The use of cannabis as a medication for musculoskeletal pain in western medicine dates back to the 1700s. Evidence from recent research suggests that cannabis-based therapies are effective in the treatment of arthritis and the other degenerative and rheumatic hip, joint and connective tissue disorders. These are extremely painful conditions but, the well-documented analgesic properties of cannabis make it useful in treating the pain associated with arthritis, both on its own and as an adjunct therapy that improves the efficacy of opioid painkillers. But cannabis has also been shown to have anti-inflammatory properties and powerful immune-modulation, suggesting that it could play a role in treating arthritis and not just in symptom management.
This article would highlight the effects of marijuana, possible treatments for arthritis, use of marijuana in treating the problem and the risk that would be involved in it.
Effects of Marijuana:
1) It Might Affect Your Mental Health:
Not everyone’s experience with cannabis is a pleasant one. It might can leave you afraid, anxious or panicked. Using marijuana may raise your chances for clinical depression or worsen the symptoms of any mental disorders that you are already suffering from. In high doses, it can make you paranoid or even lose touch with reality so you hear or see things that aren’t there in reality.
2) You Can Get “High”:
This is the reason why most of the people use marijuana. The main psychoactive ingredient, that is THC, stimulates the part of your brain that responds to pleasure, like sex and food, which unleashes a chemical called dopamine, which gives you a euphoric, relaxed and a pleasant feeling.
3) It Might Impair Your Brain
Marijuana can make it harder for you to learn, focus and remember things. This seems to be a short-term effect that lasts for 24 hours or longer in some cases, after the individual stops smoking.
But taking cannabis heavily, especially in your teen years, may leave more irreversible and permanent effects. After running the tests on some adolescents, it was found that marijuana may physically change their brains. Specifically, they had fewer connections in parts of the brain linked to learning, alertness and memory, and tests showed lower IQ scores in some people.
4) Your Thinking Might Get Distorted
Marijuana can cloud your judgement and senses. The effects can differ depending on things like how powerful the weed was, how the person took it, and how much cannabis they’ve used in the past. It might:
- Disrupt your sense of time.
- Heighten your senses where, colours might seem brighter and the sounds might sound louder than usual.
- Lower one’s inhibitions and they may have risky sex or take other chances.
- Hurt your driving skills and make driving more dangerous.
5) Your Lungs May Hurt
Smoking cannabis can inflame and irritate your lungs. If you use it regularly, you may face the same breathing problems as someone who smokes cigarettes regularly, which would mean ongoing cough with coloured mucus. Your lungs may more easily pick up on infections. THC even seems to weaken some users’ immune systems.
6) Your New born Might Be Underweight:
Women who are pregnant and still who smoke marijuana face a higher risk of giving birth to premature or underweight babies. But researchers don’t know enough to say if those infants are more likely to grow up to struggle in school, or face issues with learning and understanding things, use drugs when they grow old, or face any other problems in life.
7) It Might Ease Your Pain and Other Symptoms
Medical marijuana is legal in some form in a majority of the parts in USA, and nearly more than 10 states and Washington DC, have legalized recreational marijuana. But the federal government’s ban on cannabis has made it hard for the researchers to study its effects on humans. Limited research shows that medicinal marijuana might help:
- Muscle spasms or stiff muscles from multiple sclerosis. People with MS report stronger improvements compared to measurements by the experts.
- Ongoing pain (This is the most common use and it’s even a well-proven benefit of medical marijuana).
- Sleep problems for those with MS, fibromyalgia and sleep apnoea.
- Nausea or throwing up from chemotherapy.
- Lennox-Gastaut or Dravet syndrome.
- Loss of appetite and even weight loss in people with AIDS.
- Seizures from epilepsy.
This treatment focuses on relieving the symptoms and improve the functioning of the joint you have issues with. You may need to try several different treatments available, or a combination of treatments before you determine what would be the best for you.
The medications used to treat arthritis vary depending on the type and severity of pain. Commonly used medications include:
- Painkillers: These medications help in reducing the pain, but have no effect on inflammation. An over-the-counter option includes acetaminophen, Tylenol and others.
For more-severe joint pain, opioids might be prescribed to the patient, such as tramadol (ConZip, Ultram), oxycodone (Roxicodone, OxyContin, others) or hydrocodone (Zohydro ER, Hysingla). Opioids act on the central nervous system to relieve the pain. When opioids are used for a long time, they may become habit-forming, causing physical or mental dependence.
- Biologic response modifiers. Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that target the several protein molecules that are involved in the immune response.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs reduce both, inflammation and pain. Over-the-counter NSAIDs include ibuprofen (Motrin IB, Advil, others) and naproxen (Aleve). Some types of NSAIDs can only be bought with prescriptions. Oral NSAIDs can cause stomach irritation and might increase your risk of stroke or heart attack. Some NSAIDs are also available as gels or creams, which can be rubbed on the joints.
- Disease-modifying antirheumatic drugs (DMARDs). Often used to treat rheumatoid arthritis, DMARDs stop or slow down your immune system from attacking the joints. Examples include methotrexate (Rasuvo, Trexall, others) and hydroxychloroquine (Plaquenil).
- Counterirritants. Some varieties of ointments and creams contain menthol or capsaicin, the ingredient that makes the hot peppers spicy. Rubbing these preparations on the skin over the aching joint may impede with the transmission of pain signals from the joint itself.
There are many types of biologic response modifiers. Tumor necrosis factor (TNF) inhibitors are generally prescribed. Examples include etanercept (Erelzi, Enbrel, Eticovo) and infliximab (Inflectra, Remicade, others).
Physical therapy can be the solution for some types of arthritis. Exercises can improve range of motion and strengthen the muscles that are surrounding the joints. In some cases, braces or splints may be warranted.
If conservative measures don’t help, the doctor might suggest surgery, such as:
- Joint replacement- This procedure removes the damaged joint and replaces it with an artificial one. Joints most commonly replaced are knees and hips.
- Joint fusion- This procedure is more often used for the smaller joints, such as those in the wrist, fingers and ankles. It removes the ends of the two bones in the joint and then locks those ends together until they heal into a single rigid unit.
- Joint repair- In some instances, joint surfaces can be realigned or smoothed to reduce pain and improve its functioning. These types of procedures can often be performed arthroscopically, i.e. through small incisions over the joint.
Who Uses Medical Marijuana for Pain?
People living with rheumatic diseases, conditions that affect joints and connective tissue, often endure severe pain, and many of them use cannabis as a treatment. One study published in the September- October 2009 issue of the Journal of Opioid Management found that 80 percent of medical marijuana users in a U.S. pain clinic were using cannabis as a treatment for myofascial pain, a type of pain that affects tissue and muscle. Among medicinal marijuana users in Canada, 65 percent claimed that they use medicinal marijuana for severe pain.
The Case for Marijuana Use in Rheumatoid Arthritis Treatment:
Medical marijuana scientific advocates claimed that there’s absolutely nothing wrong with that. “Chronic pain is a symptom of rheumatoid arthritis, and when it comes to chronic pain, we have 9,000 patient years of data showing that THC [the active ingredient in cannabis] effectively treats it,” said Jahan Marcu, PhD, chief scientific officer for Americans for Safe Access, an organization that works to ensure legal and safe access to cannabis for therapeutic research and use. Cannabinoids stop the transmission of the pain and decrease inflammation, which is very important for people with joint issues.
Specific Risks That Worry Rheumatologists:
Several rheumatologists remain cautious. Mahsa Tehrani, MD, a rheumatologist in Washington, D.C., doesn’t recommend medical marijuana to her patients because of the lack of reliable evidence and the risk of heart and mind related side effects. Some of these issues, such as heart diseases and depression, are serious health conditions, complications for which people with rheumatoid arthritis already face an increased risk.
“Given the known risks of psychiatric side effects as well as heart problems reported with marijuana, recommending this drug for rheumatic conditions seems questionable,” said Dr. Tehrani.