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CBD for arthritis

Two placebo-controlled trials of CBD for arthritis pain, one at 20 to 30 mg a day and one at 600 mg a day, both found no benefit.

Facts checked 13 November 20265 min readHow we research
Trials show no benefit

Two placebo-controlled trials of oral CBD (20 to 30 mg a day and 600 mg a day) found no reduction in arthritis pain; topical CBD has no adequate trial.

How we grade evidence

CBD has been tested for arthritis pain in two placebo-controlled trials, and it did not work in either. One trial used a low dose and one used a high dose. There is no adequate trial of CBD creams for arthritis in people.

What the research shows

Hand osteoarthritis and psoriatic arthritis: low dose

One trial randomised 136 people with hand osteoarthritis or psoriatic arthritis to synthetic CBD (20 to 30 mg a day) or placebo for 12 weeks. Results were analysed for 129 of them.1

  • Pain was measured on a 100 mm scale. The difference between the CBD and placebo groups was 0.23 mm, which is no difference at all.1
  • A reduction in pain of more than 30 mm was reached by 22% of people on CBD and 21% on placebo.1
  • CBD had no effect on sleep quality, depression, anxiety or pain catastrophising (a pattern of distressing thoughts about pain).1

Psoriatic arthritis is an inflammatory arthritis linked to the skin condition psoriasis. Osteoarthritis is the most common form of arthritis and involves the gradual breakdown of joint tissue.

Knee osteoarthritis: high dose

A second trial tested a much higher dose. Eighty-six people with painful knee osteoarthritis took 600 mg of CBD a day or placebo for 8 weeks, in addition to 3 g of paracetamol a day.2

  • Pain scores on the WOMAC scale (a standard questionnaire for knee and hip arthritis) fell by 2.5 points with CBD and 2.4 points with placebo.2
  • Raised liver enzymes were found in 15 people on CBD and 5 on placebo.2
  • The authors concluded that the results “do not support the use of cannabidiol as an analgesic supplement”.2

Notice that the placebo groups improved in both trials. That is normal in pain research and is the reason uncontrolled reports of improvement carry little weight. See how we grade the evidence.

CBD creams and balms

We found no adequate randomised controlled trial of topical CBD (applied to the skin) for arthritis in humans. Absorption of CBD through the skin into the bloodstream is low.3 Two small pilot trials of CBD cream or gel for muscle soreness after exercise, which is not arthritis, found no meaningful effect.4 See CBD creams and topicals.

Rheumatoid arthritis and gout

We found no placebo-controlled trial of CBD alone for rheumatoid arthritis or gout. For these conditions the honest answer is that it has not been tested.

The wider pain evidence

These two trials are part of a larger pattern. A 2024 review found 16 randomised trials of pharmaceutical-grade CBD that measured pain, and 15 showed no benefit over placebo.5 Our chronic pain page covers the rest.

What doses were tested

Trial Daily dose Duration Result
Hand osteoarthritis and psoriatic arthritis 20 to 30 mg 12 weeks No benefit1
Knee osteoarthritis 600 mg 8 weeks No benefit, more liver enzyme rises2

The Australian limit for pharmacist-only (Schedule 3) CBD is 150 mg a day.6 One trial sat well below that limit and one well above it. A dose in between has not been tested for arthritis, but with no benefit at either end there is little reason to expect one.

What Australian medical bodies say

  • TGA. The Therapeutic Goods Administration’s guidance says that for chronic nociceptive or musculoskeletal pain, which includes arthritis pain, there is no scientific data to support the use of medicinal cannabis.7
  • Faculty of Pain Medicine (ANZCA). Its 2021 statement says the evidence for cannabinoids in chronic non-cancer pain “remains insufficient to justify endorsement of their clinical use”, and advises doctors not to prescribe them for this purpose outside a registered clinical trial.8
  • RACGP. The Royal Australian College of General Practitioners does not recommend or encourage the use of medicinal cannabis, and says it should only be considered after first-line, evidence-based treatments have been exhausted.9

See what Australian medical bodies say about CBD.

Risks to know about

  • Liver. The clearest safety signal in arthritis comes from the knee trial, where 600 mg a day alongside paracetamol led to more liver enzyme rises than placebo.2 See CBD and the liver.
  • Warfarin and other medicines. Raised INR (a measure of blood clotting time) and bleeding have been reported in people taking warfarin with cannabinoids.10 CBD blocks liver enzymes that process many other medicines.11 See CBD drug interactions.
  • Sedating medicines. CBD adds to the drowsiness caused by opioids, benzodiazepines and alcohol.11 This matters for anyone at risk of falls. See CBD for older adults.
  • Products containing THC. Some cannabis products prescribed for pain contain THC, which is a different medicine with different risks, including for driving. See CBD vs THC.

If you are considering it

  • Talk to your GP or rheumatologist about which treatments have good evidence for your type of arthritis.
  • Bring a full list of your medicines, including paracetamol and anti-inflammatories, to any appointment about pain treatment.
  • Questions worth asking: What does the trial evidence show for my type of arthritis? Do I need liver blood tests? Does the product contain THC? How will we judge whether it is working, and when would we stop?

See also talking to your GP about CBD.

Footnotes

  1. Vela J, et al. Cannabidiol treatment in hand osteoarthritis and psoriatic arthritis: a randomized, double-blind, placebo-controlled trial (conference abstract; published in Pain, 2022). https://acrabstracts.org/abstract/cannabidiol-treatment-in-hand-osteoarthritis-and-psoriatic-arthritis-a-randomized-double-blind-placebo-controlled-trial/ ↩ ↩2 ↩3 ↩4 ↩5

  2. Pramhas S, et al. Oral cannabidiol as add-on to paracetamol for painful chronic osteoarthritis of the knee. The Lancet Regional Health Europe, 2023. https://doi.org/10.1016/j.lanepe.2023.100777 ↩ ↩2 ↩3 ↩4 ↩5 ↩6

  3. Review of topical and transdermal delivery of cannabidiol, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11172078/ ↩

  4. Randomised pilot study of topical cannabidiol and muscle soreness, 2024. https://pubmed.ncbi.nlm.nih.gov/38980809/ ↩

  5. Moore A, Straube S, Fisher E, Eccleston C. Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. The Journal of Pain, 2024. https://doi.org/10.1016/j.jpain.2023.10.009 ↩

  6. Therapeutic Goods Administration. Final decision on down-scheduling of low-dose cannabidiol, 2020. https://tga.gov.au/node/284859 ↩

  7. Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in Australia: overview. https://www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-australia-overview ↩

  8. Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists. Medicinal cannabis, including statement PS10(PM), 2021. https://www.anzca.edu.au/patient-information/about-pain-medicine/medicinal-cannabis ↩

  9. Royal Australian College of General Practitioners. Position statement: use of medicinal cannabis products in Australia (2019 update). https://www.racgp.org.au/advocacy/position-statements/view-all-position-statements/clinical-and-practice-management/medical-cannabis ↩

  10. Systematic review of drug interactions with cannabidiol and other cannabinoids, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11167383/ ↩

  11. US National Library of Medicine, DailyMed. Epidiolex (cannabidiol) oral solution prescribing information, revised 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec ↩ ↩2

Common questions

Does CBD help arthritis?

The two placebo-controlled trials say no. In hand osteoarthritis and psoriatic arthritis, 20 to 30 mg a day for 12 weeks made no difference to pain. In knee osteoarthritis, 600 mg a day for 8 weeks made no difference either.

Does CBD cream work for arthritis in the hands or knees?

Nobody knows, because no adequate randomised trial of CBD cream for arthritis in people has been found. Absorption of CBD through the skin is low. In Australia, the pharmacist-only category for low-dose CBD covers oral products only, not creams.

Does CBD reduce inflammation?

We found no human trial showing that CBD reduces inflammation in arthritis. The trial that included people with psoriatic arthritis, an inflammatory form, found CBD no better than placebo for pain.

Is CBD safe to take with arthritis medicines?

Check with your doctor or pharmacist first. In a trial where people took 600 mg of CBD a day with paracetamol, raised liver enzymes were more common with CBD than placebo. CBD can also change the levels of other medicines, including warfarin.

This page is general information, not medical or legal advice. Laws and evidence change; we show the date we last checked the facts at the top of every page. Talk to your doctor or pharmacist before starting, stopping or changing any medicine.

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