Rheumatoid arthritis (RA) is a difficult disease to cope with for those who suffer from it. The pain that RA patients experience in their joints can vary from person to person, but most say their RA pain greatly affects their lives. There’s no cure for RA, but physical therapy and various medications can be prescribed to help slow the disease’s progression. These medications, along with cannabis, are a few tools that physicians may use to help RA patients achieve a better quality of life.
In a healthy person, the immune system fights off bacteria and viruses. Rheumatoid Arthritis is an autoimmune disease where the immune system begins attacking healthy body tissue. A patient with RA has an immune system that misfires, sending antibodies to the lining of the joints, where they attack the surrounding tissue that protects the joint.
A thin layer of cells called synovium covers joints. In RA patients, these cells react, becoming sore and inflamed. The reaction releases chemicals that damage nearby bones, cartilage, tendons, and ligaments. If left untreated, these chemicals gradually cause the joint to lose its shape and alignment and can destroy the joint completely.
Short answer—we just don’t know. Various theories of why the immune system attacks the joints have been suggested, such as a being triggered by an infection, but none of these theories have been proven. Some experts suggest that rheumatoid arthritis can run in families, but there is weak evidence pointing to a genetic component to the disease.
Because rheumatoid arthritis is more common in women than men, it’s also thought that the hormone estrogen may play a part. Additionally, there is some evidence that suggests that people who smoke have an increased risk of developing rheumatoid arthritis.
In the early stages of RA, you may not notice the telltale signs of redness or swelling in your joints. You may also start to experience joint pain, tenderness, swelling or stiffness that doesn’t go away for six weeks or more. If you get up in the morning each day, and you’re still struggling with stiffness after a halfhour, it might be a symptom of RA.
Typically, more than one joint is affected and you’ll probably notice pain in your wrists, hands, and feet first. Many people with RA also find that the same joints on both sides of the body are affected, indicating it’s not just an injury. It’s also normal for patients with RA to complain of fatigue and some report a low-grade fever. RA symptoms may come and go, making it hard to diagnose.
There is no blood test that definitively detects rheumatoid arthritis, but doctors can use a combination of physical examinations and other testing to search for the rheumatoid factor. A rheumatoid factor test is one blood test used to help pinpoint a diagnosis of rheumatoid arthritis. Patients with RA often have an elevated erythrocyte sedimentation rate or C-reactive protein, which may indicate the presence of an inflammatory process in the body. Other blood tests may look for anti-nuclear antibody or anti-cyclic citrullinated peptide (anti-CCP) antibodies.
Besides RA, a number of other diseases and conditions can raise rheumatoid factor levels, including cancer, inflammatory lung diseases, such as sarcoidosis, mixed connective tissue disease, Sjogren’s syndrome, and systemic lupus erythematosus. Many of these conditions can co-occur with RA, making diagnosis tricky.
Disease-modifying anti-rheumatic drugs (DMARDs) attempt to slow or stop the progression of RA by interrupting the immune process that promotes inflammation. These drugs can take up to six months to be fully effective, so they are often used along with glucocorticoids to help ease pain. Hydroxychloroquine sulfate (Plaquenil) is one of the more common DMARDs that are prescribed to RA patients.
Additionally, physicians may recommend NSAIDs, analgesics and corticosteroids to treat RA inflammation. These medicines should only be used for brief periods as they can cause severe digestive tract problems.
Cannabis doesn’t cure RA, but anecdotal evidence shows that patients find that it helps ease their joint pain. The use of cannabinoids for the relief of pain associated with RA has only been assessed by one study. The 2005 study revealed that, in comparison with placebo, the cannabis-based drug Sativex was associated with significant improvements in certain pain parameters and quality of sleep.
Research tells us that the endocannabinoid system has an impact on pain mechanisms, immune function, inflammation, and bone health. In the setting of arthritis, it’s thought that the endocannabinoid system becomes activated locally in response to tissue changes and functions as an endogenous pain modulator. However, this mechanism has not been thoroughly studied, and much more research is necessary before we know how cannabis might work to specifically target RA pain.
One important consideration for RA patients is the route of administration of their cannabis. Research shows that as many as one in 10 people with RA develop lung problems over the course of their lives, and RA can make a patient susceptible to scarring of the lung tissue. Luckily, medical cannabis that from a dispensary comes many forms that do not involve smoking. Many RA patients find that tinctures, edibles, topicals, and patches are best-suited to help to treat their RA pain.
Leafly suggests that to find a dispensary product to help with arthritis, choose strains that are CBD-dominant. The natural anti-inflammatory properties of these strains may provide relief from painful symptoms.
We asked Ohio patients with RA how they medicate now that they have legal access to medical marijuana. This is what Susan S. said: “I have RA and have so much relief from cannabis products. The topical cream reduces the inflammation in my hands and low back, as does the CBD gummies. The pomegranate Wana gummies are really good pain relief, without the inability to drive, etc.”
Ohio patient Gretchen C. also mentioned that indica gummies are helpful, especially at night. She said she uses Wana blueberry Indica gummies for sleep and the strain Orange 43 for daytime pain.
Another medical cannabis choice that a few Ohio patients noted worked for their RA pain was RSO/FECO oil.
Do you have RA and want to see if medical marijuana might help treat your symptoms? Reach out to us today to schedule a consultation.
Author: Gabrielle Dion Visca
Gabrielle has been writing and editing professionally for the medical and wellness industries for more than 20 years. She’s held positions with The Journal of Pediatrics, Livestrong, The Cincinnati Enquirer, and Patient Pop. She currently writes articles about medical marijuana for Duber Medical, and is the founder of the Ohio cannabis journalism non-profit, MedicateOH.