regulations exist, we have listened to our constituents and consulted with leading experts** to develop these general recommendations for adults who are interested in trying CBD.  

“Listening to people with arthritis – using data (surveys and Live Yes! INSIGHTS), patient listening sessions and testimonies – drives our work, from science to programming to setting our advocacy agenda,” said the Arthritis Foundation’s McDaniel.

The Arthritis Foundation continues to ask people with arthritis to raise their voice and share their day-to-day experiences via Live Yes! INSIGHTS, so the organization can continue to break down barriers to care, accelerate research and tailor local and national programs that fit the needs of people with arthritis.

“The Arthritis Foundation values the patient voice,” said Stacy Courtnay, rheumatoid arthritis patient and a member of the Arthritis Foundation Patient Leadership Council. “Some doctors aren’t open to discussing CBD with patients, and it’s fantastic and encouraging that the Arthritis Foundation is helping people with arthritis gain access to whatever treatments might help them.”

While there are no established clinical guidelines for CBD use, the medical experts who worked in partnership with the Arthritis Foundation agree on the following points:

  • CBD may help with arthritis-related symptoms, such as pain, insomnia and anxiety, but there have been no rigorous clinical studies in people with arthritis to confirm this.
  • While no major safety issues have been found with CBD when taken in moderate doses, potential drug interactions have been identified.
  • CBD should never be used to replace disease-modifying drugs that help prevent permanent joint damage in inflammatory types of arthritis.
  • CBD use should be discussed with your doctor in advance, with follow-up evaluations every three months or so, as would be done for any new treatment.
  • There are no established clinical guidelines to inform usage. Experts recommend starting with a low dose, and if relief is inadequate, increase in small increments weekly.
  • Buy from a reputable company that has each batch tested for purity, potency and safety by an independent laboratory and provides a certificate of analysis.

Beyond providing CBD guidance for people with arthritis, the Arthritis Foundation has a track record for bringing important issues that people with arthritis face into the public dialogue, including authoring the Osteoarthritis (OA) Voice of the Patient Report that presented treatment options most important to patients with OA and helped influence the FDA’s updated osteoarthritis research and treatment guidance and legislation calling for transparency at the pharmacy counter.

To impact the future of arthritis, visit Live Yes! INSIGHTS

*Read the survey results, “Patients Tell Us About CBD Use.”  

**Our gratitude to the following experts for their partnership and guidance:   

Kevin Boehnke, PhD, a researcher at the Chronic Pain and Fatigue Research Center at the University of Michigan, focuses on medical cannabis as an analgesic and opioid substitute in chronic pain.  

Daniel Clauw, MD, a professor of anesthesiology, rheumatology and psychiatry at the University of Michigan and director of the Chronic Pain and Fatigue Research Center, leads research on arthritis pain and fibromyalgia, and the effects of cannabis, particularly CBD, in pain.  

Mary-Ann Fitzcharles, MD, an associate professor of medicine in the Division of Rheumatology at McGill University in Montreal, Quebec, conducts research on pain and rheumatic diseases. She is the lead author of the 2019 Canadian Rheumatology Association (CRA) position statement for medical cannabis.

About the Arthritis Foundation:

The Arthritis Foundation is the Champion of Yes. Leading the fight for the arthritis community, the Foundation helps conquer everyday battles through life-changing information and resources, access to optimal care, advancements in science and community connections. The Arthritis Foundation’s goal is to chart a winning course, guiding families in developing personalized plans for living a full life – and making each day another stride towards a cure. The Foundation also publishes Arthritis Today, the award-winning magazine that reaches 4 million readers.

Claire Villines  


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Patients Tell Us About CBD Use

Managing the chronic pain of arthritis every day can be a major balancing act. Those suffering from arthritis are desperate to find ways to decrease pain and improve sleep and their overall ability to function. Today, it’s common for people with arthritis to be asked: “Have you tried CBD for your arthritis pain?”

The Arthritis Foundation recently asked this question in a survey, and more than 2,600 arthritis patients answered. People with many different types of arthritis responded — the majority of whom have been living with osteoarthritis (52%) or rheumatoid arthritis (45%) for 10 or more years.

The results were clear: People with arthritis are curious to learn more about CBD. Cannabidiol, or CBD for short, is extracted from the hemp plant, a variety of cannabis that does not have the psychoactive effects of the variety grown for marijuana. CBD-based products are booming and have become increasingly easy to buy online and in local stores and clinics. Industry reports show that people who buy CBD cite arthritis and/or pain from arthritis as one of the most common reasons for purchasing CBD.

How are people with arthritis using CBD today? And what questions do patients have about the therapy? Here’s what you shared:

1. Many people with arthritis are using CBD or have used it.

There is no cure for arthritis, but people with arthritis want to take control by managing their symptoms.

  • 79% surveyed are currently using CBD, have used it in the past or are considering using it.
  • 29% report they currently use CBD to manage their arthritis symptoms.
  • Daily use is reported by 63% percent of those currently using CBD and 26% use it several times per week.
  • Of those surveyed, 62% use a liquid form of CBD and 55% use a topical product they apply to their joints.

2. Patients are using complementary and alternative therapies to relieve their pain.

Most people currently using CBD report relief of pain, the #1 arthritis symptom.

  • 87% of those who are currently using it say they use CBD to manage their arthritis symptoms.
    • The primary reason for using CBD is to relieve pain (94%).
    • Several survey respondents indicated they use CBD products for pain because it seems less addictive than opioids; a few say they have also used CBD to help wean off opioids following joint replacement surgery.
  • 33% of those surveyed have never tried CBD but are considering it. Those not considering using CBD say their symptoms are managed by other treatments, primarily nonsteroidal anti-inflammatory drugs, or NSAIDs.

3. Respondents report a variety of benefits beyond pain relief from using CBD.

While pain is consistently cited as the most oppressive arthritis symptom in all past surveys, the disease causes many troubling effects. Of those currently using CBD to manage arthritis symptoms, roughly 3 out of 4 report it was either effective or very effective in relieving several symptoms.

  • 67% report improvement in their physical function.
  • Over 30% say it provides relief from morning stiffness and helps get them moving.
  • Three-fourths report improvements in their ability to sleep (71%).
  • Over 30% say it helped relieve symptoms of fatigue.

4. People report improvements in overall well-being, too.

CBD may be beneficial for the body, mind and spirit. People who have used or are currently using CBD report emotional and mental health benefits, in addition to relief of physical pain.

  • 41% report a better overall sense of well-being with the use of CBD.
  • Relieving symptoms of anxiety was reported by 77% of those currently using CBD.
  • 67% report effectiveness in improving depressed mood.

5. People with arthritis have questions and uncertainties about CBD and want more information from their doctor and from resources they can trust.

  • 66% report having a conversation with their doctor about CBD use.
  • Less than half (46%) were given information about it from their health care provider, pertaining mostly to its effectiveness and safety.
  • Almost half surveyed (47%) are unsure if it will be effective.

Your priorities are our mission at the Arthritis Foundation. Your patient insights are powerful — from influencing decision-makers at the FDA to informing articles in Arthritis Today magazine. Your priorities are our priorities.

Take the next step to change the future of arthritis by sharing your personal experiences in the Live Yes! Insights patient assessment. 

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