Psoriatic arthritis (PsA) is type of arthritis that affects individuals living with psoriasis, a condition that includes red patches of skin with silvery scales on the surface. It is normal to develop psoriasis first, followed by the psoriatic arthritis diagnosis, but it is possible to have joint issues before the skin lesions appear.
It is estimated that anywhere from 18% to 42% of people living with psoriasis in Europe and North America develop PsA. An estimated 36% of America’s 7.5 million psoriasis sufferers have PsA, and up to 40% of people with the condition didn’t know they had the disease and had never been diagnosed with it before.
Symptoms of Psoriatic Arthritis
This is a chronic condition that becomes worse with the passage of time. However, it is normal to see your symptoms improve briefly and also to experience spells where symptoms become worse. PsA can affect joints on one or both sides of your body and its symptoms, which are similar to those associated with rheumatoid arthritis, include:
- Extremely painful swelling of the fingers and toes. You could also develop deformities in your hands and feet before you have major symptoms.
- A lower back condition called spondylitis, which inflames the joints between the vertebrae of the spine.
- Pain at the points where the ligaments and tendons attach to your bones. This pain is especially common at the back of the heel and sole of the foot.
PsA is a progressive condition, which means early diagnosis and treatment is crucial to decrease the risk of irreversible joint damage. When the condition is caught relatively early, physicians can use medication to treat the arthritis.
Diagnosis, Outlook, and Traditional Treatments
PsA is caused by your body’s immune system attacking healthy cells and tissue. The result is inflammation of the joints and excessive production of skin cells. While scientists are not sure what causes the immune system to behave in this manner, it seems as if environmental and genetic factors play a significant role.
A large proportion of people with PsA have a family history of the condition or psoriasis. It has been found that certain genetic markers are also associated with the disease. In some cases, a viral or bacterial infection can trigger PsA in people with a family history of the condition. Risk factors include:
- Age: Psoriatic Arthritis is most common in people aged 30 – 50.
- Family History: You are at greater risk if a parent or sibling has the disease.
- Psoriasis: You are especially likely to get PsA if you already have psoriasis, especially if you have lesions on your nails.
Physicians face major challenges in trying to identify the condition. Most notably, the lack of standardized criteria coupled with the fact that five different individuals with PsA could see five different types of medical professional. For instance, you could see your physician, a rheumatologist, or a dermatologist for a diagnosis. That said, we recommend seeing a doctor if you have joint problems that appear to be getting worse. Today, it is possible to diagnose a large percentage of people with psoriatic arthritis via patent history and a physical exam alone.
If you have PsA, everyday tasks are a struggle because you could be in constant pain. A small percentage of sufferers develop a severe and debilitating form of the condition called arthritis mutilans. Eventually, this form of psoriatic arthritis will destroy the small bones in the hands, leading to permanent disability and deformity. Individuals with PsA are at higher risk of cardiovascular disease and may also develop ocular conditions such as uveitis or pinkeye.
It is common for physicians to prescribe NSAIDs to help deal with the pain and inflammation. Other options include protein-based drugs called biologics, acupuncture, antidepressants and DMARDs. Side effects of these treatments include possible liver and kidney damage, stomach irritation, and heart problems. Perhaps this is why an increasing number of people are looking towards CBD as a potential way to alleviate the symptoms of PsA.
Can CBD Help Treat Psoriatic Arthritis’ Symptoms Effectively?
Although research relating to CBD’s effect on PsA is relatively thin on the ground, it is important to remember that the condition is essentially a form of arthritis. Also, there is detailed research that suggests cannabidiol could help alleviate the inflammation, swelling and pain associated with psoriasis.
There is a myriad of studies that appear to support the view of CBD offering arthritis pain relief. Overall, arthritis affects 50 million Americans. Osteoarthritis and rheumatoid arthritis are the two most common forms. A 2011 study* by Schuelert and McDougall, published in Neuroscience Letters, discovered that CBD helped to reduce inflammatory pain in rats. The marijuana compound affected the way the rodents’ pain receptors responded to stimuli.
Perhaps more pertinently, a 2016 study* by Hammell et al., published in the July edition of the European Journal of Pain, determined that topically applied CBD had the potential to relieve the inflammation and pain associated with arthritis. In this study, CBD gels of four different strengths, ranging from 0.6mg to 62.3mg per day, were applied to rats with induced arthritis over four consecutive days.
The research team found that 6.2 mg and 62 mg a day were effective doses, as the CBD gel “significantly reduced joint swelling, limb posture scores as a rating of spontaneous pain, [and] immune cell infiltration.” Moreover, there was no alteration in “exploratory behavior” which suggests a limited effect on higher brain function – hardly a surprise since CBD is non-intoxicating.
The reason why CBD, and other marijuana compounds, are potentially effective against arthritis pain is because of their relationship with our endocannabinoid system (ECS). Weed’s cannabinoids attach themselves to specialized receptors in the brain and immune system. It is suggested that the CB2 receptor is what manages pain and inflammation in the immune system, and recent research suggests that CBD possibly attaches to CB2 receptors to trigger a better ECS response.
An alternative theory suggests that the body produces natural cannabinoids in the ECS which attach to the CB2 receptors. In essence, scientists now believe that CBD has an impact on how these receptors respond to the signals they are sent, which could be the reason for the reduction in inflammation and pain.
What About Anecdotal Evidence?
The trouble with anecdotal evidence is that you never know whether a change in environment or lifestyle had as much to do with a sudden improvement as the supposed ‘wonder drug’. Even so, there are a lot of positive stories involving cannabis and psoriatic arthritis. California-based writer, Cynthia Covert, suffers from PsA (and fibromyalgia) and once described herself as a “chronic corpse.”
She was confined to a wheelchair and, for 12 years, the pharmaceutical drugs she received failed to improve her condition. Cynthia used biologics, Valium, opioids, and muscle relaxers, but to no avail. In 2013, one of her friends (who had cancer) suggested that Cynthia start using medical marijuana.
Within three weeks of beginning weed-based treatment via the consumption of edibles, Cynthia regained the use of the pointer finger and thumb on her left hand. Her use of the wheelchair was reduced by 80% and she found that using topical CBD on her psoriasis cleared up her skin condition. Although it took longer to work than pharmaceuticals, the CBD cream ensured the patch did not return.
Final Thoughts on CBD For Psoriatic Arthritis
Please remember that PsA and psoriasis are completely separate conditions. While there is plenty of CBD-related research on the latter, there isn’t a great deal on the former. However, there are hundreds of studies which seem to suggest that medical marijuana, especially CBD, is potentially capable of alleviating chronic pain in people living with other forms of arthritis.
CBD’s connection with our ECS is fascinating and could explain why it is championed as an effective painkiller by an increasing number of users. Researchers believe that cannabidiol could affect receptors in the brain and immune system, resulting in reduced pain and inflammation. Alas, a LOT more research is required before it becomes reasonable to act as advocates for CBD to treat conditions such as psoriatic arthritis. Therefore if you are thinking of going down the CBD route it is extremely important to consult with your primary physician before any use.
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