Rheumatoid arthritis is a condition that not only affects the joints, but the eyes, skin, heart, and more. It happens when your own body attacks itself, a type of friendly fire. Rheumatoid arthritis is caused by rheumatism, an autoimmune disease in which the immune system perceives your own healthy joint tissue as a foreign body. It then begins to degrade the synovial sac, which contains lubricant and keeps everything that doesn’t belong there out of your joints.
What is rheumatoid arthritis (RA)?
RA is an autoimmune disorder of the joints, triggered by an aggressive response by antibodies attaching to individual proteins and mistaking normal joint tissue for an invading pathogen. The result is a powerful inflammatory response that causes immense pain and debilitation, and is very difficult to effectively treat.
In 2007-2009 the Center for Disease Control reported that almost 50 million people over the age of 18 had been diagnosed and dealing with osteoarthritis or rheumatoid arthritis, which have similar symptoms during the early stages of disease.
Cause(s) of rheumatoid arthritis
RA is initiated by an inflammatory attack within the synovial fluid that lubricates all joints. This inflammation prevents the normal flow of nutrients to the joint, causing it to begin breaking down. Eventually, the cartilage and bone within the joint are destroyed. The destroyed tissue is partially replaced with scar tissue, resulting in deformation and further immobilization.
There are many different cells of the immune system, and RA involves two kinds: T-Cells and B-Cells. T-Cells are supposed to recognize an injury or a pathogen, and activate B-cells to release antibodies which mark it as the enemy. In RA, T-cells inappropriately react to cells which are native to our own body; specifically those in the synovial fluid surrounding major joints. For this reason, joints are the first areas to be damaged by rheumatism/rheumatoid arthritis. The fingers of many patients with this disease will often become deformed due to accumulation of scar tissue within the joints.
Scientists do not fully understand why this condition occurs. It is believed that some genetic factors are at play that can be aggravated by environmental factors. The symptoms of RA are also not limited to the joints. According to Mayo Clinic, about 40% of patients with RA experience symptoms related to their : eyes, heart, lungs, kidneys, salivary glands, nerve tissue, bone marrow and blood vessels. While osteoarthritis is also characterized by an autoimmune assault of the joint tissue, rheumatism involves a more severe and systemic autoimmune reaction that simply affects the joints first. For this reason, there is a blurry line between rheumatoid arthritis and rheumatism, which refers to the system-wide immune system pathology which is associated with the later stages of RA. Instead, RA may simply represent the early stages of rheumatism.
Diagnosis and characteristics of rheumatoid arthritis
For a physician to diagnose rheumatism or rheumatoid arthritis, many other similar conditions must be ruled out. In the early stages, it proves difficult to diagnose. This disease has symptoms similar to many other diseases (i.e. fever, fatigue, weight loss, joint stiffness).
However, for physicians, it is relatively easy to identify the difference between rheumatoid & osteoarthritis. RA is a much more serious and acute autoimmune reaction, that causes other symptoms in addition to the joint problems. Osteoarthritis, on the other hand, is simply the immune system’s natural (or slightly accelerated) reaction to the normal wear and tear that our joints accumulate over a lifetime.
There are four essential tests to verify rheumatoid arthritis:
- Red Blood Cell Sedimentation Rate: this test is a non-specific means of determining whether there is an inflammatory process occurring within the body.
- C-Reactive Protein Test: this helps determine whether there is an auto-inflammatory process occurring within the body.
- MRI : a magnetic resonance imaging test helps physicians track the severity of the disease, especially at the tissue and muscle level across various organs of the body.
- X-Ray: a physician will request this if they want to track the disease’s impact on the joints thus far.
Current treatment options and best practices for rheumatoid arthritis
The best practices for patients with rheumatoid arthritis is based on the severity of their condition. The most common methods of treatment are as follows.
NSAIDS: non-steroidal anti inflammatory drugs are available over the counter and include Advil and Aleve. They relieve pain & inflammation, but the possible side effects are ringing in the ears, stomach irritation, heart problems, and liver and kidney damage if consumed in excess.
Steroids: potent drugs able to reduce pain, inflammation, and slow joint damage. They are usually prescribed when a physician wants to relieve intense acute symptoms. The drawbacks to steroids are possible bone thinning, weight gain, dependency, and diabetes.
- Therapy: a physician may order a patient to see a physical therapist to help teach the patient exercises to increase or improve the flexibility of joints.
- Lifestyle Choices: Patients found that by applying heat and cold they could ease the pain, and also reported that regular exercise helped to retain joint flexibility and elevated metabolism. Meditation and playful activities are also correlated with an improvement of symptoms.
- Surgery: if a patient has severe damage or is no longer responding to medications and those drugs fail to slow damage and joint deformity, then surgery is an option. Surgery can restore joint ability but it runs the risk of infection and pain.
Is endocannabinoid deficiency involved in rheumatoid arthritis?
The exact cause of rheumatoid arthritis is not yet known. However, stimulation of the endocannabinoid system can improve RA and even fight back the processes that result from the disease. The endocannabinoid system is a primary regulatory network throughout almost all of our body systems. The ECS is highly involved in the development of muscle and bone, and it also is the main control mechanism of the immune system.
In nearly all autoimmune diseases, an abnormality of ECS expression or signaling is demonstrated. In RA, cannabinoid receptors fail to regulate the healthy activity of immune system cells responsible for maintaining the composition and environment of joints.
Therefore, researchers and anecdotal experience suggest that modulation of the ECS could be a highly effective method for treating the underlying pathology of rheumatism and other autoimmune conditions.
Does CBD improve cases of rheumatoid arthritis?
CB2 receptors, one of the main cannabinoid receptors in the body, have a vital role in the physiology of the immune system and musculoskeletal system. In rheumatoid arthritis the first membrane to be attacked is the synovial membrane, and CBD inhibits inflammation in this area by increasing free endocannabinoids’ ability to bind and activate CB2 receptors.
In addition, CBD is hypothesized to inhibit the destruction of cartilage in RA. Because CBD has been proven to down regulate the immune response, it is also suggested that CBD can inhibit the production of autoantibodies, cytokines (inflammatory molecules), as well as inhibit bone erosion, which is also a process mediated by a type of immune cell.
CBD oil for inflammation is a strong alternative according to many researchers. Current research involving the efficiency of CBD applied across the skin for the treatment of inflammation and pain in mice found motivating results. In 2016 D.C. Hammell and company concluded that CBD is a good candidate for arthritis-causing diseases, including rheumatism.
The actual research was conducted on mice induced to have inflammation and neuropathic pain. The graphs compiled in the study by Hammell showed that the CBD dosage for rheumatoid arthritis was 6.2mg/day sublingually to halt continuation of the disease.
The results of the study concluded that CBD reduced not only the inflammation and pain but also the quantity of secretions (i.e. pro-inflammatory and bone degrading molecules) that were produced. CBD oil for rheumatoid arthritis could quite possibly reduce inflammation and further progression of RA by also reducing the thickening of the joint membrane that leads to joint stiffness and pain.
CBD is a truly revolutionary treatment for arthritic diseases, and its lack of negative side-effects has boosted support among the medical community.