Can Cannabis Help Tendinitis?
Apr 5, 2020
Cannabis treatment is potentially effective for symptoms that are present with tendinitis such as pain and inflammation. However clinical research investigating the effectiveness of cannabis treatment specifically for tendinitis has yet to be published.
The endocannabinoid system, with which cannabis interacts, is well-known to regulate pain and inflammatory processes.
Cannabis-based medicines such as Sativex, Nabilone, as well as CBD, have been shown to help reduce chronic pain associated with inflammation. Cannabis may, therefore, be effective for treating the pain associated with tendinitis, although we can’t be sure until specific clinical trials looking at tendinitis are published.
Furthermore, there are multiple cannabis strains. To date, research hasn’t shown whether certain strains are more or less effective for certain diseases.
Cannabis is safe to use for pain relief for most people and is a viable alternative to opioids which are frequently abused.
How Cannabis Works on Tendinitis
The endocannabinoid system (ECS) exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.
The endocannabinoid system is involved with modulating two indicators of tendinitis — pain, and inflammation. Cannabinoid receptors such as CB1 and CB2 are central to how the endocannabinoid system modulates these effects. These are the main receptors identified that can be influenced by cannabis. The main difference between these receptors is their distribution in the body.
CB2 receptors are primarily expressed only when there is active inflammation, mainly on immune cells, in small concentrations in the brain, and have also been found on bone and connective tissue cells. CB2 activation by endocannabinoids in mouse models of inflammation has been shown to decrease inflammatory markers.
CB1 receptors are primarily expressed in the nervous system and neurons within the brain. The CB1 receptor is located in regions of the peripheral and central nervous system where pain signaling is controlled such as the dorsal root ganglion, and also in cortical regions such as the prefrontal cortex and amygdala.
Tendinitis causes pain and inflammation, while the endocannabinoid system and its cannabinoid receptors regulate bodily processes related to these symptoms. Modulation of the endocannabinoid system may, therefore, produce beneficial effects for these symptoms.
Medical Studies On Tendinitis & Cannabis
Multiple studies have shown cannabis may help to reduce pain in conditions that have similar symptoms to tendinitis such as fibromyalgia, rheumatoid arthritis, and general chronic pain. None of the research to date is specific to tendinitis, but the following studies give us an insight into the potential benefits cannabis may have for tendinitis symptoms.
- One study examined the results of 28 different researchers on cannabis and chronic pain and concluded that “there was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain.” One limitation of this review is that many of the studies had small sample sizes. These studies were also not specifically looking at tendinitis.
- In a 2006 randomized controlled trial, researchers examined the effects of Sativex (a CBD and THC mixture) on 58 eligible participants with rheumatoid arthritis. Thirty-one participants were randomized to the Sativex treatment and 27 to the placebo group. After five weeks, patients who were given Sativex reported improved pain on movement and rest, ‘disease activity’ scores improved and quality of sleep also improved.
- Tendinitis is often a symptom of fibromyalgia and a leading cause of pain in the disorder. One randomized controlled trial in 2008 examined the effects of Nabilone (a THC-based drug) on 40 patients with fibromyalgia. Patients either received Nabilone or a placebo over four weeks and were evaluated for measurements of pain (e.g tender points). After four weeks no significant improvements were found in the placebo group, while the Nabilone group experienced significant decreases in pain measurements.
There is a lack of clinical or pre-clinical research on cannabis and tendinitis. That being said, several clinical trials show positive outcomes for cannabis as a pain-reliever.
Sativex, Nabilone (which mimics THC), and inhaled THC appear to help decrease pain in patients with rheumatoid arthritis, fibromyalgia, and neuropathic pain, respectively.
CBD & Tendinitis
Several studies have examined the effects of CBD on conditions that cause joint pain and inflammation such as fibromyalgia and osteoarthritis. Despite a lack of specific research on cannabis and tendinitis, the following studies may indicate that CBD could help tendinitis symptoms.
- One 2018 review examined the effectiveness of CBD for relieving chronic pain. In this review, researchers examined pain in a range of conditions including cancer pain, neuropathic pain, and also fibromyalgia pain (which can appear in the joints). The conclusion was that CBD was effective overall and didn’t cause adverse effects.
- One 2017 study published in the journal Pain examined how CBD affects osteoarthritis. Researchers induced osteoarthritis in rats and then administered CBD to determine whether it helps with pain and prevents the development of joint issues. The results showed that CBD reduced acute joint inflammation, prevented the development of joint pain and also prevented further development of pain and nerve damage in the osteoarthritis-affected joints.
- A 2015 study on rats showed that CBD gel reduced joint pain and inflammation without causing any side effects.
CBD appears to be safe and effective for decreasing symptoms of several conditions characterized by joint pain. While all of this research is promising, we can’t conclude the effectiveness of CBD for tendinitis due to an absence of clinical trials.
Cannabis and especially CBD for the treatment of pain and inflammation is well-tolerated.
Cannabis-based medicines containing THC can cause short term side effects such as increased appetite, fatigue, anxiety, impaired cognitive function, and mood changes.
Long-term adverse effects from cannabis use are uncommon but do occur in some people. Psychological dependence and cognitive deficits are possible side effects of regular cannabis use. These long-term side effects are primarily seen in those who begin using cannabis regularly at a young age.
Cannabis can also trigger and exacerbate symptoms of underlying mental health conditions such as schizophrenia in genetically predisposed individuals.
The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.
Tendinitis, or tendonitis, is a condition that affects your tendons, which are tough, fibrous cords that connect your muscles to your bones. Tendinitis is when the tendons become inflamed, irritated or get tiny tears, causing pain and discomfort.
Although you have tendons all over your body, some of them are more likely to develop tendinitis. It’s most common in your:
- The base of the thumb
Sometimes, tendinitis goes by other names, like tennis elbow, jumper’s knee or swimmer’s shoulder. You might not know what’s caused our tendinitis, but most often it’s because the tendon has been overused or overloaded.
Tendinitis is a very common condition, especially among athletes, and most people will experience tendinitis at one point or another in their lives. Generally, tendinitis improves within a couple of weeks with rest and home treatment.
The primary symptoms of tendinitis are:
- Pain in and around a joint where the tendon attaches to a bone, which gets worse when you move
- Sudden loss of movement in a joint, like a “frozen shoulder”
- Inflammation and mild swelling
- Feeling something grating or crackling when you try to move the tendon
- A lump on the tendon
The pain of tendinitis can appear suddenly or build up gradually over time.
Occasionally, when tendonitis is caused by a sexually transmitted infection like gonorrhea, you might also have a fever, see a rash or notice discharge from the vagina or penis.
If you keep on overusing or overloading your tendon and don’t treat tendinitis properly, you increase your risk of rupturing a tendon, which is a more serious complication. A ruptured tendon often needs surgery.
Untreated tendinitis can also cause tendinosis, a condition that provokes degeneration in the tendon and abnormal blood vessel growth.
If you’re feeling pain, heat, and/or swelling around a joint, it’s a good idea to begin treating yourself for tendinitis at home. If it doesn’t get better after a few weeks, visit your doctor.
Your doctor will examine the painful area, and ask about your medical history and recent activities. You’ll probably be asked to move your joint in certain ways to check for limitation of motion.
Occasionally, your doctor might order blood tests to rule out other causes of inflammation, like gout or rheumatoid arthritis, or X-rays to check that you haven’t fractured or dislocated a bone.
Ultrasound and MRI tests are sometimes used if you have Achilles tendinitis or rotator cuff tendinitis, to check how much damage has been done to the tendon.
There are two main causes of tendinitis:
- Overusing the tendon by repeating a movement too often, like clicking a mouse or bending and lifting items in a warehouse.
- Overloading the tendon by trying to lift a weight that is too heavy, for example, or putting too much strain on it by not using the right technique, e.g. in tennis.
Occasionally, tendinitis can be caused by an infection like gonorrhea, or after a cat or dog bite.
Although anyone can get tendinitis, there are some known risk factors:
- Age. As you get older, your tendons lose elasticity and tear more easily. Tendinitis is more common in adults over the age of 40.
- Having diabetes raises your risk of tendinitis, although scientists aren’t sure why.
- Other disorders such as rheumatoid or psoriatic arthritis, thyroid disorders, and gout.
- Bones or joints that are abnormal or poorly-placed, putting more stress on one set of tendons.
- Taking some medications, including ciprofloxacin or levofloxacin.
People who take on strenuous exercise without increasing it gradually, and/or don’t warm up properly before and stretch after exercise, are more likely to experience tendinitis. It’s also more common among people who play sports infrequently.
Most of the time, tendinitis can be treated at home using the RICE approach:
- Rest the affected area. Don’t use it for at least a few days, and up to a few weeks. You can still move around; just don’t use the painful tendon.
- Ice the painful area as soon as possible, for 20 minutes every 3-4 hours over the first few days.
- Compress the painful area with a compression bandage until the swelling goes down.
- Elevate the tendon above the level of your heart, if it’s in your knee or your heel, to reduce the swelling.
Although you need to rest the tendon by avoiding stress on it, you shouldn’t keep it totally immobile because then it will get stiff. Once the pain goes down, stretch and move it gently to keep your range of motion.
Over-the-counter or prescription anti-inflammatories, like ibuprofen, aspirin, and naproxen sodium, can help reduce the pain and swelling of tendinitis. You can also use topical anti-inflammatory pain relief creams.
If your tendinitis doesn’t improve, your doctor might prescribe corticosteroid injections, which relieve pain quickly. However, they aren’t recommended for long-term use, because they can weaken the tendon and raise the risk of tendon rupture.
Physical therapy, especially a program called eccentric strengthening, helps to gently stretch and strengthen your tendons and muscles to relieve tendinitis.
Shockwave therapy, or ultrasonic therapy, is when the surgeon makes a small incision near the injured tendon and inserts a device that bombards the tendon with ultrasonic sound waves to remove damaged tendon tissue.
Dry needling uses a fine needle to make small holes in the tendon to stimulate healing.
In extreme cases, like when the tendon has torn away entirely, you might need surgery to repair the tendon.