Prevalence of Cannabidiol (CBD) Use in an Outpatient Hand Surgery Clinic

The aim of this study was to evaluate the prevalence and perceived efficacy of cannabidiol (CBD) products in patients presenting to an orthopedic hand and upper extremity clinic.

New patients seen for an initial surgical consultation between July and December 2022 were surveyed regarding CBD use, pain, and function. Pain was measured with the Numeric Pain Rating Scale (NPRS, 0-10) and function with the Single Assessment Numeric Evaluation (SANE, 0-100). Demographic and clinical factors were collected via chart review.

A total of 918 patients completed the survey (53% female; mean age 63 years, range 18-97). Joints involved included elbows (106), wrists (335), and hands/fingers (667). Common diagnoses included arthritis (199), tendinopathy (273), and nerve-related conditions (160). Overall, 15% (135/918) reported prior CBD use, and 39% (53/135) perceived pain relief. CBD users were more likely to be female (65% vs 51%; P=0.003), to present with wrist pathology (44% vs 35%; P=0.038), and to have arthritis (36% vs 19%; P<0.001). Compared to non-users, CBD users reported higher pain scores (mean NPRS 6.2 vs 5.1; P<0.001) and lower contralateral function (mean SANE 77.3 vs 87.4; P<0.001).

In this cohort, CBD use was uncommon, and only a minority of users reported subjective benefit. CBD users tended to report higher pain and worse function, particularly in the setting of wrist arthritis. CBD products did not appear to provide measurable objective improvement in pain or function. Further studies are needed to clarify optimal dosing, administration, and potential role in upper extremity care.