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CBD or cannabidiol and cannabigerol (CBG) are two non-psychoactive components present in the Cannabis sativa plant and to which therapeutic properties are attributed. New work has now found that they could be useful in relieving pain in patients with bone fractures and that, in addition, the use of these cannabinoids promotes fracture healing, as demonstrated in studies with mice.
The research has been carried out by scientists from Penn State College of Medicine (Pennsylvania, USA), who have published their promising findings in the Journal of Bone and Mineral Research. An analysis by The Lancet indicates that around 178 million people in the world suffer a bone fracture injury each year, and the drugs available to manage pain in these patients – such as non-steroidal anti-inflammatory drugs (NSAIDs) – are not the Better option.
In their healing process, “fractures go through an early inflammatory phase, followed by repair and remodeling. Nonsteroidal anti-inflammatory drugs (NSAIDs) are not recommended for the control of fracture pain, as they potently inhibit the inflammatory phase and therefore impair healing. Opioids do not offer a better alternative for several reasons, including the potential for abuse. “Consequently, there is an unmet clinical need for analgesics that effectively improve postfracture pain without impeding healing,” the authors wrote.
Effect of cannabinoids on fracture healing and pain
The main goal of Reyad Elbarbary, author of the work and associate professor of orthopedics and rehabilitation at Penn, and his team was to separately measure the pain-relieving properties of CBD and CBG in mice with tibia fractures. The researchers have defined their work as the first research to analyze cannabinoids in the context of fracture healing and pain management. They found that cannabinoids were comparable to NSAIDs in their ability to relieve pain, but they were also surprised to discover that CBD and CBG facilitated the fracture healing process.
“CBD and CBG treatments increased bone volume fraction and mineral density more than NSAIDs, leading to newly formed healthy and functional bone”
They used immunofluorescence microscopy techniques, microcomputed tomography, and biomechanical testing to study the fracture healing process, everything from bone density and strength, to the expression of genes that are necessary for the progression of fracture healing.
In the early phase of treatment, cannabinoids were associated with an increase in the abundance of periosteal bone progenitors, which later become specialized bone cells that assist in the formation of bone tissue. During the later phase of healing, CBD and CBG accelerated the process by which the body absorbs minerals to strengthen the newly formed bone.
“Both treatments resulted in a higher bone volume fraction and mineral density than with NSAID treatments, leading to the formation of healthy, functional bone,” Elbarbary said. “We still have a lot to learn about the biological mechanisms that provide these results.”
According to Elbarbary, future research will focus on defining the cellular and molecular processes involved in the role that cannabinoids play in early and late stages of fracture healing, as well as developing medications that allow their use in adult patients with fractures.
Although CBD is already approved by the FDA to treat seizures in children, finding a formulation or dose that is suitable for adults in the context of bone fractures will be a fundamental next step, adds the researcher, who explained that “there are already “There is strong safety data gathered on CBD, and it is more likely to be repurposed to treat fractures once a formulation is found and its efficacy for treatment in the context of bone fractures is determined.”
