Does CBD Work for Tendonitis?
- Tendonitis (also called tendinitis) is a common sports injury caused by either overusing or overloading the tendons during physical activities. Its symptoms include pain and inflammation of tendons.
- In a recent study, CBD oil has shown anti-inflammatory, immunomodulating, and pain reduction properties for rheumatic diseases(1).
- CBD is the only cannabinoid that is allowed to be used by athletes, according to the updated World Anti-Doping Code of the World Anti-Doping Agency (WADA)(2).
- Some traces of CBD or THC may show up on drug tests(3), especially if products are improperly labeled(4).
- Further clinical trials and medical research are needed for CBD to be considered useful in treating tendonitis.
Why People Are Using CBD for Tendonitis
Tendonitis is often treated with over-the-counter (OTC) and prescribed oral painkillers called NSAIDs, like aspirin, ibuprofen, and naproxen.
Although the said drugs are used to treat minor pains, taking them together may cause one drug to be ineffective(5). Taking two similar medications may increase the risk of severe side effects, such as gastrointestinal bleeding and heart attack(6).
People who have tendonitis also resort to corticosteroid injections for pain management(7). Athletes use this method for immediate pain and inflammation relief(8).
Based on a study, corticosteroid injections provided more improvement in patients’ shoulder pain than oral NSAIDs(9). However, repeated corticosteroid injections may cause the tendons to weaken and eventually rapture(10).
The side effects caused by these pain and anti-inflammatory drugs may cause people to look for other alternative treatments for tendonitis.
According to studies, cannabidiol (CBD) has anti-inflammatory properties that may help relieve inflammation in certain medical conditions(11).
One medical condition included in the study is arthritis. This condition can affect the connective tissues, such as tendons and ligaments(12).
In a recent study, CBD oil has shown anti-inflammatory, immunomodulating, and pain reduction properties for rheumatic diseases(13).
The study also stated that traditional prescription drugs showed inefficacious results, leading to uncontrolled rheumatic pain. Thus, some people are inclined to seek new and safe treatments for pain.
Rheumatic diseases are inflammation of the body’s connecting structures, such as joints, tendons, ligaments, muscles, and bones.
However, according to the study previously mentioned, there is still a need for further research on the effective dosage and formulation of CBD products(14).
In another study, CBD and tetrahydrocannabinol (THC) showed great potential in combating chronic pain caused by rheumatic diseases.
The compounds are comparable to other drugs, like opioids and antidepressants. Unfortunately, opioids and antidepressants can have adverse side effects(15).
Meanwhile, CBD is generally safe to use(16), as opposed to THC, its counterpart that elicits psychoactive effects.
In the 2020 updated World Anti-Doping Code of the World Anti-Doping Agency (WADA), CBD is the only cannabinoid that is allowed to be used by athletes(17).
The code is a comprehensive list of prohibited substances and methods for competing and non-competing athletes. WADA is a foundation that monitors drug use and abuse in sports worldwide.
How CBD Oil Works to Help Alleviate Symptoms of Tendonitis
Tendonitis is characterized by swelling and pain in the area where tendons are located. Symptoms may last from days to weeks, depending on the severity of the injury. Recovery time for this condition varies from two days to six weeks.
Chronic pain, joint stiffness, and movement restriction are symptoms of a more serious case of tendon degeneration called tendinosis.
The condition happens when the tendon’s collagen starts to break down due to overuse while the tendons are not fully healed(18).
Collagen is the most abundant protein in the human body. This protein is responsible for elasticity, strength, and structure of the skin and bones.
Tendonitis takes longer to heal, around three to six months. Treatments for this condition include stretching, massaging, surgery, and shockwave therapy(19).
People with severe tendinitis conditions may wear temporary splints, braces, or slings on affected areas. In some severe cases where the tendons rapture, surgery is done to realign and repair them.
CBD for Pain Relief
CBD works in the body through the endocannabinoid system (ECS), the system involved in pain modulation(20).
The ECS has two primary receptors, called CB1 and CB2, that are found throughout the body. These cannabinoid receptors work closely with the molecules called endocannabinoids.
The molecules regulate the body’s physiological functions, such as inhibiting pain and maintaining homeostasis(21).
When administered, CBD works as a cannabinoid that activates the receptors that help treat various pain felt throughout the body(22). CBD is a non-psychoactive phytocannabinoid found in cannabis plants.
In a study about pain management, patients with chronic pain reduced their opioid intake upon taking CBD. They also improved their quality of life within eight weeks of constant CBD use(23). Based on the study, CBD may be an alternative for people taking opioids.
On the other hand, an animal study conducted on rats has found that the transdermal application of CBD may provide pain relief for arthritis(24). Although the study was conducted on animals, the results may be useful in further studies to be conducted on humans.
CBD for Inflammation
Another physiological function of the cannabinoids present in the ECS is to regulate the immune system’s response to inflammation(25).
Inflammation is the body’s natural response when injuries or harmful substances enter the body.
CBD is also known for its inflammatory response of macrophages(26). When CBD activates the cannabinoid receptors, the macrophages inhibit the release of cytokines.
Cytokines are proteins that signal inflammation(27), while macrophages are white blood cells that respond to infections.
In a study conducted on rats, an increase in CBD’s daily oral dosage further reduced edema or inflammation on the test subjects’ paws(28).
There was also a significant decrease in the swelling a few hours after the first CBD administration.
The results suggested that further clinical trials on CBD should be conducted on humans to test if similar results would occur.
The Pros and Cons of CBD Oil for Tendonitis
- According to the World Health Organization (WHO), CBD has a good safety profile(29).
- CBD may have the potential to alleviate symptoms of tendonitis. It may be safer than prescription drugs mentioned because it has no severe side effects.
- Studies presented showed the effects of CBD on other rheumatic diseases. The results of the studies may spark further interest in conducting studies on CBD’s effect on tendonitis.
- People who take CBD may experience side effects, like diarrhea and constipation, that may affect their lifestyle(30).
- Traces of THC in full-spectrum CBD oils may show up on drug tests(31), especially if products are improperly labelled(32).
- CBD may interact with other medications and may cause potential adverse side effects(33).
Tendonitis is a condition that usually requires rest. RICE (rest, ice, compression, and elevation) treatment is a common home remedy for tendonitis.
Other than that, some physicians may require the patient to undergo occupational and physical therapy.
The goal of the former is to improve the person’s motor and cognitive skills for daily living. Some examples of the tasks and skills an occupational therapist might focus on are getting dressed, writing, or cooking.
The latter helps people recover from injuries by either aligning the bones and joints or increasing mobility by easing pain. This therapy involves handling conditions from diagnosis to full recovery.
Some topical creams may also work as temporary pain relievers for swollen muscles that come with tendinitis. These ointments may contain essential oils that may quickly relieve pain and soreness.
Essential oils can be used in diffusers or by massaging directly on the target area. In rare cases, gargling helps if the inflammation is inside the mouth.
Conventional essential oils used to lessen inflammation and pain are the following(34):
- Peppermint oil contains menthol and is practical for soothing sore, achy muscles and joints.
- Marjoram oil is typically used for coughs and headaches but can also be used to ease pain and inflammation.
- Lavender oil is known for its fragrant smell. This oil can calm and relax tense muscles.
- Eucalyptus oil has the same cooling effect as peppermint oil. This oil can reduce pain and inflammation in target areas.
- Chamomile oil can be used in various conditions other than inflammation and pain. It can be used in wound healing, digestion, and sleep problems(35).
All the treatments mentioned may be used as supplementary treatments for oral medications.
CBD also comes in products that may help relieve pain caused by tendonitis. Topical products, such as CBD creams, salves, and lotions, may contain essential oils combined with CBD’s pain-relieving benefits.
Other CBD products, like tinctures and oils, may be taken orally in small doses. CBD oils may act as topical pain relievers. These may be applied to swollen areas, such as the Achilles tendon and knees.
However, taking oral CBD alongside other drugs may elicit adverse side effects(36). It is better to consult a doctor before taking any CBD product for the first time.
How to Choose the Right CBD Oil for Tendonitis
CBD oil is classified into three types: CBD isolates, broad-spectrum, and full-spectrum CBD.
CBD isolates are pure CBD. All other cannabinoids and plant impurities are eliminated through a series of extraction processes. CBD isolates are non-intoxicating and contain 99% CBD.
Broad-spectrum CBD oil contains all the cannabinoids, flavonoids, fatty acids, and terpenes, except THC.
Flavonoids are plant chemicals that are widely found in fruits and vegetables. They are responsible for giving vivid colors to plants. They also provide health benefits because of their antioxidant, anti-inflammatory, and anti-carcinogenic effects(37).
Terpenes are the compounds that produce the natural odor and flavor of the plants. CBD is derived from the hemp plant, which contains the essential fatty acids omega-3 and omega-6.
Full-spectrum CBD oil is the most complete among the three types since it contains the full profile of compounds, including the psychoactive cannabinoid THC.
As a legal requirement, full-spectrum CBD products should adhere to the Farm Bill, which states that hemp-derived products are allowed to contain 0.3% THC or less(38).
Using broad- and full-spectrum CBD oil may evoke the entourage effect. This effect is described as the synergy of all the compounds, providing benefits to a person’s well-being.
Although a full-spectrum CBD oil may have maximum benefits attached to it, athletes may opt for a broad-spectrum CBD oil. Even if the full-spectrum has relatively low THC levels, traces of it may still be detected in drug tests.
There are other factors to consider when choosing the right CBD oil, and some of those are the following:
- Choose a reputable supplier that manufactures high-quality CBD products that are safe for human consumption.
- Look for the certificate of analysis from a third-party lab. This document ensures that the products are lab-tested and do not contain any harmful substances. The lab results should match the information indicated on the product label.
- Research about the extraction methods used by CBD companies. The methods used have a vital impact on the quality of the end product.
- Research on other practices that the company may have been employing, such as organic farming and purification processes. These may be crucial to the consumer’s decision-making process.
- Read online reviews before purchasing any CBD products online or in-store.
- Get the opinion of a trusted physician on the best CBD products and formulas for tendonitis.
CBD Dosage for Tendonitis
There are no standard dosages for CBD products. The US Food and Drug Administration (FDA) has no approved CBD dosage for any medical condition(39).
Several factors, such as body weight, the severity of the condition, existing medical conditions, body sensitivity, allergic reaction to substances, and body chemistry may influence the CBD dosage.
Initial doses may start on low amounts and may gradually increase if there are no significant changes in the condition.
According to research, dosages may range from 1 to 50 mg of CBD per day, with lower doses for anxiety relief and higher doses for more severe conditions, such as epilepsy and seizures(40).
The best way to determine the right dosage is to consult a medical professional that can give sound advice on the amount of CBD needed to treat tendonitis symptoms.
How to Take CBD Oil for Tendonitis
CBD comes in various products and forms suitable for every person’s lifestyle and condition.
For swollen muscles, CBD topicals, like salves, lotions, and creams, may alleviate the pain and inflammation.
These topical products differ in texture and consistency. CBD salves are oil-based, lotions are water-based, and creams are typically equal mixtures of oil and water.
Topical CBD products may be applied to target areas for a quick but short-term effect. Product reapplication may be needed after a few hours.
CBD oil and tinctures are taken orally or sublingually using a dropper. The difference between the two is their base carriers.
CBD oil may be infused with oils like olive oil, coconut oil, and grapeseed oil. CBD tinctures are alcohol-based concentrates that are often added to food or beverages.
CBD oil may also be applied directly to the skin. It may feel more greasy than lotions or creams.
Another edible form of CBD is gummies. It is suitable for first-time CBD users who want an easy and discreet way to take CBD for their condition.
CBD vape pens are for those who want a fast-acting agent with prolonged effectiveness. Vaping CBD maximizes the bioavailability of the cannabinoid as it instantly circulates throughout the bloodstream.
Bioavailability refers to the rate of activation of a drug as it enters through the body circulation. Based on studies, CBD’s oral bioavailability is around 13-19%, which is relatively low compared to smoking or inhaling CBD, which provides 31% bioavailability(41).
What is Tendonitis
Tendonitis or tendinitis is the inflammation of the tendons, the tissue that connects the muscle to the bone. This condition is a common sports injury, where a part of the body that contains tendons is either overused or overloaded.
Overuse is the frequent repetition of movement. Weight lifting is an exercise where tendons are overused because of the repeated movements of the arms or legs for strength training.
Overload is movement with a sudden increase in speed. An example of tendon overload is running at high speed immediately after running at a moderate pace. This action may cause the Achilles tendon, the tissue located at the back of the lower leg, to swell.
Tendonitis can also occur as a result of infections, deformities, or other medical conditions, like gonorrhea, Haglund’s deformity, and diabetes.
Types of Tendonitis
Tendonitis may happen in any part of the body where tendons are located. The most common types of tendonitis can happen in the shoulder, elbow, knee, wrist, and heel.
Rotator Cuff Tendonitis
Rotator cuff tendonitis or bicep tendonitis is a type of shoulder pain caused by an inflammation of the biceps tendon. Pain may be felt from the shoulder blades to the upper arm.
This condition may be caused by heavy lifting or frequent stretching of the arms overhead, like throwing and swimming.
A person with rotator cuff tendonitis may have difficulty sleeping and reaching any object or surface above the head or behind the back.
Tennis elbow is an inflammation caused by irritation of the tendons on the outside of the elbow. Pain may crawl from the forearm to the wrist and fingers.
This condition is common among tennis players, plumbers, construction workers, and painters whose jobs and lifestyles involve constant arm movements.
Golfer’s elbow is the condition where the tendons of the forearm swell, affecting the inside of the elbow and forearm.
Activities with repetitive hand movements, such as gripping, flexing, throwing, and swinging, can cause inflammation of the tendons. Bowling, baseball, and wall climbing may also cause golfer’s elbow.
Jumper’s knee or patellar tendonitis is the swelling of the tendons on the knee. The tissue connects the kneecap to the tibia, the large bone in front of the leg.
This condition usually affects athletes and people who do exercises or sports that require frequent jumping or knee movements, such as volleyball, gymnastics, running, and soccer.
Achilles tendonitis is the inflammation of the largest tendon in the body called Achilles tendon. This tissue connects the heel to the calf muscles.
It is a sports injury for runners who suddenly increase in speed or duration of their runs. It may also happen to a person who has an abrupt intensity increase during any physical activity.
Differences and Similarities Between Tendonitis and Arthritis
Tendonitis is sometimes mistaken as arthritis because of the tendon’s proximity to the joints. While both conditions involve inflammation, the difference between the two is the source of inflammation.
Arthritis is the inflammation of the bony aspect of joints and is characterized by joint pain. Meanwhile, tendonitis is the inflammation of the tendons characterized by difficulty in tendon movement.
Tendonitis can be easily identified if a person has engaged in any physical activity that might cause injuries. Meanwhile, arthritis may be caused by old age, cartilage deterioration, or a misdirected immune system.
The best way to determine what condition a person is experiencing is by consulting a doctor. The correct diagnosis of a condition can help identify what treatments may be done for rapid rehabilitation.
The Legality of CBD
Medical CBD is allowed in 18 states in the United States(42). Most states have legalized CBD use for neurological conditions, like epilepsy and seizures.
Three states, namely Florida, Iowa, and Georgia, allow CBD use for muscle spasms, chronic pain, and intractable pain, respectively. Intractable pain is a more severe condition than chronic pain, which cannot be relieved or treated easily.
Three other states have authorized the use of CBD for any clinically-diagnosed condition as prescribed by a doctor. These states are Virginia, Wisconsin, and Kansas.
Specific state laws in Virginia and Wisconsin permit patients to use any product formulation of CBD. Other states have only legalized the use of CBD in oil form.
A patient can obtain CBD oil for medicinal purposes that contain 5 to 15% of CBD and no more than 0.3 to 0.5% of THC.
Florida is the only state that allows a patient to acquire a higher THC dose as long as a physician prescribes it. The product must be obtained from a state-licensed dispensary.
Patients that are part of any state-supported clinical research are authorized to use CBD. They are also protected by the laws to obtain CBD outside of the research facility.
Tendonitis is the inflammation of tendons, which are tissues that connects the muscles to the bones. It is a common condition among athletes, physically active individuals, and professionals that engage in repetitive movements.
Although home remedies can cure tendonitis, not giving the tendons enough time to heal may lead to a more severe condition called tendinosis. It may require constant therapy and surgery.
No direct studies have stated that CBD is a cure for tendonitis. However, CBD can help alleviate the symptoms of the condition, such as inflammation and pain.
Various CBD products may be used to address the symptoms of tendonitis. The products’ effectiveness may depend on a person’s body weight, and body chemistry.
Consulting a physician with a background in CBD studies may give a person more insight and guidance. A trusted medical practitioner may help a person decide if CBD is the best treatment for the condition.
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