{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T07:35:11Z","timestamp":1776497711861,"version":"3.51.2"},"reference-count":73,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Cannabinoids have gained popularity recently with special emphasis on their use for chronic pain. Although NICE guidelines advise against their usage for management of chronic pain, almost all rheumatologists encounter a few patients in their daily practice who either use them or are curious about them.<jats:list list-type=\"bullet\">\n<jats:list-item>\n<jats:p>We reviewed the mechanism of action of cannabinoids, current knowledge about their role in rheumatology and potential drug interactions with common drugs used in Rheumatology.<\/jats:p><\/jats:list-item>\n<jats:list-item>\n<jats:p>We attempted to answer the question \u201cIf cannabinoids are friend, foe or just a mere bystander?\u201d<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We adhered to a search strategy for writing narrative reviews as per available guidelines. We searched PubMed with the search terms \u201cCannabinoids\u201d, \u201cRheumatology\u201d and \u201cChronic pain\u201d for published articles and retrieved 613 articles. The abstracts and titles of these articles were screened to identify relevant studies focusing on mechanism of actions, adverse effects and drug interactions. We also availed the services of a musculoskeletal librarian.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Despite the NHS guidelines against the usage of cannabinoids and associated significant stigma, cannabinoids are increasingly used for the management of pain in rheumatology without prescription. Cannabinoids act through two major receptors CB1 and CB2, which are important modulators of the stress response with potential analgesic effects. Their role in various rheumatological diseases including Rheumatoid arthritis, Osteoarthritis and Fibromyalgia have been explored with some benefits. However, in addition to the adverse effects, cannabinoids also have some potential interactions with common drugs used in rheumatology, which many users are unaware of.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While the current studies and patient reported outcomes suggest cannabinoids to be a \u201cfriend\u201d of rheumatology, their adverse events and drug interactions prove to be a \u201cFoe\u201d. We were unable to arrive at a definite answer for our question posed, however on the balance of probabilities we can conclude cannabinoids to be a \u201cfoe\u201d. Under these circumstances, a disease and drug focussed research is need of the hour to answer the unresolved question.<\/jats:p><\/jats:sec>","DOI":"10.1002\/msc.1636","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T18:23:29Z","timestamp":1651083809000},"page":"416-428","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Cannabinoids in rheumatology: Friend, foe or a bystander?"],"prefix":"10.1002","volume":"20","author":[{"given":"Nibha","family":"Jain","sequence":"first","affiliation":[{"name":"Department of Rheumatology University of Leicester  Leicester UK"},{"name":"University Hospitals of Leicester NHS Trust  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5903-1125","authenticated-orcid":false,"given":"Arumugam","family":"Moorthy","sequence":"additional","affiliation":[{"name":"University Hospitals of Leicester NHS Trust  Leicester UK"},{"name":"College of Life Sciences University of Leicester  Leicester UK"},{"name":"Tamil Nadu Dr MGR Medical University  Chennai India"},{"name":"New Vision University  Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrev.5b00411"},{"issue":"2","key":"e_1_2_6_3_1","first-page":"e78LP","article-title":"A systematic review of systematic reviews for medical cannabinoids","volume":"64","author":"Allan G. 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