Rheumatoid Arthritis and CBD: What Does the Research Say?

For someone living with rheumatoid arthritis, waiting for stiff joints to loosen up in the morning, swollen and painful hands, and not knowing when the next flare will come can be part of everyday life. That is why many people looking for a "natural" form of support alongside their medicines are curious about CBD. In this article, we explain in plain language what rheumatoid arthritis is, why CBD is being studied, what the studies have found and what you can discuss with your rheumatologist. For a detailed table of studies on joint pain, see the arthritis page of the CBD Guide.

What is rheumatoid arthritis?

Rheumatoid arthritis is a long-term disease that causes pain, swelling and stiffness in the joints; the hands, feet and wrists are most often affected. It is an autoimmune disease: the immune system, which protects the body against infections, mistakenly attacks the tissue lining the inside of the joints. Over time, this inflammation can damage the joints, cartilage and nearby bone. Some people also have general symptoms such as tiredness and weight loss (NHS).

There is no treatment that makes rheumatoid arthritis go away completely, but with early diagnosis and the right treatment, many people can live for months or even years without flares. Treatment is built on medicines that slow the progression of the disease and help prevent joint damage (disease-modifying antirheumatic drugs such as methotrexate, and biologic medicines); physical therapy and, when needed, surgery support them (NHS). These medicines sometimes take a few months to work, so taking them regularly is important.

Why are people curious about CBD?

CBD (cannabidiol) is a substance found in the cannabis plant that, unlike THC, does not make you high or cloud your thinking. Some receptors of the body's endocannabinoid system (especially CB2) are found on immune cells; since rheumatoid arthritis is an immune disease, this link interests researchers.

Lab studies have shown that CBD can affect some signaling substances involved in inflammation (Burstein 2015). In rats with induced arthritis, CBD gel applied to the skin reduced joint swelling and pain behaviors (Hammell 2016). These findings guide research, but an effect seen in cells or animals does not mean the same result will occur in people with rheumatoid arthritis. You can also look at our article on CBD and inflammation , where we cover inflammation more broadly.

What does the research say?

In rheumatoid arthritis: a prescription spray containing THC

In the first and only controlled study in patients with rheumatoid arthritis, 58 people were randomly assigned to two groups: for 5 weeks, one group used a prescription mouth spray containing both THC and CBD (nabiximols), and the other used a placebo spray that looked the same (Blake 2006). Those who used the spray had slightly better scores than placebo for pain on movement and at rest, sleep quality and disease activity; there was no difference in morning stiffness. The researchers also noted that the differences were small and varied from person to person. Because this product contains THC, the result cannot be applied to pure CBD oil.

A review of cannabinoid studies in rheumatic diseases, including rheumatoid arthritis, could find only four short-term studies. The authors reported that because the samples were very small and the studies were short, only limited conclusions could be drawn, and that almost half of the patients had dizziness, difficulty thinking, drowsiness or nausea (Fitzcharles 2016).

Pure CBD: no studies in rheumatoid arthritis yet

There is no controlled study of pure CBD taken by mouth in patients with rheumatoid arthritis. Studies in other joint diseases that can be considered close show the following:

• Hand osteoarthritis and psoriatic arthritis (136 people): There was no clear difference in pain between people who took 20–30 mg of pure CBD a day for 12 weeks and those who took placebo; there was also no difference in sleep, anxiety or depression scores (Vela 2022).
• Knee osteoarthritis (86 people): Even at a high dose such as 600 mg a day, pain did not decrease more than with placebo; side effects and liver enzyme increases were more common in the CBD group (Pramhas 2023).
• Knee osteoarthritis, CBD-rich oil: Over 60 days of use, there was no difference from placebo in pain or joint function (Mojoli 2025).

In a review of controlled studies of pure CBD for pain, CBD was not found to be better than placebo in 15 of 16 studies (Moore 2024). In short, the effect of pure CBD on rheumatoid arthritis symptoms is not known today; there is not enough research on this.

CBD applied to the skin

There is no study of CBD applied to the skin as a cream or gel in rheumatoid arthritis. The results of a few small studies in other types of joint pain are conflicting; we covered the details in our article on CBD creams .

Possible side effects and drug interactions

In short-term use, most people tolerate CBD well, but it is not free of side effects. Some points become even more important when it is considered together with rheumatoid arthritis medicines:

• Common side effects: Tiredness, diarrhea, and changes in appetite or weight (Iffland 2017).
• Liver: In a 4-week study of healthy adults, liver enzymes rose markedly in 5.6% of those who took 5 mg of CBD per kilogram of body weight a day (Florian 2025). Methotrexate can also affect the liver, so it is monitored with regular blood tests (NHS); there are not enough data on the risk of CBD together with medicines that affect the liver. Details in our article on CBD and the liver.
• Pain relievers: Liver enzyme increases were more common in people who took high-dose CBD together with 3 g of acetaminophen (paracetamol) a day (Pramhas 2023). No meaningful documented interaction is known with medicines such as ibuprofen and naproxen, but there are no direct studies either.
• Immunosuppressants and other medicines: CBD can slow the breakdown of some medicines in the body; tacrolimus and mycophenolate are among them. You can check your own medicine on the drug interactions page .

How was it used in studies?

In the rheumatoid arthritis study, the spray containing THC and CBD was used in the evenings; in the last week, participants were using an average of about 5 sprays a day (Blake 2006; study dose, not a personal recommendation). Joint studies with pure CBD tested doses of 20–30 mg, 45 mg and 600 mg a day; none of them showed a clear difference from placebo in pain. There is no established CBD dose for rheumatoid arthritis.

If you are thinking about using CBD

When you live with a long-term disease, it is only natural to be curious about every new option. Before you decide, you can talk with your rheumatologist about:

• How active your disease is right now and whether your treatment is working well enough; options for changing medicines if needed.
• All the medicines you take, especially methotrexate, leflunomide, biologic medicines, pain relievers and blood thinners.
• How your liver tests will be monitored.
• Pregnancy, breastfeeding or plans to become pregnant.

Do not replace your rheumatoid arthritis medicines with CBD, and do not cut down or stop them on your own; there is no evidence that CBD can take the place of medicines that slow the progression of the disease, and time without treatment can cause permanent joint damage. In Turkey, products made from cannabis, including CBD, can be sold only in pharmacies (Law No. 7557, regulation of January 31, 2026). Those classified as medicines or health products are dispensed with a prescription; no prescription requirement is stated for supplement products with a THC content of at most 0.3%. As of October 2026, there is no approved CBD medicine in Turkey. Details on our page on the rules.

Conclusion

For now, the encouraging findings on CBD in rheumatoid arthritis come from lab and animal studies; the only controlled study in patients used a medicine containing THC and showed a small improvement. The effect of pure CBD in rheumatoid arthritis has not yet been studied. Today, the most solid path is treatment planned together with your rheumatologist; if you are curious about CBD, you can bring it up in that conversation too.

Frequently asked questions

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