Traumatic injuries to joints may begin as a muscle sprain or a tear of the ligaments or tendons. Issues with inflammation can follow such as bursitis, synovitis, arthritis or ankylosing spondylitis. (Arthritic degeneration of joints is reviewed in the section on “Arthritis”.)
Shoulder injuries usually happen when the muscles are weak or overused, particularly with repetitive motion. Typically the pain is caused by a soreness of the tendons in the rotator cuff. The rotator cuff is the part of the shoulder that helps the arm perform circular motions. Tendonitis results when there are partial tears of the rotator cuff. So-called “frozen” shoulder (adhesive capsulitis) is often a later stage of an overuse injury. It causes pain and stiffness with movement that may last up to 8 months. In some cases, lack of movement may last 4-6 months. And the recovery can take several more months, but pain may persist. Shoulder joints can also be loose, causing dislocation or sometimes arthritis.
Most cases of hip pain are the result of trauma or inflammation. Bursitis often occurs from climbing or from a fall or a direct blow to the hip. Arthritis of the hip is common, usually in elderly patients. The end result of this degenerative disease is joint enlargement induced by growth of cartilage, bone, ligament tendon, capsules and chronic joint inflammation. Range of motion is limited and painful, there are flexion contractures, and loss of mobility. A hip fracture can occur as a result of a fall or a motor vehicle accident. Stress fractures in the elderly are often the result of osteoporosis.
Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions including arthritis, gout and infections can also cause knee pain. Tendonitis around the joint is usually related to the patellar tendon, the large tendon over the front of the knee. Chondromalacia causes knee pain under the kneecap and is due to softening of the cartilage, which is more common in younger patients. Osgood-Schlatter disease is due to irritation of the growth plate just at the front of the joint, which is a condition seen in adolescents.
Joint Pain and Cannabis
NOTE FOR FIRST TIME READERS: Cannabinoids – such as THC, CBD – and terpenes are the main medically active components in cannabis (aka marijuana). For more information on these components, and much more about the plant, see our section on the Science of Cannabis.
The use of cannabis (both internally and topically) for musculoskeletal and joint pain has been handed down as a folk-remedy and used by clinicians for centuries. Evidence now exists to support the anti-inflammatory and pain relief properties of cannabis as well as CBD and THC. Some patients take a daily dose one to three times per day as their ongoing anti-inflammatory treatment. The fact that cannabis can also alleviate chronic pain makes it especially useful, whether on its own or to enhance the effect of opiates. Research has also shown that patients are able to reduce their usage of potentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) when using cannabis as an adjunct therapy.
Topical applications of cannabis is a safe and a powerful method of delivery with few side effects. It can be applied to the affected area without causing psychoactive effects.
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Miller RJ, Miller RE. Is cannabis an effective treatment for joint pain? Clin Exp Rheumatol. 2017, 35 (Suppl. 107): S59-S67.
Hammell DC, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviors in a rat model of arthritis. Eur J Pain. 2016, 20(6): 936–948.
Burston JJ, et al. Cannabinoid CB2 receptors regulate central sensitization and pain responses associated with osteoarthritis of the knee joint. PLoS One. 2013, 8(11): e80440.