What is rheumatism?
Rheumatism is a collective name for more than a hundred different conditions of the joints, muscles and tendons. In the Netherlands an estimated 2 million people live with a form of it. The most common are inflammatory rheumatism (such as rheumatoid arthritis), osteoarthritis and soft tissue rheumatism.
The causes differ per type. With inflammatory rheumatism the immune system plays the main part: the body attacks its own tissue, which causes chronic inflammation. With osteoarthritis it is more about wear of the cartilage between joints. On the surface the symptoms resemble one another (pain, stiffness, limited movement), but the approach differs a great deal per type.
How is rheumatism treated at the moment?
Rheumatism cannot currently be cured. Medical care focuses on slowing the disease process, managing symptoms and preserving mobility. Rheumatologists work with a combination of medication (often DMARDs or biologicals for inflammatory rheumatism, painkillers for osteoarthritis), physiotherapy, lifestyle adjustments and sometimes surgery.
Many people with rheumatism also look at additional ways of dealing with their symptoms. Nutrition, exercise, relaxation techniques and supplements are widely discussed. One of those supplements is CBD.
What is the endocannabinoid system?
To understand why research is being done into CBD in relation to rheumatism, it helps to know first what the endocannabinoid system (ECS) is.
The ECS is a system of the body’s own that was discovered in 1992 and has been researched worldwide ever since. It consists of receptors (CB1 and CB2) spread throughout the body, and of signalling compounds the body makes itself. The system plays a role in processes such as immune regulation, the experience of pain, sleep, appetite and mood.
Cannabinoids from the hemp plant, including CBD, can act on this system. Exactly how and with what effect is the subject of active scientific research. Much of that is still at an early stage.
What does research say about CBD and joint inflammation?
Scientific research into CBD and rheumatic conditions is still in its infancy. There are pre-clinical studies (in the laboratory and in animals) and a handful of small human studies that looked at effects on inflammatory processes or the experience of pain.
The recent reviews conclude that the body of evidence is still too limited and methodologically too weak to recommend CBD as a treatment for rheumatism. Large, long-running clinical studies among rheumatic patients do not exist at this point.
Important: neither ReumaNederland nor the Dutch Society for Rheumatology currently recommends CBD as part of rheumatological care. If you are considering using CBD alongside your regular treatment, it is best to do so in consultation with your treating rheumatologist.
What if you want to try CBD?
CBD is legally available in the Netherlands as a food supplement, provided the THC content stays below the legal limit. It is not a medicine and is not sold as one.
If you want to try CBD alongside your regular care, these are a few sensible steps:
- Consult your doctor or pharmacist first, especially if you take medication. CBD can affect how certain medicines work (including some blood thinners, antidepressants and anti-epileptics).
- Start low, 10 to 20 mg of CBD a day for instance, and build up calmly over a few weeks. Whether you experience anything, and what that is, differs per person.
- Keep your expectations realistic. Research is still limited, and what one person experiences, another does not.
- Choose products that are transparent about their composition and that publish an independent lab report per batch.
Different forms of CBD
CBD is available in various forms, each with its own absorption profile:
- CBD oil is dropped under the tongue and absorbed through the mucous membrane of the mouth. Fast onset.
- Capsules or edibles are absorbed through the digestive tract. Slower, but working for longer.
- Products for the skin (ointments, balms, patches) are for local use on a specific area.
Which form suits your situation depends on your preference and any advice from a doctor.
Frequently asked questions
Is CBD a treatment for rheumatism?
May I combine CBD with my rheumatism medication?
How much CBD per day is used in research?
Is CBD reimbursed by health insurance?
Do rheumatologists recognise CBD as a treatment?
Sources and further reading
- ReumaNederland: reumanederland.nl
- Dutch Society for Rheumatology: nvr.nl
- PubMed search term “CBD AND arthritis”: pubmed.ncbi.nlm.nih.gov
This article is informative and not medical advice. For complaints or questions about your health, consult your doctor or another healthcare professional. CBD is a food supplement and not a replacement for medical treatment.
