CBD For Ankylosing Spondylitis

Cannabidiol reduces inflammation and pain associated with AS (Ankylosing Spondylitis).

CBD as a treatment for the chronic pain of ankylosing spondylitis (AS) is gaining ground as a pain management alternative. Current treatments, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) naproxen and indomethacin, are the medications doctors most often recommended for ankylosing spondylitis. However, there may be undesirable side-effects: bloating and gas, gastrointestinal bleeding, ulcers, vomiting, diarrhea, or constipation.

Unresolved pain can result in conscious and unconscious reflex responses that are far from optimal. Unrelieved pain also impacts health, social and occupational interactions, mental and emotional states.

What is ankylosing spondylitis?

Ankylosing spondylitis is a type of spinal arthritis and an autoimmune disease. As with rheumatoid arthritis, AS pain is an overactive inflammatory response to the disease itself, which leads to damage to healthy tissue. Over time, AS can cause vertebrae to fuse, leading to the distinctive hunched posture, and loss of spinal flexibility. It can even affect the ribcage, leading to difficulty in breathing deeply.

AS occurs more often in men than women, with symptoms beginning in adulthood (17 – 45). However, onset has been noted in children and the elderly.

Signs and symptoms typically begin in early adulthood. They may include pain and stiffness in the lower back and hips, neck pain, and fatigue. It’s also common for AS to cause eye inflammation or inflammation in other areas of the body. AS also affects areas where tendons and ligaments attach to bones, primarily along the spine, as well as the Achilles heel tendons and the cartilage between the breastbone and ribs.

There is no cure for ankylosing spondylitis. Treatment can help manage symptoms and perhaps slow the progression of AS.

Standard treatment regimen of CBD for AS

Treatment for ankylosing spondylitis involves a multi-pronged approach of medication, exercise, and physical therapy. NSAIDs are usually the first line recourse for the management of pain and inflammation. The potential side effects of NSAIDs have been noted above. Practicing good posture and the application of hot/cold packs are other treatment options.

Pain and fatigue are key symptoms. Given the individualized response to treatment, there are clinical challenges. The progressive nature of AS makes it difficult to rely solely on a single medication over the course of the disease. Opioids, in particular, pose grave risks of addiction and overdose.

CBD for ankylosing spondylitis

As an alternative treatment for the chronic pain of ankylosing spondylitis, CBD is a good choice. Studies reported in the Journal of Experimental Medicine showed that CBD reduced chronic pain and inflammation in some subjects.

CBD is a potent anti-inflammatory that inhibits cell proliferation, which basically means the cell production and division that are responsible for the excessive build-up of bone tissue in the vertebrae.

CBD also suppresses cytokine production, responsible for between cells for immune response. Cytokines stimulate responses towards the inflamed sites.

Cannabidiol also induces T-regulatory cell production to combat the adverse effects of an overactive immune system.

Because AS is an autoimmune disease, it begins at a cellular level, and that is where CBD is at its most helpful. In simple terms, CBD calms the immune response and helps to lessen pain and inflammation.

The human body’s endocannabinoid system (ECS) regulates pain and the body’s immune response, among its other functions. Made up of receptors in the central nervous system (CB1) and the immune system (CB2), the ECS promotes and facilitates the production and delivery of the body’s neurotransmitters. The ECS’ role in healing inflamed tissue correlates clinically with preventing and treating inflammation-induced pain.

The National Institutes of Health sponsored an investigation into CBD’s role in reducing chronic pain and inflammation. The research has shown that CBD’s anti-oxidative and anti-inflammatory properties were instrumental in reducing chronic pain. CBD acts on your body’s CB1 receptors to mute the pain signal to the brain through the cellular mechanisms outlined above.

Frontiers in Pharmacology reviewed studies done between 1975 and 2018 into the effects of CBD on pain. In the studies, researchers investigated pain as a symptom of arthritis. The 2018 review concluded that CBD is an effective treatment for pain, with few side effects.

Cannabidiol agonist activity (initiation of a physiological response, combined with a receptor) at CB2 receptors appears to be responsible for its anti-inflammatory properties and its influence on pain perception. Initial human and animal studies support the premise that CBD reduces chronic pain and inflammation.

CBD has another role in improving pain and inflammation related to AS, and that is in improving sleep quality. Poor sleep may be a result of pain, which in turn impacts pain management. Proper rest improves not only pain management efficacy but also mood that can play a part in improving perceived pain. 

Many drugs used to treat chronic pain carry a significant risk, not only of addiction but also of breathing-related sleep disorders. Opioids are the most common culprits, especially when combined with central nervous system depressants. CBD, on the other hand, is non-addictive and has few side effects, but as always, consult the doctor before beginning a CBD regimen.

How to use CBD for AS

CBD comes in many forms, but the most common ways to take it are orally or topically. Capsules or tinctures are the most common oral forms. It may take as long as 2 hours for CBD capsules to begin working, depending on stomach contents and digestive health.

Sublingual sprays or tinctures offer better absorption, going directly into the bloodstream. Users hold the liquid under the tongue for 1 – 2 minutes. The CBD should take effect in about an hour.

Usually, it takes time and experimentation to find an effective dose. Most new users begin with two 5 mg doses, taken morning and evening. Every 7 – 10 days, increase each dose by about half until pain relief is effective. 

CBD topicals come as lotions, ointments, creams, and balms and are applied directly to the skin where pain relief is desired. Ointments, salves, and balms tend to require fewer applications than lotions and creams. Some early research has shown that topical applications can have better absorption rates than oral rates. Apply generously and frequently for pain relief.

Whether taken orally or used topically, find a provider that can show a third-party testing analysis. The analysis will show the purity and ingredients. The certificate of analysis should also show how much CBD is delivered per dose. The goal is CBD purity of greater than 98%. The remaining ingredients should be other cannabinoids, terpenes, and flavonoids, as well as the carrying agent.

The science into CBD and its potential for conditions such as ankylosing spondylitis is in the very early stages. Preliminary studies, trials, and user reports show that CBD holds great promise for the relief of chronic pain.

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Jack Studebaker

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