A tablet that contains cannabidiol, or CBD, reduces pain after shoulder surgery with no safety concerns, a study presented Friday during the American Academy of Orthopaedic Surgeons meeting found. Cannabis and CBD for Frozen Shoulder If you’re over the age of 45 and recovering from a recent shoulder injury, you may experience a painful condition called “frozen shoulder.” Whether your
CBD tablet seems to relieve pain after shoulder surgery, study finds
March 25 (UPI) — A tablet formulated with cannabidiol, or CBD, reduces pain after shoulder surgery, with no safety concerns, a study presented Friday during the American Academy of Orthopaedic Surgeons meeting found.
The tablet, called Oravexx, developed by New Jersey-based life sciences firm Orcosa, contains 50 milligrams of CBD and safely managed pain after minimally invasive rotator-cuff surgery, the data showed.
In addition, treatment with it did not produce any of the side effects associated with CBD use, such as nausea, anxiety and liver problems, the researchers said, during the meeting in Chicago.
“There is an urgent need for viable alternatives for pain management, and our study presents this form of CBD as a promising tool after arthroscopic rotator cuff repair,” study co-author Dr. Michael J. Alaia said in a press release.
“It could be a new, inexpensive approach for delivering pain relief,” said Alaia, an associate professor of orthopedic surgery at NYU Langone Health in New York City.
CBD is an ingredient in marijuana that does not cause the drug’s intoxicating effects, according to Harvard Health. It does not contain tetrahydrocannabinol, or THC, the ingredient that makes marijuana users “high.”
As a result, researchers have explored using the marijuana extract for medical purposes, including for relief of pain and anxiety symptoms, but results to date have been mixed.
For this phase 1/2 clinical trial, the first stage in testing, Alaia and his colleagues recruited 99 adults who underwent minimally invasive rotator cuff surgery at either NYU Langone Health and or the Baptist Health/Jacksonville Orthopaedic Institute in Florida.
The participants, all of whom were between 18 and 75 years old, were prescribed a low dose of the pain-killer Percocet during recovery and instructed to wean off the narcotic as soon as possible, the researchers said.
They were then instructed to take the CBD tablet or a placebo, or sham treatment that offers no clinical benefit for comparison purposes, three times a day for 14 days after their surgery, according to the researchers.
On the first day after surgery, the patients who took the CBD tablet experienced 23% less pain, on average, based on a commonly used assessment, compared with those on the placebo, the data showed.
On both the first and second days after surgery, patients who took the CBD tablet reported up to 25% greater satisfaction with pain control compared to those receiving placebo, the researchers said.
No major side effects were reported, they said.
Despite the promising results, the researchers cautioned against using commercialized CBD products to manage pain without consulting with a physician.
Multiple phase 2 studies, the second step in the development process, are in the planning stages and will evaluate the drug’s potential benefits for other acute and chronic pain management issues, the researchers said.
“This is currently still experimental medicine and is not yet available for prescription,” Alaia said.
Cannabis and CBD for Frozen Shoulder
If you’re over the age of 45 and recovering from a recent shoulder injury, you may experience a painful condition called “frozen shoulder.” Whether your shoulder injury occurred after your shoulder muscles were overused, such as from repetitive overhead motion, or an impact injury, frozen shoulder (or adhesive capsulitis) can occur after someone’s arm has been immobilized, perhaps while in a sling, after a surgery or fracture.
It’s called frozen shoulder because, along with the dull or achy pain, you may experience stiffness, making it difficult or impossible to move your shoulder at all. You might also feel the pain in the shoulder muscles that wrap around the top of your arm. You might feel the same sensation in your upper arm. Your pain could get worse at night, which can make it difficult to sleep. Often affecting women more than men, if you experience frozen shoulder in one shoulder there’s a 20-30% chance you will get it in the other shoulder, as well.
Three Phases of Frozen Shoulder
There are usually three phases with a frozen shoulder. Each has its own unique symptoms and timeline.
- The freezing stage is associated with pain in your shoulder any time you move it, and some restriction of motion. That can last anywhere from 6 to 9 months. The pain is often worse at night, making it hard to sleep.
- Next is the frozen stage, when the stiffness and immobility gets worse. That can last 4-12 months. This is the most disconcerting period because it usually impacts activities involved in daily living, with one arm being of limited use.
- Finally, comes the thawing or recovery stage when the range of motion begins to improve. This can take anywhere from 6 months to 2 years.
Frozen shoulder is frustrating for those affected by it because of the extremely long limitation of function and course of recovery. Treatment for a frozen shoulder is focused on relieving pain and restoring the shoulder’s normal range of motion. Standard treatment may include NSAIDs (anti-inflammatory drugs), physical therapy and mild range-of-motion exercises, often starting with barely perceptible movements.
How Can CBD and/or Cannabis Help Frozen Shoulder?
Using CBD, cannabis , or a combination of the two can help your frozen shoulder a lot! CBD and cannabis may help frozen shoulder in three essential ways:
Now, it’s not always the case that pain is treated equally as well by CBD and cannabis, but in the case of frozen shoulder, however, the type of pain, inflammatory pain, is treated well by both due to their effect on the inflammatory “cascade” (the metabolic response to inflammation).
In fact, both CBD and THC have been proven to be as effective as anti-inflammatory drugs, a standard of treatment. It is essential to decrease inflammation as soon as possible in the process of evolution of a frozen shoulder. The shoulder joint will be less likely to progress to “adhesive” capsulitis (frozen) after an initial injury if inflammation is effectively decreased. Even if immobilized, a shoulder can’t have capsulitis without inflammation.
What Should You Take and How Should You Take It?
As far as what to take, both cannabis and CBD products provide internal (such as capsules or tinctures ) and external ( topical lotion or balm ) delivery methods. Using both of these may accelerate recovery time. A typical regimen might be 10 mg of a mixed THC/CBD cannabis (or possibly 50 mg of pure CBD isolate) 3 times per day, as well as a topical applied to the shoulder 3 times per day.
Other components of cannabis that are useful for inflammation are the cannabinoids in acid form, such as CBDA (cannabidiolic acid) and THCA (tetrahydrocannabinolic acid). These forms exist in raw, unheated cannabis and are not psychoactive. Since they bind to different receptors than the neutral cannabinoids (CBD and THC), the potential for relief is increased by using a combination of all of the above.
If you’re using a topical, it is best to apply it prior to any physical therapy exercise sessions to decrease the potential inflammation and pain that the session may generate. Pulling the “frozen” tissues apart is not only painful but is made more effective by releasing immobilized tendons. The muscle relaxant properties of cannabis and CBD aids in the release of the frozen tissues, extension of tendons, and increase in mobility of the shoulder.
Finally, if your sleep is impaired due to your frozen shoulder pain, a cannabis sleep product may be helpful. Most often this involves a dose of an indica cannabis strain that contains THC. CBD, unfortunately, is not often sleep inducing. Of course, if inflammation and pain are relieved, insomnia will improve.
Remember, you may have to stay on this modest cannabis or CBD regimen for months, maybe years, for severe cases of frozen shoulder. The earlier in the process you begin, the shorter the recovery time will likely be. After recovery, a maintenance dose of 10 mg once per day may prevent recurrence of shoulder inflammation in the future.