Nearly 1 in 4 osteoarthritis patients had tried CBD products, but they reported worse pain than non-users | Research

The takeaway

Among 200 patients with hip or knee osteoarthritis, 24% had used CBD products, but CBD users reported significantly worse pain scores than non-users at their initial evaluation.

Orthopedic specialists, patients with osteoarthritis considering CBD, primary care physicians

24% of osteoarthritis patients had tried CBD products

What the researchers found

24% of 200 patients presenting with hip or knee osteoarthritis had used CBD products. CBD users had significantly worse SANE scores (41.3 vs. 50.8, p=0.012) compared to non-users. Most learned about CBD from friends (60%) and purchased from dispensaries (67%). Oral tinctures (43%) and topicals (36%) were the most common forms.

Why it matters

With CBD products widely marketed for joint pain, understanding their actual prevalence and perceived effectiveness among osteoarthritis patients helps set realistic expectations and guides clinical conversations.

The numbers in context

200 patients (80 hip OA, 108 knee OA, 12 both); 66% female; average age 67; 24% used CBD; CBD users SANE score 41.3 vs. non-users 50.8 (p=0.012); 60% learned from friends; 67% bought from dispensary; 43% used tinctures; 36% used topicals; 8% tried marijuana

How the study worked

Cross-sectional survey of 200 consecutive patients presenting with painful hip or knee osteoarthritis at a large academic orthopedic center. Pain and function assessed using Single Assessment Numeric Evaluation (SANE) scores. Chart review provided demographic data.

What this study cannot tell us

Cross-sectional design cannot determine whether CBD use preceded or followed worse pain. Selection bias: patients presenting for evaluation may not represent all OA patients. No information on CBD product quality, dosage, or duration of use. SANE score differences could reflect baseline severity rather than CBD effects.

How to read the evidence

Cross-sectional survey at a single academic center with a reasonable sample size but no control for CBD product quality or timing of use.

When this study was published

Published in 2021.

The bigger picture

The finding that CBD users reported worse pain does not mean CBD worsened their condition. More likely, patients with more severe pain were more motivated to try CBD. But the lack of perceived benefit challenges the marketing claims surrounding CBD for joint pain.

Questions still open

Are patients with worse pain simply more likely to try CBD, or does CBD fail to provide meaningful relief for OA? Would standardized, pharmaceutical-grade CBD products show different results than the over-the-counter products these patients used?

Common questions

Did CBD help osteoarthritis patients?

No significant perceived benefit was found. CBD users actually reported worse pain scores (SANE 41.3 vs. 50.8) than non-users, though this likely reflects that people with more severe pain were more motivated to try CBD rather than CBD making pain worse.

How were patients using CBD?

The most common forms were oral tinctures (43%) and topical applications (36%). Most patients learned about CBD from friends (60%) and purchased products from dispensaries (67%).

Read the original research

Prevalence of Cannabinoid Use in Patients With Hip and Knee Osteoarthritis.

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 5(2)

View on PubMed ↗Publisher’s paper ↗

Citation

Deckey, David G; Lara, Nina J; Gulbrandsen, Matthew T; Hassebrock, Jeffrey D; Spangehl, Mark J; Bingham, Joshua S. (2021). Prevalence of Cannabinoid Use in Patients With Hip and Knee Osteoarthritis.. Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 5(2). https://doi.org/10.5435/JAAOSGlobal-D-20-00172