A CBD tablet reduces pain after shoulder surgery without side effects sometimes associated with CBD use, such as nausea, anxiety, and liver toxicity. 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 Woken up in the morning in pain & loss of full range of motion in your shoulder? Hit with pain when working out at the gym. Rotator cuff tear..read on
CBD tablet safely eases pain after shoulder surgery
“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,” says Michael J. Alaia. (Credit: Getty Images)
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An orally absorbed tablet containing cannabidiol, also known as CBD, effectively reduces pain after shoulder surgery with no safety concerns, a new study finds.
Researchers found that the tablet ORAVEXX safely managed pain after minimally invasive rotator cuff surgery, and did not produce side effects sometimes associated with CBD use, such as nausea, anxiety, and liver toxicity.
“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,” says lead investigator Michael J. Alaia, associate professor in the orthopedic surgery department at New York University.
“It could be a new, inexpensive approach for delivering pain relief, and without the side effects of anti-inflammatory drugs like NSAIDs and addiction risks linked to opiates. Additionally, CBD has the benefit of pain relief without the psychotropic effects associated with THC or marijuana.”
The multicenter phase 1/2 clinical trial randomly sorted 99 participants across two study sites (NYU Langone Health and Baptist Health/Jacksonville Orthopaedic Institute) between the ages of 18 and 75 into a placebo group and a group receiving oral-absorbed CBD.
Participants were prescribed a low dose of Percocet, instructed to wean off the narcotic as soon as possible, and to take the placebo/CBD three times a day for 14 days after the surgery.
On the first day after surgery, patients receiving CBD experienced on average 23% less pain as measured by the visual analog scale (VAS) pain score compared to patients receiving the placebo, highlighting that in patients with moderate pain, CBD may render a significant benefit.
On both the first and second days after surgery, patients receiving CBD reported 22 to 25% greater satisfaction with pain control compared to those receiving placebo. Further analysis also showed that patients receiving 50 mg of CBD reported lower pain and higher satisfaction with pain control compared to patients receiving placebo. No major side effects were reported.
While the results are promising, Alaia cautions consumers against seeking out commercialized CBD products.
“Our study is examining a well-designed, carefully scrutinized product under an investigational new drug application sanctioned by the FDA. This is currently still experimental medicine and is not yet available for prescription,” he adds.
ORAVEXX, the buccally absorbed tablet used in this study, is a non-addictive, fast-absorbing CBD composition designed to treat pain. Orcosa Inc., a life sciences company, designed and manufactured it.
Moving forward, researchers have launched a second study looking at whether ORAVEXX can specifically treat chronic pain in patients with osteoarthritis. Multiple phase 2 studies also are planned to evaluate the drug’s efficacy for other acute and chronic pain management issues and to assess the role of CBD on inflammation.
Researchers presented the findings at the American Academy of Orthopaedic Surgeons (AAOS) 2022 Annual Meeting in Chicago. Additional coauthors are from NYU Langone Health and Baptist Health in Jacksonville, Florida.
The Jacksonville Jaguars Foundation funded the work.
Alaia reported consulting for Arthrex, JRF Ortho, and DePuy Mitek Sports Medicine, and research support from Orcosa Inc. Kevin Kaplan of Baptist Health, reported consulting for Arthrex, Inc. and holding shares in Orcosa Inc. No other disclosures were reported.
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.
Do you have a Rotator Cuff Tear?
Pain in your shoulder can be debilitating and seriously affect your quality of life. It can limit your movement and prevent you from doing the things you love. Even something as simple as typing on a computer would be difficult or even impossible with shoulder pain.
When shoulder pain strikes, one of the things that people fear the most is rotator cuff damage. A torn rotator cuff will seriously weaken your shoulder and make everyday activities difficult and painful.
If you have pain in your shoulder that gets worse when you raise your arm, it could be the result of a tear. Or it could be the result of rotator cuff tendonitis. In order to diagnose and treat your rotator cuff injury , the first step will be a trip to the Doctor’s, or a health practitioner, such as an Osteopath.
Do you have a rotator cuff tear?
The first step to discovering if you have a rotator cuff tear, tendonitis or another type of shoulder injury. An ultrasound is a good place to start, if the health professional feels it needs further investigation. With an MRI scan, being the next step, if signs of damage have been found from the initial scan. When visiting the doctor or a health practitioner, it’s important to note when your pain first started and if you have been doing any physical activity which could have caused it.
Rotator cuff tears are most commonly caused by overuse, repetitive activity or an accident or sudden injury. The rotator cuff is a collection of muscles and tendons which keep the “ball” of your upper arm in the shoulder socket. This structure helps you to raise and rotate your arm, so it is important for normal movement. It acts rather like the hand over a gear stick to move your arm in different directions.
When the rotator cuff is torn, you might experience weakness in your shoulder. You might also struggle to lift or carry things that you would normally have no trouble with. And finally, your shoulder will be very painful.
The problem with diagnosing a rotator cuff tear is that it often presents with similar symptoms to tendonitis and frozen shoulder.
Difference between a tear and tendonitis
With tendonitis, you will typically experience pain at the tip of the shoulder and the upper outer arm. The pain will be made worse by lifting, pushing, pulling, reaching, lying on your side and raising your arm.
With a tear, you will experience weakness in your shoulder in addition to the pain. A doctor or a health practitioner will diagnose a tear by examining your shoulder and asking you to complete a series of movements to test your range of motion and strength. As mentioned earlier on in the post, they will also order tests such as an ultrasound or MRI.
A tear may require surgery to fix it, while tendonitis will require rest and rehabilitation.
Types of tears
There are two types of a rotator cuff tear, acute and degenerative.
An acute rotator cuff tear is often the result of a fall, injury, or lifting something too heavy with a jerking motion. If you are in an accident and suffer a broken collar bone, for example, you may also suffer a rotator cuff tear.
Degenerate rotator cuff tear is often the result of wear and tear on your shoulder. Athletes who do repetitive motions such as swimmers, tennis players and baseball players are often susceptible to this type of injury. Professionals such as painters and carpenters can also suffer this type of injury.
Will I need surgery?
If you require surgery and the type of surgery you have will all depend on your personal circumstances. Your doctor will consider things like your age, overall health and the severity of the tear to determine if you require surgery.
There are three main types of surgery which your doctor will consider. Arthroscopic surgery will involve making a small incision and using a tube with a camera and small instruments to carry out the repair. As this is less invasive, the recovery time will typically be shorter.
In open surgery, the doctor will make a larger incision and use larger instruments to repair the muscles in your shoulder. There is also the option to perform something known as mini-open surgery, which starts with the arthroscopic method and then finishes with larger instruments.
Only your doctor will be able to determine if you need surgery and which type of surgery should be performed.
Recovering from surgery
If you do have surgery, you can expect to wear a sling on your arm for 4-6 weeks. You will also need to perform daily exercises to keep blood flowing to your arm and hand. Daily exercises will also help to encourage healing and strengthen the muscle – repetitive pain free movement of any kind will help it heal quicker and stronger.
Once your sling has been removed, this sadly won’t be the end of your recovery journey. This is when the real work begins to rehabilitate your shoulder and ensure you regain full movement. It can take up to a year for you to regain full range of motion after a tear.
Your doctor will give you some exercises to try at home, or they may give you the opportunity to work with a physical therapist. It’s important that you take your time with your recovery and don’t try to push yourself too soon. Follow your doctor’s instructions and listen to your body throughout your recovery.
Alternatives to surgery
If your doctor decides surgery isn’t necessary, they will offer some alternative therapies for you to try. In the case of minor tears or tendonitis, you will be able to treat this as home with rest and some physical therapy.
The first thing you will need to do is to stop using your shoulder. Wearing a shoulder wrap will help to immobilise the joint while offering compression and support. You should also ice your shoulder to help reduce inflammation and pain. Use a cold compress for 20 minutes not more than 5 times a day.
If you are looking for a natural method to reduce pain, you could try cannabis oil. CBD oil or cannabis oil is one of the compounds found in cannabis or hemp plants. It doesn’t get you high, but it can help to manage pain and inflammation.
Protecting your rotator cuff
Once you have recovered from surgery or rotator cuff tendonitis you will want to look for ways to protect your rotator cuff in future. These steps might also be helpful for those who have experienced shoulder pain and have been warned that it could develop into tendonitis or a rotator cuff tear.