Purpose
Since the passage of the Agricultural Improvement Act of 2018, hand surgeons have
increasingly encountered patients seeking counseling on over-the-counter, topical
cannabidiol (CBD) for the treatment of pain. To this end, we designed a human clinical
trial to investigate the therapeutic potential of CBD for the treatment of pain associated
with thumb basal joint arthritis.
Methods
Following Food and Drug Administration and institutional approval, a phase 1 skin
test was completed with 10 healthy participants monitored for 1 week after twice-daily
application of 1 mL of topical CBD (6.2 mg/mL) with shea butter. After no adverse
events were identified, we proceeded with a phase 2, double-blinded, randomized controlled
trial. Eighteen participants with symptomatic thumb basal joint arthritis were randomized
to 2 weeks of twice-daily treatment with CBD (6.2 mg/mL CBD with shea butter) or shea
butter alone, followed by a 1-week washout period and then crossover for 2 weeks with
the other treatment. Safety data and physical examination measurements were obtained
at baseline and after completion of each treatment arm.
Results
Cannabidiol treatment resulted in improvements from baseline among patient-reported
outcome measures, including Visual Analog Scale pain; Disabilities of the Arm, Shoulder,
and Hand; and Single Assessment Numeric Evaluation scores, compared to the control
arm during the study period. There were similar physical parameters identified with
range of motion, grip, and pinch strength.
Conclusions
In this single-center, randomized controlled trial, topical CBD treatment demonstrated
significant improvements in thumb basal joint arthritis-related pain and disability
without adverse events.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: May 27, 2022
Accepted:
March 2,
2022
Received:
July 9,
2021
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
