Hand and Upper Limb Orthopedic Surgeon Dr. Badia Calls ‘Medical Marijuana’ Potential Option; Offers Tips to Patients
An increasing amount of research, much of it done in animal models, is demonstrating CBD’s efficacy in mitigating chronic musculoskeletal, back, and joint pain due to arthritis, fibromyalgia, spinal and nerve disorders, and systemic inflammation.
Cannabidiol? Call it simply CBD and know that this derivative from the marijuana plant will not give you a “high” – only welcome relief for those aching joints, says orthopedic surgeon Alejandro Badia MD. The FDA has been slow to act on CBD pharmaceuticals — just one prescriptive medication containing a purified form of CBD has been officially approved by the federal agency, this one for treatment of epileptic seizures. But an increasing amount of research, much of it done in animal models, is demonstrating CBD’s efficacy in mitigating chronic musculoskeletal, back, and joint pain due to arthritis, fibromyalgia, spinal and nerve disorders, and systemic inflammation, Dr. Badia says. Musculoskeletal issues and orthopedic problems are considered the second most common reason why patients in the United States see a physician.
Dr. Badia cites a variety of recent studies, including a 2020 report published in Clinical and Experimental Rheumatology, which concludes that addition of medical cannabis therapy to standard analgesic treatment for fibromyalgia offers “a clinical advantage” and does enhance quality of life for patients. Fibromyalgia is a chronic disease marked by musculoskeletal pain, general fatigue, and malaise.
A scientific poster presentation published in 2020 by the American Academy of Orthopaedic Surgeons indicates that about 20 percent of surveyed patients suffering from chronic musculoskeletal distress report using a cannabis compound, with the majority of those users saying the drug has helped them manage their pain. An earlier Arthritis Foundation poll determined that nearly 30 percent of arthritis patients were using CBD-based products, with many of them saying CBD seems to enhance their physical functioning and improve sleep.
Some scientists suggest that CBD may even be effective in bone-fracture repair, says Dr. Badia, a Miami-based orthopedic specialist noted for his treatment of musculoskeletal problems affecting the upper limbs, including hands, elbows, and shoulders. He points to a study, published in the Journal of Bone and Mineral Research, indicating CBD plays a role in catalyzing the work of “collagen crosslinking enzymes” needed for healing of cracked bones.
“What is truly exciting is that CBD may help patients avoid addictive narcotics – opioid drugs – and long-term dependence on over-the-counter medications like ibuprofen to relieve pain,” says Dr. Badia, founder and chief medical officer of the Badia Hand to Shoulder Center and OrthoNOW®. Long-term ibuprofen use can increase risk for heart attack and stroke and lead to hypertension, as well as kidney and gastrointestinal problems.
Authors of a study published online in 2017 wrote that “prescription drug overdoses are the leading cause of accidental death in the United States” and indicated, “Cannabis can be an effective treatment for pain, greatly reduces the chance of dependence, and eliminates the risk of fatal overdose compared to opioid-based medications.”
Considered generally safe with limited side effects, CBD – or “medical marijuana” in more common terms — is one of more than 300 cannabinoid chemicals that can be obtained from the Cannabis sativa plant. It is completely separate from THC, another of the plant’s cannabinoids but one that affects a person’s mental state, causing the euphoric “high” associated with marijuana.
CBD’s reported anti-inflammatory effects are linked to the chemical’s ability to activate the body’s own cannabinoid receptors. Excitation of these receptors launches a cascade of natural processes that eventually prompt the body’s white blood cells to repair and heal injured tissue, tendons, and joints, says Dr. Badia. He offers select patients CBD medications, under the brand name OrthoNaturals™, in his own practice.
The National Center for Complementary and Integrative Health of the National Institutes of Health suggests cannabinoids offer “modest benefits” for chronic pain. Other scientists, however, call for longer-term human studies to provide “compelling evidence” of potential advantages and risks of CBD. They also warn of the current lack of medically accepted standards for administration of CBD to specific patients under varying conditions.
Dr. Badia concurs but says CBD products can be given safely by physicians who have extensive clinical experience and expertise in the use of cannabinoids. “Medical marijuana is not a new concept. Health practitioners have been administering cannabinoids for more than 3,000 years to alleviate digestive disorders, relieve pain, even treat psychological problems,” he says.
Despite the history, Dr. Badia’s advice to patients with chronic musculoskeletal pain and other orthopedic issues is to “avoid use of cannabinoids on your own. Do so only under the guidance of an experienced orthopedic specialist. The market is filled with a bewildering array of products that have outpaced medical science; come in a variety of topical, oral, and sublingual forms; and lack agreement on application and dosage.”
He also offers these tips to patients considering cannabinoids as a treatment option:
Do the research. Find an orthopedic specialist with a positive track record in using CBD medications.
- Moderate expectations. Cannabinoids take time to produce positive results. Be patient and do not anticipate a “miracle cure.”
- Take CBD as part of an overall plan to reduce musculoskeletal or joint-specific pain. That plan should include other physician-prescribed therapies, such as injections to reduce inflammation; use of standard anti-inflammatory pharmaceuticals compatible with cannabinoids; exercise protocols; a healthy diet; and programs to control stress.
- Do not use cannabinoids as a substitute for seeing a physician.
“Know there is no stigma to medical marijuana therapy. Some of our most significant and effective medications have been derived from plants,” Dr. Badia says. “Future research should help us identify even more of the benefits of CBD and its effectiveness in returning patients to quality of life.”
Bio: Alejandro Badia, MD, FACS, internationally renowned hand and upper-limb surgeon and founder of Badia Hand to Shoulder Center and OrthoNOW®, a walk-in orthopedic care clinic. He is a member of the American Society for Surgery of the Hand, American Association for Hand Surgery and the American Academy of Orthopedic Surgeons and an honorary member of many international professional hand societies. Dr. Badia specializes in treating all problems related to the hand and upper extremities, including trauma, sports injury, joint reconstruction, nerve injuries and arthroscopic surgeries. https://www.OrthoNOWcare.com and https://www.drbadia.com.
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