Cannabidiol (CBD) for Joint Health in Aging Adults

For the aging population, maintaining joint health becomes increasingly important to preserve mobility, independence, and overall quality of life. Traditional treatments such as NSAIDs, corticosteroids, and physical therapy remain mainstays, but many older adults are seeking complementary approaches to improve quality of life and reduce reliance on pharmaceuticals. Cannabidiol (CBD), a non-psychoactive compound derived from Cannabis sativa, has gained attention for its potential anti-inflammatory and analgesic properties. CBD is known for reducing pain and arthritis symptoms, and emerging research suggests it may also promote collagen production and protect joints from damage during aging.

Osteoarthritis (OA) Clinical Studies

Numerous human trials have shown that cannabinoids can help manage chronic pain, with a few specifically examining the effects on osteoarthritis (OA).¹

A study evaluating the patient-perceived effect of CBD on OA symptoms showed that pain intensity was 84.8% better, physical function 71% better, and sleep 67.1% better. Multiple joints were affected, listed in descending order, including knee, hand, hip, shoulder, wrist, ankle, and elbow. Validated scoring systems were used as indicators of clinically important benefit. The study showed that CBD may be more effective in patients with OA compared to rheumatoid and other autoimmune arthritis groups.¹

A randomized, double-blind, placebo-controlled trial assessed whether 12 weeks of CBD gel would reduce knee pain due to OA. Patients (n=320) received 250 mg CBD, 500 mg CBD, or placebo in 2 divided doses. 250 mg CBD was significantly better than placebo for improving the responder analysis, defined as an average weekly improvement in worst pain score of ≥30%, and a decrease in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) physical function subscale of at least 20% at the last observation. Men had a more favorable effect compared to women.²

Trials on CBD for hand OA are mixed; however, those using topical CBD preparations showed pain reduction and improved grip strength. Efficacy may depend on dosing, form (natural versus synthetic), and delivery (topical versus oral).^3–5

How Does CBD Control Joint Pain?

The body’s built-in endocannabinoid system (ECS) regulates pain signalling among numerous other physiological functions. Endogenously produced cannabinoids and their receptors are located throughout the body, including in articular cartilage and joint synovial tissue, which are damaged in OA.^1,6 The ECS is upregulated in synovial tissue and fluid from OA patients, indicating that the ECS maintains joint homeostasis.^6,7 Preclinical models show that activating the ECS enhances the survival, migration, and chondrogenic differentiation of mesenchymal stem cells to preserve cartilage.⁸

CBD shares a similar structure with endocannabinoids and engages not only cannabinoid receptors, but also other receptors involved in pain regulation. It blocks the reuptake of endocannabinoids, activates vanilloid receptor 1 (TRPV1) and certain G-protein-coupled receptors, and enhances the function of serotonin 5-HT1A receptors. These interactions contribute to its antioxidant, anti-inflammatory, and pain-relieving effects.^4,9

CBD reduces inflammation and pain behaviors in animal models with arthritis.¹ CBD reduced inflammatory cytokine infiltration into the joint, swelling, and thickening of the synovial membrane, and prophylactic treatment prevented pain and nerve damage in OA joints. Effects were dose-dependent.¹⁰

CBD: A Safer Alternative

The aging population may have obstacles to overcome regarding CBD use. A survey on CBD use showed that patients using CBD were younger than patients who had not used CBD. Of the participants who had not tried CBD for arthritis pain, 49.6% needed more information or evidence, and 24% were concerned about side effects.¹ Healthcare practitioners can provide evidence-based information to patients about this safe and effective therapy, which helps manage osteoarthritis pain and maintain overall healthy aging.

CBD is a safe alternative to pain medications and does not have abuse potential. Survey data shows that over half of individuals taking CBD can reduce or discontinue opioids, acetaminophen, and anti-inflammatory medications, which can have serious side effects with chronic use.¹

CBD is generally not associated with major adverse effects.¹¹ The most frequently reported mild side effects include dry mouth, drowsiness, appetite changes, dry eyes, impaired concentration, dizziness, headache, and digestive complaints.^1,12 Selecting a high-quality CBD product minimizes adverse effects linked to mislabeling.¹³

Adding CBD to Your Osteoarthritis Toolbox

Research suggests CBD may help alleviate OA symptoms, improve physical function, and enhance sleep quality. CBD interacts with the body’s endocannabinoid system and other pain-regulating receptors to reduce inflammation and joint discomfort. It is generally well-tolerated and poses a low risk of side effects or addiction, making it a potentially safe supplement for aging individuals. Evidence supports CBD’s role in reducing reliance on conventional pain medications and improving the quality of life for those managing joint conditions.

References

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2. Hunter D, Oldfield G, Tich N, Messenheimer J, Sebree T. Synthetic transdermal cannabidiol for the treatment of knee pain due to osteoarthritis. Osteoarthritis and cartilage. 2018;26:S26.
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11. Iffland K, Grotenhermen F. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research. 2017;2(1):139-154.
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