Osteoarthritis

#013: The Role of Cannabinoids in Management of Osteoarthritis

Arthritis is like an umbrella word that has over a hundred subcategories of inflammatory disorders. Not just limited to the elderly population, arthritis is the leading cause of disability in the United States. In this episode, I’m going to talk about the causes and treatments for osteoarthritis. Stay tuned for the next episodes which will cover gout and rheumatoid arthritis and how to manage the pain for those diseases.

Cartilage is the substance between bones that prevents the bones from rubbing against each other, but as we age, the cartilage begins to wear and tear. Eventually, it’s just the bones rubbing against each other. Pain, swelling, and inflammation are just a few of the symptoms of osteoarthritis.

As we get older, our body kind of becomes rebellious, so age is a big factor in osteoarthritis. Other risk factors include being a woman, diabetes, genetics, or being overweight or obese. That makes sense when you think about the effects of all of the extra weight on the body.

While there is no cure for osteoarthritis, we can manage it with both non-pharmacological and pharmacological therapy. It is always best to start slow and try non-pharmacological therapies first. I share some common treatments for pain management, and their common side effects. Many of the side effects are exacerbated by other drugs the elderly population may be taking, so great care should be taken when pursuing a pharmacological treatment plan.

There are many, many anecdotal testimonies about the benefits of cannabinoid-based products in the treatment of pain management. We know from studies that THC has 20 times the anti-inflammatory properties of the currently popular NSAIDs that are normally prescribed for osteoarthritis. We really need to start backing up the anecdotal evidence we have with scientific studies that will offer us solid proof about the efficacy of cannabinoids in the treatment of chronic pain.

What’s Inside:​

  • The symptoms and causes of osteoarthritis.
  • Because it causes tremendous pain for patients, many other conditions become interwoven within OA.
  • Topical creams, balms, and steroid shots can all help to address the pain right at the source.
  • We must educate patients about how this disease is going to progress.
  • According to studies, THC has 20 times the anti-inflammatory properties of NSAIDs.

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Transcription:

TRANSCRIPT

This show is for educational purposes and should not be taken for a doctor’s advice. Welcome to Let’s Talk About Medical Cannabis with Doctor O. A clinical pharmacist certified in medical cannabis. Every week, you’ll learn about alternative ways to improve your health and well-being, using the powers of healing botanicals.

Hey, guys, thank you for joining me on Episode 13 of Let’s Talk About Medical Cannabis with Doctor O. I’m Dr. Lola Ohonba. I’m a clinical pharmacist certified in medical cannabis. I’m also the CEO of WCI Health, alternative health and wellness store. At WCI Health, we help people get and stay well, using the healing powers of botanical. Thank you for joining this episode. On today’s episode, we’ll be looking at the role of cannabinoid in the management of arthritis. But before we get into today’s details, so let me just say a shout out to our sponsor. This show is sponsored by WCI Health. At WCI Health, we help people get and stay well, using the healing powers of botanicals such as cannabinoids. They are the manufacturers of Glows beauty. It’s a line of health and skin care CBD infused product. So do check their products out online. WCI-Health.com. We also carry high quality, CBD product, tincture, ointment, whatever you need.

And also products for your pet. So do check it out online at WCI-Health.com. Also like to say thank you to our sponsors. All our sponsors, we want to say thank you for those supporting us. And if you have not join or subscribed to this show yet, please do subscribe. There is a link on our website where you can subscribe. And to be a sponsor, to be a donor to this show, to support this show, you can check out any information that you need on the Web site or sign up with our Patron group. Thank you, guys, so much for joining me today.

On today’s show, we’ll be looking at the role of cannabinoid in the management of arthritis. So what is arthritis. When you hear the word arthritis, people think, oh, this is supposed to be older people for elderly population. These are people that are affected by this condition. Not at all.

Arthritis is like an umbrella word that has over a hundred subcategory of inflammatory disorder. So basically a charities involve inflammation of your joints. All the joints of the body is inflamed. Now, when this happens, people experience swelling, they experience pain the joint so they have so many arthritis conditions.

So it’s not just for elderly population, it also happens in younger population. So what are these signs and symptoms of arthritis? It involves swelling and tenderness of various joints of the body. It involves stiffness, decreasing motion range. The symptom worsens with age and can become a chronic condition.

Arthritis is the leading cause of disability here in the United States. And arthritis pain can result in inability to do basic daily work, such as walking, climbing or even opening a bottle. Just to open a bottle can become really, really stressful for people going through this condition. So we have various arthritis condition. Example is osteoarthritis that we call OA. Rheumatoid arthritis. That’s the autoimmune disorder. Then we also have Psoriatic Arthritis. This is an Auto Immune Disorder. We have gout. This has to do with inflammation of more of a dietary arthritis apart from rheumatoid arthritis.

So today, like I said, we’ll be focusing on OA. Osteoarthritis. What is osteoarthritis? In our upcoming episode, we will look at rheumatoid arthritis. We will look psoriatic arthritis. Then we will also look at gout, but today will focus on OA. So what is OA? This is a degenerative disorder. The cartilage is between the joints of the bone and the cartilage prevent the bone from grinding against each other. So all parts of the joints of our body has a cartilage. It’s kind of slippery, very slippery, it’s not a bone. But it’s in the form of a bone, but it’s not really a bone. It’s kind of slippery. So when bones glide on it, it makes the bone easier to move. Also, the cartilage is surrounded by what we call sign novia fluid. This fluid also helps in the range of motion in every joint of our body.

So just like I said, cartilage prevent the bones from rubbing against each other. So as time goes on, as we age, this cartilage begins to wear the wear and tears of our lives reduce the cartilage that we have in the joint. When this happens, the bones begins to rub against each other. So when the bones start rubbing against each other, that’s when we start experiencing pain.

People start experiencing pain at the joint. And as the pain progresses, it can start affecting the fluid surrounding the cartilage and the bone. That is the sign novia fluid. When these parts of the body is inflamed then you’ll have not just pain. Then you have swelling, which we also call inflammation of the joint.

So for osteoarthritis, what are the symptoms that we can see from osteoarthritis? Some of these symptoms, like I said, pain, swelling. This is due to the inflammation of the soft tissue surrounding the affected joint. Even though we have bones in our joint, we also have soft tissue surrounding these bones. So inflammation of these areas of the body leads to pain and swelling. That’s also stiffness and tenderness. There is reduced flexibility.

And that will make sense. You know, when you are going through pain, when you have a swollen ankle or a swollen finger, you don’t want to move so much. So you start feeling that tenderness. Because of that tenderness, you are unable to move, so that reduces flexibility. And as time goes on, if this is not managed effectively, it can also result in what we call bone spurs.

So what are the risks of osteoarthritis. Age is a big factor as a everything in life is all about age. As we grow older, the body also kind of becomes rebellious sometimes. So the older we are, the greater the risk of us having osteoarthritis. Also it affects sexes. And what I mean by that. For the female population, there tends to be affected more than their male counterparts.

And also people do have on the heavy side, obesity. And that will also make sense with the extra weight dies or pressure that has been exerted on the joints of the body. This can also lead to OA of the weight bearing part of our body like the hip bones and the knees. And apart from obesity, age, sex, also, this can be a genetic related. You can have a genetic predisposition to this disease. So that we can’t really explain why some people we have this tendency to have one disease and some people do not have the same tendency. Basically, it could be due to mutation when genes are mutated, things change in our lives.  So apart from genetic predisposition, diseases like diabetes are also a risk factor for osteoarthritis.

So what are the complications, the result of having this disease? Some of the complication that results from osteoarthritis include uncontrolled pain. This could lead to a reduced quality of life. And now, when we go through pain, really, you’re not able to do a lot of things. You’re unable to have fun when you are going through pain. So this can reduce quality of life. Apart from that, when you are not going through. You are not having fun like you wanted to have fun, this could lead to depression. So some of the results of disease like osteoarthritis could result in depression. It could result in sleep disorder. And that will also make sense if you are going through pain. You have a swollen ankle, swollen feet. You can’t sleep. So are these other diseases tends to interwoven when we talk of painful conditions like OA.

So I’m sure some people will say, How do we cure, What are the cures for this condition? There’s really no cure for osteoarthritis, but we can manage its with pharmacological therapy that is the drugs. Or we can manage it with non-pharmacological therapy. But first of all we want or try non pharmacological therapy. Basically what that means is we try means of doing things that doesn’t involve drugs. So the first non-pharmacological therapy that we use when we are managing or is education, we have to educate patient about the extent of the disease progression because the disease starts slowly then it stops progressing.

So as it progresses, the way we manage is changed and we have to prepare patient and we have to prepare people for what to expect. When you know what to expect in this situation, you can get yourself ready for you.

You can find other ways of managing whatever side effect, whatever uncomfortable situation that is coming. So we have to educate patient about how this disease is going to progress. Apart from that, for people down on the heavier side the best way to go about it is diet and exercise. We have to use dietary and weight control to manage the disease. So if one is able to shed, lose a few pounds and watch the food that can help with the weight bearing joints of the body. Other than diet and weight loss, we can do exercise.

This helps to maintain our restore joint range of motion. So it doesn’t have to be thirty hours of gym. You know, we can just like take a walk. When it comes to exercise, I just say start slow, go slow. You don’t have to follow other people’s way of doing things. Normally, I when I try to walk, I just take a slow walk. I walk like 30 minutes and I go back home. Some people run. Some people walk. Some people ride by. Whatever works for us is what we should do. We shouldn’t have to be pressured to do what other people are doing. So the exercise helps to restore the joint range of motion.

It also reduces the pain and muscle spasms due to the inflammation dies going on around a joint. That’s what exercise does for us. So when we have tried exercise and we have tried diet and we have tried education, and we’re still having a problem. The other means that people try that are non-pharmacological means: surgery. But surgery is going to be the last resort I take before we’re going to surgery, people will probably try pharmacological therapy first. But these are some of the surgery that we do is based on people who are unable to function effectively or not responding to pharmacological therapy. So basically, if you are using medication and is not working effectively then we’ll look into surgery.

Some of the surgical procedure that are available are joint fusion, osteotomy, and the arterial patch? This are some of these surgeries that is available to help manage the pain and the inflammation due to OA. So for pharmacological therapy, that means the drug. The drug is targeted at the pain relief. The main purpose of using the medication is to help control the pain and also to help control the inflammation.

So far, the mild to moderate pain, we use topical cream. We can use the topical cream. You can use the balm. You can use an ointment. Example of the creams and ointments and the balms that we can use are Glucosamine, coroutine. These are the natural substance that is found in our joint. So sometimes when the ones in our joint is not functioning well, we can supplement with glucosamine, chondroitin and some over the kind of medication contain some of these. Another topical product that can be used is capsaicin.

These are localized effect. Basically what localized effect means is that it doesn’t really absorbed into your bloodstream, it doesn’t absorb into your system. It’s just topical at that particular localized area. That’s how this one works. Other than capsaicin we can also use pencet, and we can also use of vutarin gel. Depencet and votary gel these are topical what we call nonsteroidal anti-inflammatory product. These are examples like diclofenac. They are anti-flammatory but you use it topically. Other than that, for the pain and we can also use. I said acetaminophen, which is Tylenol. The brand name is Tylenol. But we want to make sure when we use Tylenol, acetaminophen or paracetamol, as it might be known in Europe or other parts of the world. We want to make sure we are not exceeding four grams per day because over four grams per day, that could result what we call liver damage. So we do not want to exceed four grams of Tylenol per day.

Apart from that, other medication that people buy over the counter, contain Tylenol. I swear sometime it contain. Say, your cough medicine, or your cold medicine sometime they have additive additional Tylenol in there. So we have to be very careful to make sure we don’t exceed that four grams. So for patients with inflammation like the topical ones are for the pain, for the inflammation, we can use the oral nonsteroidal anti-inflammatory products.

Those are NSAIDS. The NSAIDs examples of NSAIDS, ibuprofen, naproxen, miloxacin, but for this nonselective, the ibuprofen, miloxacin, naproxen, these are what we call nonselective. So basically it means it combines to any receptor or in the system that binds to do those particular drugs. They are not selective. And some of the reason why we try to be careful when we use product like that is that it tends to have side effects of GI, gastro intestinal bleeding. There’s a potential for gas, gastro intestinal bleeding. We said like ibuprofen, miloxacin. All especially for people that have history of ulcers.

Those that have a history of ulcers, we have to be careful when they are using medication like that. So sometimes for those patients in that population or for the elderly that have a risk for G.I. gastrointestinal bleeding, they can’t combine or have a combination product like maybe they add what we call proton pump inhibitors. The proton pump inhibitor, those are like your omeprazole, like Prilosec. What that does is helping the lining of the wound. So your stomach really. So when it helps into a lubricating lining of your intestine that prevents the G.I. bleeding.

Well, we still got to be careful when we are using instead NSAIDS. Other products that we use it’s also an NSAID, but it’s a selective NSAID. That is the cost to selective inhibitors. These are your Celebrex. The Celebrex, kind of a little better than the ibuprofen because they are selective. They don’t just bind to everything. They bind specifically to a specific receptor, but they also have their own side effects as well. So the side effect for the selective NSAID, like Celebrex, the rate of G.I. bleeding or ulcer is lower in those products. The rate of G.I. or ulcer is lower for Celebrex because it’s selective.

But the side effect that comes with that. There’s the potential for cardiovascular side effects like for people with heart disease. They have to be very careful, like myocardial infection, like, you know, strokes, heart attack and things like that. So basically, for people with heart disease, they have to be a little bit careful when they are using products like Celebrex. So other than NSAID, the other part of your drug that we also use are the steroids. The steroid, the corticosteroids are NSAID too. The corticosteroids, I mean the corticosteroids are exactly what we call them. They are steroids and they are the most effective ways of treating inflammation.

So when we use steroid, we’re using it not for the pain, we are using it for inflammation. But we also have to be careful because our longer use of steroids can result in other side effects. Like you can’t have all the major side effect when it comes, especially when you use the injection steroid injections. So we have to be very, very careful. It causes increase in weight and a whole bunch of other endocrine side effects. So we want to be careful when we are using steroid ingestion as well.

But other than steroid injection, we have what we call hyaluronic acid injection. The hyaluronic, they are a natural product that is found in our joint. These are naturally found around the cartilage, but as we grow older and we age, and this cartilage wears out. These hyaluronic acids that is supposed to happen side novia fluid with lubrication, it reduces. So what does hyaluronic acid do? It provides lubrication and reduces shock. It’s kind of like a shock absorber and helps to reduce us from falling. When we move fast like you want, you walking and suddenly turn or twist. Well it helps you to not break your leg or break your bone, that is the synovia fluid and the hyaluronic acid that is in that joint. So when we have a reduced level in our body, there’s a potential to break our bone. So now they are having it in forms of injections so people can have injections.

And I’m sure a lot of people out here, there are a lot of other topical products that are now being supplemented with hyaluronic acid and at WCI Health, some of our products that we are about to launch in the Glow beauty lines are going to have a hyaluronic acid. So we’ll be launching those product towards the end of June. So you need to stay tuned for those products. So what does that do? It’s being, it’s a kind of supplement. It supplements what your body does not have.

So after using all these other products and we’re still going through pain. We’re still going through inflammation, the other alternative that people tend to go to is the opioid. And basically opioids, what that does is help with the pain when the pain becomes severe. Opioids like oxycodone, hydrocodone, hydromorphone, fentanyl. These are some other alternatives that patients are left with. But as we all know, there’s a risk of opioid addiction, or opioid overdose that has been so many issues with opioids of late. So everybody is trying to reduce the level of opiate and we are trying to all get a safer alternatives to patients.

So I having said that. So what do we do? How does cannabis cannabinoid products? How are they able to help in this field for patients? They have tried all these other alternatives. And you’re still having problems? How can cannabis help? Cannabinoids have been shown to reduce pain associated with osteoarthritis. One of the number one reason why people use cannabis is for pain. It’s been documented for generations, for years and years and years, centuries ago. They’ve been using cannabinoids-based product. The doctors were prescribing it for their patients to treat fibromyalgia and people were using cannabinoid product of for childbearing pain.

So it’s also used in the pain of osteoarthritis. According to a study that was done, THC is said to have 20 times anti- inflammatory properties of NSAIDs. NSAIDs are the ibuprofen and like I said earlier, those are like the go-standard when you are trying to treat inflammation. The gold standard that is steroids and the ibuprofen. Those are the NSAIDs. And we have found that, studies have found that THC has 20 times anti-inflammatory properties compared to ibuprofen. That is like, seriously like 20 times. That is major, for real. This is major. So since it has been found. And for the corticosteroids like hydrocortisone, prednisone, which are like the big guns when it comes to an inflammation, THC was found to be two times the power of steroids. So it has an anti-inflammatory property, that is twice that of steroids, and 20 times that of ibuprofen. That is huge.

I don’t know why we are not having research more into this product. Other than that CBD is found to many of mice destruction of the joints in rats and mice. Basically, CBD is being found in studies to reduce the destruction of the joined in animal studies. If it’s doing that in the Animal Studies, how about we try it in a human being and see. I mean, we really don’t need studies to validate all this anecdotal, word of mouth. People say, oh I’ve used it. It works. That anecdotal testimony. So we really do need to try that. Cannabinoid is also said to improve the symptoms of osteoarthritis like stiffness, mobility, our range of motion. So we have cannabinoid product that is helping with mobility, range of motion and the stiffness, which is the main symptom that is seen in all this osteoarthritis.

And other than that, the other symptom that comes as a side effect of having this, ah, disease like osteoarthritis, like depression, CBD, THC. They’ve all been proven, the serotonin, to help with people suffering from depression. So apart from helping with the pain, it can also help with the sleep disorder. It can also help with mood like depressive episode. So we really do need more studies to look into all this claim.

And that is our show for today. I’m so glad that you guys were able to hang out. Thank you, guys, so, so much. For those of you that have yet to subscribe to the show, please go to Apple podcast, Spotify, and you can go to our website, WCI-Health.com. We have a page there where you can just click and you have your subscription. Also, we totally need your support. Join our Patreon group. Go to our website. We have a Patreon group, donate, so we can continue with this show. And like I said earlier on the show, this show is sponsored by WCI-Health. Be on the lookout for WCI-Health Glows beauty line of hair, cosmetics product.

Apart from the hair and the cosmetics and beauty products. We are also gonna be launching our pet product. So we have for your pets, like your cats, your dogs, your ferret, all of them. We have a shampoo for them. It’s coming soon, it’s going to be launching at the end of June. So please do stay tuned. And like I said, thank you so much. At WCI-Health, we help people get and stay well using the healing powers of botanical such as cannabinoid. And until next time, remember health equals wealth. See ya. Have a good one.

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