In a recent study published in the Journal of Bone and Mineral Research, it was found that two compounds found in cannabis, cannabidiol, and cannabigerol, may not just ease the pain of fractures but also speed up fracture healing. The study, titled “Cannabidiol (CBD) and Cannabigerol (CBG), Nonpsychotropic Cannabinoids, as Analgesics that Effectively Manage Bone Fracture Pain and Promote Healing in Mice,” is important because, as the researchers stated, “NSAIDs may help patients manage pain, but they also reduce inflammation, which is a crucial first step in fracture healing,” Dr. Elbarbary, the chief researcher, said. “An alternative for pain management is needed that does not prevent inflammation from occurring.”
Over 175 million people suffer a fracture every year around the world, and these fractures hurt. Opioids used to be the go-to medication for fractures, but the current political environment in the U.S. makes it almost impossible to use them safely. I don’t mean safely for the patient; opioids have been used medically for over a hundred years and medicinally for thousands. I mean safely for the doctor. Right now, if an elderly patient on the same dose for twenty years dies in their sleep, a doctor can be prosecuted for prescribing opioids and “contributing” to their death. Prove it didn’t. That leaves doctors all over the U.S. talking about how acupuncture and VR can be used to treat pain. That’s true. They can be. And they will help some. But a propane blowtorch can be used to treat skin infections, and it would be very effective. That doesn’t make it good medicine. Doctors need something new, and they need it now.
Bone fractures heal by going through an inflammatory phase and then a repair and remodeling phase. NSAIDs are not recommended for fracture pain because their inhibition of the inflammatory phase impairs healing. Dr. Elbarbary and his team decided to measure whether CBD and CBG could be used to alleviate pain safely. They decided to use mice as it is easy to correct for genetics and to create a controlled fracture. This was the first study to analyze cannabinoids in the context of fracture healing and pain management.
A fractured tibia causes mice to exhibit an increased sensitivity to pain and discomfort of almost any kind. Mechanical, cold, and hot stimuli were all tested, and in the end, the analgesic effects of both CBD and CBG were comparable to NSAIDs. Then, by using immunofluorescence microscopy, microcomputer tomography imaging, and biomechanical testing, the researchers were able to study the fracture healing process and discovered that, as an incredible bonus, instead of inhibiting bone healing, both chemicals promoted bone healing.
Early in the inflammatory phase, both compounds stimulated stem cells in the bone to produce periosteal bone progenitor cells as the healing hematoma formed around the fracture. In the later phases of healing, they enhanced the mineralization of the fibrocartilaginous callus and enhanced the proliferation and viability of bone marrow cells. These changes created higher bone volume and mineral density, which improved the mechanical properties of the healed bone. The compounds seemed to accomplish this by increasing the expression of genes that are necessary for the progression of fracture healing.
The study went further, analyzing the expression of the cannabinoid receptors. CB1 and CB2 are the primary cannabinoid receptors, and their respective genes are CNR1 and CNR2. After analyzing the expression of these genes, the research found that treatment with either CBD or CBG increased the abundance of the PDGFRa progenitors by three to four times, thereby promoting bone formation and healing and normalizing their gait pattern.
The study went on to conclude, “Overall, the protective, proliferative, and pro-osteogenic effects that we identified for CBD and CBG during the different healing phases culminated in accelerated repair, promoted bone formation, and enhanced biomechanical strength of the healed bone. These data extend our understanding of the impact of CBD on fracture healing and demonstrate for the first time the therapeutic potential of CBG in the context of bone regeneration and repair. Taken together, the data we present here propose CBD and CBG as effective alternatives to NSAIDs in managing pain in fracture patients.”
It never fails to amaze me how many therapeutic treatments are being developed from a substance that the federal government has declared to be “with no currently accepted medical use and a high potential for abuse.”
L. Joseph Parker is a distinguished professional with a diverse and accomplished career spanning the fields of science, military service, and medical practice. He currently serves as the chief science officer and operations officer, Advanced Research Concepts LLC, a pioneering company dedicated to propelling humanity into the realms of space exploration. At Advanced Research Concepts LLC, Dr. Parker leads a team of experts committed to developing innovative solutions for the complex challenges of space travel, including space transportation, energy storage, radiation shielding, artificial gravity, and space-related medical issues.