Recovering after knee surgery: How CBD and marijuana can help
With America being slow to warm to understanding cannabis’s role in medicine, a clinical trial sponsored by McMaster University in Canada is looking into the role of cannabis in post-surgical pain. Photo by iStock / Getty Images Plus
With knee pain, everything seems to be a chore. From climbing stairs, to getting in-and-out of the car, individuals that suffer from prolonged knee soreness and discomfort often benefit from surgery, with many stating that after-care can be almost as difficult as the pain itself. In fact, Googling “knee surgery aftercare” often brings up results in how to avoid surgery altogether.
However, delaying surgery can have subtle effects that patients often don’t realize. BoneSmart, a website by AESCULAP Implant Systems, found research on why delaying surgery could bring additional complications. From a risk of deformities to the increased inability to manage pain, BoneSmart also found that delaying the procedure could prolong time under anesthesia.
Recovering after knee surgery: How CBD and marijuana can help Back to video
The Arthritis Foundation also echoed the research of others like BoneSmart on the internet but added the caveat that most patients could make an informed decision with knowledge of weighing the pros and cons of having immediate surgery or choosing to delay the procedure.
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Additionally, the Foundation shared a study by the Agency for Healthcare Research and Quality, showcasing the fact that demand for the total knee replacement procedure has been steadily rising since 2011, as has patient questions about avoiding opioid addiction and additional therapies available in after care.
Multiple studies have shown that THC and CBD offer an alternative to opioids and other pain medicines but often patients don’t know where to look for proven studies on the effects of cannabis on pain within the body. As Brandon May from Clinical Pain Advisor shares, “Research examining the therapeutic effects of CBD remains limited, as the majority of clinical studies focus on THC, which binds CB1 receptors rather than on CBD itself.”
The role of THC and CBD
With America being slow to warm to understanding cannabis’s role in medicine, a clinical trial sponsored by McMaster University in Canada is looking into the role of cannabis in post-surgical pain. In their trial brief, they explain:
“Medicinal cannabis has begun to emerge as a potential therapy for pain reduction and produces effects largely due to 2 active components: (1) cannabidiol (CBD), and (2) tetrahydrocannabinol (THC). Studies of CBD have shown analgesic, anti-inflammatory, and anti-anxiety properties, but without the psychoactive effects (feeling ‘high’) that THC produces. This study will assess the feasibility of a definitive trial to explore whether adding CBD vs. placebo to usual care before and after surgery can reduce the rate of persistent post-surgical pain after total knee replacement. This study will randomize 40 patients to receive either CBD or placebo and follow them for six months to confirm our ability to recruit patients, adhere to protocol, and capture full outcome data for at least 90% of patients.”
As the U.S. continues to struggle in hosting trials and studies due to the classification of cannabis, pressure continues to mount on all involved in healthcare to explore additional therapies.
How technology is improving patient outcomes
With many patients choosing to move forward with surgery, there seems to be a feeling of apprehension of what to expect after, as each individual’s recovery plan is usually customized. Medicare’s Comprehensive Care for Joint Replacement Model started recommending immediate discharge after surgery instead of placing patients in after-care facilities, which some say has added depth to the opioid-epidemic for those unable to discontinue pain medicine at proper times.
Dr. Michael Suk, chair of Geisinger’s Musculoskeletal Institute, shared recently with Modern Healthcare that while after-surgery care is set individually with each patient, certain best practices are a guideline. These include timeframes for check-ins with the health care team and offering specific resources for education. Noticing a need to offer home-bound patients a way to connect to resources throughout their recovery, Dr. Suk and his team partnered with Force Therapeutics to offer an app that allows patients to not only have touchpoints with nurses and gives access to detailed care plans. Geisinger’s strategic partnership has helped create big cost savings, and helped patients feel empowered.
Other technologists and entrepreneurs have taken notice of recent trends in helping patients stay connected after surgery. The MyMobility app has been rolled out at Hoag Orthopedic Institute to allow patients to showcase their rehabilitation statistics (steps taken, amount of time spent in activity) so the care team can make further recommendations for follow-up care.
Technology is helping care teams to better align best practices with patients who may need extra support or experience hesitation at completing physical therapy at home with the added bonus that more frequent communication may help identity an opioid addiction, with more eyes and ears on care. However, patients must feel empowered to share that they are dependent on opioids, which often is kept silent due to a myriad of reasons.
Tackling opioid addictions after surgery
A 2018 report looked at opioid use after knee replacement surgery and found:
- While the number of opioid pills prescribed is dropping from 85 pills to 82, surgeons often feel pressure to prescribe more opioids than they feel are necessary.
- Patients were often prescribed more than double the 20 morphine milligram equivalents (MMEs) dose when many were given opioids of 50+ MMEs, which poses not only an overdose risk, but could lead to complications to the liver and body.
- Most interesting, patients undergoing a knee replacement surgery reported an incidence of later dependence of 15.2% versus the overall average of 12%, (an increase from a rate of 9% of a 2017 study.)
With opioid addiction facing unprecedented scrutiny, doctors and rehabilitation specialists are not only looking to new technologies to combat a dependence on painkillers, but also demonstrating a want to understand new ways of treating ancient issues of pain.
Here’s the bottom line
“Survey data indicates that the use of cannabis is common among patients with chronic pain and patients who use it for this indication typically report it to be an effective treatment. Majorities further report that cannabis possesses fewer side effects than conventional pain medications and that it provides greater symptom management than opioids.” (NORML.org)
NORML, a national organization committed to revamping the U.S.’ marijuana believes in the power of cannabis in relieving pain and other organizations are starting to post their own guides for patients. The Arthritis Foundation, The Rheumatoid Arthritis Support Network, and many more organizations are starting to give their members new information on CBD and THC for pain. Even more, other studies are popping up from around the world, hoping to recruit individuals who are recovering from knee surgery to identify the benefits of THC and CBD in after-care.
If you’re readying for surgery, consider discussing CBD and THC with your medical practitioner and care team. Not only might the compounds play a role in decreasing a long-term dependence on opioids, but they may also provide other benefits as well.
TheFreshToast.com, a U.S. lifestyle site, that contributes lifestyle content and, with their partnership with 600,000 physicians via Skipta, medical marijuana information to The GrowthOp.
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Using CBD Oil for Knee Pain Relief
In the world of athletics, injuries to the knee are amongst the most infamous. Even outside athletics, the knee supports an incredible amount of weight and usage. Whether it be from sports or just daily life, at some point you are likely to have trouble with your knee. And with such a vital role in walking, standing, and even sitting, it should be no surprise that you and many others want relief for it. So, can CBD help pain with your knee? In this article, we’ll go over that question. But first, let’s dive deeper into the knee itself.
The knee is a complicated joint. Unlike most other joints, it must support almost the entire weight of your body! Furthermore, it needs to remain flexible – but not too flexible. Case in point, you’ll probably cringe when I mention twisting your leg at the knee joint. We know that isn’t supposed to happen, and the mere thought can be uncomfortable! So, what keeps the knee together and functioning?
Let’s first talk about the three major bones of the knee: the patella (or knee cap), the tibia (or shin bone in the lower leg), and the femur (or thigh bone in the upper leg). The patella sits in front of the other two bones where they meet. All three bones are kept connected via ligaments, bands that prevent the bones from doing things that are too crazy. Some of these ligaments include the PCL and ACL – bands that connect the femur and tibia bones in the space directly between them.
Imagine if your bones were scraping against each other all the time. Sounds painful, right? Fortunately, the body tries to prevent that by using cartilage, or rubber-like material, and bursas, or fluid-filled sacs. These things provide shock-cushioning for your knee joint, so the bones never smack each other directly.
Injuries to the knee can greatly vary, but some common ones include breaking ligaments (like tearing your ACL) or inflammation of bursas. In the case of an ACL tear, you’ll have trouble moving your knee joint, and it will likely require surgery. In the case of bursitis (a flamed bursa), you probably won’t need surgery, but moving the knee joint will be hard and painful. 1
While the more serious injuries tend to come about from sports, ordinary wear and tear on the knee can also present problems. It is for this reason that knee issues are likely to hit everyone at some point in life. So, what can CBD do for your knee?
CBD for Pain and Inflammation
Research on CBD is still early, but between the so-far published studies and reviews, great things are known. Furthermore, anecdotal evidence in support of CBD is quite good, hence part of its sudden surge in popularity. So, can CBD relieve pain?
While the term “pain killer” may not be applicable (that’s usually reserved for NSAIDs like ibuprofen), CBD has been established as having analgesic (pain-killing) properties. Of particular note, inflammation and pain-related behavior was suppressed in rats using CBD for arthritis. 2
CBD is also known to interact with TRP channels. A TRP channel is a special gateway into the cell that helps its communication with the nervous system. There are many kinds of TRPs, and they have a broad range of effects, from helping you sense temperature, to experiencing pain. Some of the channels CBD interacts with – such as TRPV1 – are related to pain. 3 CBD is known to desensitize these channels, nullifying a good amount of the pain signal at its start.
CBD is also known for its anti-inflammatory effects. These stem from its interactions with the immune system. CBD is considered an immunosuppressant, meaning it suppresses some elements of the immune system. 4 Don’t worry: this doesn’t mean taking CBD will suddenly make you sick. In fact, CBD has been well documented in safety and tolerance for many people. 5
What does it mean, then, for CBD to suppress the immune system? Well, one specific thing it means is its pushes down inflammation. The inflammation tends to be mediated by chemical messengers called cytokines that tell the rest of the body there is a problem somewhere, and inflammation is necessary. As many of us known, inflammation is not always necessary – a lot of the time, the body is making a mistake and causing inflammation in places where there is no infection of any kind. CBD – and some of the other cannabinoids it tends to come packed with – can help suppress some of those inflammation-signaling cytokines, thus aiding in inflammation. 6 7 8
CBD and the Knee
So how does this all relate to the knee? While CBD won’t miraculously fix a torn ACL (no, really, it won’t), it can help with some of the pain that accompanies common knee injuries. Issues like bursitis can be dealt with, although don’t expect inflammation to just magically disappear. While some pain-relieving elements of CBD may be fast-acting, inflammation tends to involve a gradual decrease of cytokine signaling, meaning it can take some time for it to go away. Furthermore, CBD won’t magically heal all inflammation: some bad cases of arthritis may be out of the realm for CBD, even if it can help relieve some of the pain. Even so, CBD for bursitis of the knee may be just what the doctor ordered.
Speaking of doctors, it is important to always speak with them on the subject of knee injuries. The knee has an incredibly strenuous job in the body, and any issues with it should be given the care that is duly needed. Even if you think CBD can help, speak with your doctor about the problem, and make sure any medication or treatments he provides are safe with CBD. CBD does have a safe record of drug interactions, but it is better to be safe than sorry.
Finally, you should try a combination of both orally-taken tinctures and topically-applied gels and creams for your knee. The orally-taken CBD oils will help mediate healing and pain-relief from deeper inside your body, while the topical products can help soothe you more immediately, and from the outside more. Because problems in the knee can range greatly in how deep or superficial they are, both kinds of products should be considered.
Yes.Life offers both oral and topical products. Not only this but Yes.Life provides powerful, water-soluble, nano-sized CBD oil, meaning that – despite being an oil – the CBD can bypass the water layers that fill your body. This increases absorption greatly and means you don’t have to pay for nearly as much CBD. Merely hold the orally-taken oil under the tongue for 15-30 seconds, or apply and rub in just about a nickel’s-worth of gel and cream to the knee for results. Keep in mind that some problems may take a few weeks to resolve over, but don’t worry: Yes.Life also has a 30-day money-back guarantee. If you don’t find the results you’re looking for by then, Yes.Life will gladly reimburse you.
So what are you waiting for? If you are having trouble with your knee, give Yes.Life CBD oil a shot right now. The best topical product will be the Nano Pain Relief Cream, although the Yes.Life CBD Roll-on can also provide quick relief in an easy-to-carry package. As for orally-taken tinctures, try out the 250 mg first: while some sellers claim you need much more, Yes.Life has taken great measures to keep their CBD highly absorptive, meaning you get a much greater effect with significantly less than much of the competition. The tinctures come in two flavors: Mixed Berry and Cinnamon. Pick what suits your tastes best, and try it out now! Just remember, always talk to your doctor about knee troubles first!
1 FNP, Kathleen Davis. “The Knee: Anatomy, Injuries, Treatment, and Rehabilitation.” Medical News Today, MediLexicon International, 18 Aug. 2017, www.medicalnewstoday.com/articles/299204.php.
5 Iffland, Kerstin, and Franjo Grotenhermen. “An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies.” Cannabis and Cannabinoid Research 2, no. 1(1 June 2017): 139–154., doi:10.1089/can.2016.0034.
6 Zhang, Jun-Ming, and Jianxiong An. “Cytokines, Inflammation, and Pain.” International Anesthesiology Clinics 45, no. 2 (2007): 27–37., doi:10.1097/aia.0b013e318034194e.
7 Nagarkatti, Prakash, et al. “Cannabinoids as Novel Anti-Inflammatory Drugs.” Future Medicinal Chemistry 1, no. 7(2009): 1333–1349., doi:10.4155/fmc.09.93.