Columnist Andrea Wyckoff shares her experience with trying medical marijuana for AS, and which forms of cannabis offer the most pain relief. People with arthritis may consider CBD products for pain relief. Learn what science and experts say about CBD’s benefits, risks, different ways the product can be used and how to be a smart shopper.
How Medical Marijuana Has Reduced My AS Pain
Medicinal marijuana has been a true lifesaver for me as someone with ankylosing spondylitis (AS). I have so much gratitude and appreciation for this plant, as it provides pain relief and brings balance and well-being into my life. On top of that, the cannabis industry has provided me with a job that I love.
I got serious about using medicinal marijuana three years ago, and my health and quality of life have continued to improve the more I use it. I live with some pretty serious spinal fusions because I had AS for so long and didn’t know it. I had no idea my spine was actually fusing together throughout my 20s when I was experiencing all of that mysterious, undiagnosable back pain. But even with a fused spine, kyphosis, and scoliosis, I am thriving today at age 42, pain free thanks to cannabis.
Following are the cannabis edibles, extracts, and flowers that help me feel my tip-top each day and live my best life with AS.
THC edibles, Rick Simpson Oil, joints, and a few marijuana buds, all purchased from a legal dispensary in Oregon. (Photo by Andrea Wyckoff)
For anyone new to trying medicinal marijuana for pain relief, deeper sleep, and its overall relaxing benefits, I recommend starting with edibles that contain THC, the main psychoactive ingredient found in cannabis, and obtaining them from a licensed dispensary. Most edible products come in serving sizes of 5 to 10 mg of THC per dose, and you can adjust the dosage as needed.
I find 10 mg of THC in an edible to be a greater pain reliever than an NSAID or an opiate. And I love that I experience zero negative side effects from cannabis.
Part of marijuana’s magic is the way it helps relax my body, mind, and spirit to be in a better state of flow.
Rick Simpson Oil (RSO), also known as full-extract cannabis oil, is the most potent cannabis medicine I’ve tried. It is a thick, black, tar-like extract that comes in a syringe, minus the sharp needle. You squeeze out a dose the size of a grain of rice and eat it. A full syringe typically costs $30 to $40 and contains about 600 mg of THC.
RSO is sold in dispensaries in three different concentrations. One contains mostly CBD, the nonpsychoactive compound in cannabis that produces feelings of relaxation and calm. This high-CBD concentration will usually have a little THC to help amplify the effects, but not enough to cause much of a “high.”
Then there is 1:1 RSO, or one part CBD to one part THC. This is my favorite option, as you get a large concentrated dose of each cannabinoid (the compounds found in cannabis).
Or, you can buy THC-only RSO that will induce the most “high” feeling, which I also enjoy. This is especially nice when I can get cozy and relax into a deep meditative dream state, such as a DIY spa day state of bliss .
I discovered the Phoenix Tears Cannabis Oil Advice Facebook group, where people share their personal experiences using RSO extract to treat many serious health conditions including multiple sclerosis, rheumatoid arthritis, body aches, bone pain, leukemia, and other cancers. You can visit Rick Simpson’s website and watch his video, Run From the Cure, to learn more.
Flowers for smoking
The two main types of cannabis strains are sativa and indica. Like many, I find that sativa is generally a good choice for the daytime, as it can be more energizing, while indica strains tend to bring deeper relaxation, pain relief, and help with falling asleep.
Dispensaries sell these flowers either as loose buds for smoking in pipes and bongs or as pre-rolled joints.
Vaping and dabbing
You can also explore vaping (inhaling heated cannabis oil through a vaporizer) and dabbing (inhaling concentrated doses of cannabis through a dab rig). But I find that edibles, RSO extract, and a few puffs from a joint work best for me.
CBD vs. THC
These days you can find CBD-only products for sale almost anywhere, including grocery stores, mini marts, and the internet. I have not found any great pain relief benefits from CBD-only products. Through trial and error, I found it takes a little bit of THC to amplify the effects of the CBD enough to provide any noticeable relief.
If you start experimenting with CBD, I highly recommend buying it from a licensed dispensary where they can legally add the tiniest bit of THC to help the user feel a wider spectrum of benefits.
As with anything new, consult your doctor, start in small doses, and be patient, as it may take a few weeks before you find the right dose of CBD and THC for your body, mind, and spirit. It took a few weeks of trying different cannabis products and allowing my body to adjust before I was convinced this was the medicine for me.
Note: Ankylosing Spondylitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis , or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Ankylosing Spondylitis News , or its parent company, BioNews, and are intended to spark discussion about issues pertaining to ankylosing spondylitis.
About the Author
Andrea Wyckoff Andrea lives in a little off-grid cabin on Mt. Shasta with her cat, dog, and a forest full of critters. She currently works on a cannabis farm with the nicest co-workers on the planet. Andrea has found medical marijuana to be a lifesaver for treating the symptoms of ankylosing spondylitis and she feels so lucky to enjoy working in that industry, too. Over the years she has shared many of her favorite anti-inflammatory paleo, keto, and raw-food recipes on her blogs, BettyRawker.com and ForestandFauna.com. She looks forward to sharing her adventures in “Kicking AS” with all of you.
I live in a state where it’s not legal yet South Carolina,I’m not sure when if ever medical use will be granted,I can’t keep using pain medication for it makes me sick and I have to use a nother medicine to keep it down,do you recommend anything that is legal here in my state I’m so sick of being in pain and feeling like I have no options for treatment besides pain medication and injections. thank you
I have AS and I am 34 single mother to a little girl and I am in debilitating pain. I have smoked joints for years but now with this new diagnosis I have been told I can no longer smoke tobacco in my joints. How do you smoke a joint? Is it pure marijuana or with tobacco? Is the smoke from the joint even without tobacco damaging (from the paper etc.)? I am terrified of making myself worse as I am already in a serious way but a vape just does not do it for me. Please give me some suggestions if you can and thank you so much for your article, it was really helpful.
I hope you are ok.
I have been in pain now over 10 years with my bk I have nerve damage in both sides off my bk I have had 3 failed pesiders the last one I got was nerve blockers which left me in more pain as I ever had before on my back not only that now I suffer with pain in both my legs I’m worn out I’m on so much medication it’s not even funny all in all 16 tablets a day plus 2 strong patches I’m at my withs end if anyone out there could help me it would b much appreciated
RSO has been such a game-changer for me. I cannot take opiods (they make me sick and dull my mind) and I cannot take NSAIDs either. In truth, if I was not lucky enough to live in a state with medical marijuana, I would move. It’s that big of a deal.
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CBD Oil For Ankylosing Spondylitis
Online resource that helps patients better understand health coverage options, choose the right coverage, manage the denial process and reduce health care costs.
CBD for Arthritis Pain: What You Should Know
Learn what the science says about the risks and benefits of CBD use for arthritis and what to shop for.
What is CBD? CBD, short for cannabidiol, is an active compound found in the cannabis plant. CBD is not intoxicating but may cause some drowsiness. The CBD in most products is extracted from hemp, a variety of cannabis that has only traces (up to 0.3%) of THC, the active compound that gets people high.
Does CBD work for arthritis? Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties, but these effects have not been validated in quality studies in humans. Anecdotally, some people with arthritis who have tried CBD, but not all, report noticeable pain relief, sleep improvement and/or anxiety reduction.
Is CBD safe to use? Research evaluating the safety of CBD is underway. At this point very little is known. So far, no serious safety concerns have been associated with moderate doses. CBD is thought to have the potential to interact with some drugs commonly taken by people with arthritis. Talk to your doctor before trying CBD if you take any of the following: corticosteroids (such as prednisone), tofacitinib (Xeljanz), naproxen (Aleve), celecoxib (Celebrex), tramadol (Ultram), certain antidepressants, including amitriptyline (Elavil), citalopram (Celexa), fluoxetine (Prozac), mirtazapine (Remeron), paroxetine (Paxil), sertraline (Zoloft), and certain medications for fibromyalgia, including gabapentin (Neurontin) and pregabalin (Lyrica).
Are CBD products legal? CBD products derived from hemp are no longer considered Schedule I drugs under the federal Controlled Substances Act, but they still remain in a legal gray zone. There are changes underway on federal and state levels that will ultimately clarify the laws and regulations related to CBD-based products and sales. Despite that, they’re widely available in nearly every state and online. People who want to use CBD should check their state laws.
Taking the First Step
Should I give CBD a try? Without quality clinical studies on CBD and arthritis, doctors have not been able to say who might benefit from CBD, at what dose and in which form, who likely won’t benefit and who should avoid it. Still, there is agreement on several points:
- CBD is not a substitute for disease-modifying treatment for inflammatory arthritis.
- Patients who are interested in trying CBD should first talk to the health care provider who treats their arthritis before trying CBD. Together, they can review what has worked or not worked in the past, whether there are other options to try first, how to do a trial run, what to watch for and when to return for a follow-up visit to evaluate the results. Keep a symptom and dose diary to track effects.
- Quality CBD products can be expensive, especially when used for prolonged periods. To avoid wasting money, be completely sure that the product is truly having a positive effect on symptoms.
What type of product should I consider? CBD-based products can be taken orally, applied to the skin or inhaled. There are pros and cons for each.
By mouth. CBD that is swallowed, whether in capsules, food or liquid, is absorbed through the digestive tract. Absorption is slow and dosing is tricky due to the delayed onset of effect (one to two hours), unknown effects of stomach acids, recent meals and other factors.
Capsules can work for daily use after a safe, effective capsule dose has been established. Experts discourage taking CBD via edibles, like gummies and cookies, because dosing is unreliable, and they are appealing to children but do not come in childproof containers. Like any medicine, edibles should be secured out of sight and reach of children.
CBD can also be absorbed directly into the bloodstream by holding liquid from a spray or tincture (a liquid dosed by a dropper) under the tongue (sublingual) for 60 to 120 seconds. The taste may not be pleasant. Effects may be felt within 15 to 45 minutes.
On the skin. Topical products, like lotions and balms, are applied to the skin over a painful joint. Whether these products deliver CBD below the skin is unknown. Topical products may also include common over-the-counter ingredients such as menthol, capsaicin or camphor, making it difficult to determine if a positive effect is due to the CBD or another ingredient.
Inhaled. CBD can be inhaled via a vaporizing, or vape, pen. However, inhalation of vapor oils and chemical byproducts carry unknown risks, particularly for people with inflammatory arthritis. For this reason and because the Centers for Disease Control and Prevention is investigating vaping in association with widespread hospitalizations and deaths from severe pulmonary disease, vaping is not recommended.
How much CBD should I use? While there are no established clinical guidelines, the medical experts consulted by the Arthritis Foundation recommend the following for adults:
- When preparing to take a liquid form, be aware that the CBD extract is mixed with a carrier oil, so there are two measures to know: the amount of the liquid product to take (the dose) and the amount of CBD in each dose.
- Go low and slow. Start with just a few milligrams of CBD in sublingual form twice a day. If relief is inadequate after one week, increase the dose by that same amount. If needed, go up in small increments over several weeks. If you find relief, continue taking that dose twice daily to maintain a stable level of CBD in the blood.
- If CBD alone doesn’t work and you are in a state where medical or recreational marijuana is legal, talk to your doctor about taking CBD with a very low-dose THC product. Be aware that THC, even at low levels, may get you high, creating cognitive, motor and balance issues. Try THC-containing products at home or at night first, so you can sleep off any unwanted effects.
- After several weeks, if you don’t find relief with CBD alone or with a combination of CBD and very low THC, CBD may not be right for you.
- If you experience any unwanted side effects when using a CBD product, immediately discontinue use and inform your doctor.
What to Look for When Shopping
There is good reason to be a cautious shopper. CBD products are largely unregulated in the U.S. market. Independent testing has shown mislabeling and lack of quality control. The biggest issues are strength of CBD (significantly more or less than the label says), the presence of undeclared THC, and contamination with pesticides, metals and solvents. Here’s what to look for:
- Find products manufactured in the U.S. with ingredients grown domestically.
- Choose products made by companies that follow good manufacturing practices established by the FDA for pharmaceuticals or dietary supplements (a voluntary quality standard because CBD products are not federally regulated under either category) or required by the state where they are manufactured.
- Buy from companies that test each batch and provide a certificate of analysis from an independent lab that uses validated standardized testing methods approved by the American Herbal Pharmacopoeia (AHP), the U.S. Pharmacopeia (USP), or the Association of Official Agricultural Chemists (AOAC).
- Avoid companies that claim their products have disease benefits.
- Be aware that marketers and people behind retail counters are not health professionals; they are salespeople. That’s why your doctor is your best source for guidance and monitoring when using an unregulated product.
Our gratitude to the following experts for their guidance and review:
Kevin Boehnke, PhD, a researcher at the Chronic Pain and Fatigue Research Center at the University of Michigan, focuses on medical cannabis as an analgesic and opioid substitute in chronic pain.
Daniel Clauw, MD, a professor of anesthesiology, rheumatology and psychiatry at the University of Michigan and director of the Chronic Pain and Fatigue Research Center, leads research on arthritis pain and fibromyalgia, and the effects of cannabis, particularly CBD, in pain.
Mary-Ann Fitzcharles, MD, an associate professor of medicine in the Division of Rheumatology at McGill University in Montreal, Quebec, conducts research on pain and rheumatic diseases. She is the lead author of the 2019 Canadian Rheumatology Association (CRA) position statement for medical cannabis.
During Pain Awareness Month in September and all year long, we’ve got you covered with unique pain management tools and resources you won’t find anywhere else.