The Role of the Human Endocannabinoid System in Bone Metabolism and Fracture Healing

Scientists have discovered fascinating physiology in the endocannabinoid system (ECS) in the constant remodeling of bone tissue. New research has uncovered that the ECS plays a critical role in maintaining adequate skeletal system functioning.

A study from the Journal of Neuroendocrinology 2008 focused on the major components of the ECS in bone metabolism. The two main endogenous cannabinoids, 2-arachidonoylglycerol (2-AG) and anandamide, are densely concentrated in the body’s osteoblasts and osteoclasts, bone forming and bone resorbing cells. The two main receptors in the ECS, CB1 and CB2 receptors, are both implicated in the activity of these bone cells.

Non-endocannabinoid related studies have investigated the influence of the sympathetic nervous system, specifically the adrenaline receptors, on bone remodeling. CB1 receptors have been well researched in the brain and autonomic nervous system. CB1 receptors in the synaptic terminals of neurons work in a retrograde manner to modulate the release of key neurotransmitters like dopamine, serotonin, glutamate, GABA, and others. New literature demonstrates that CB1 receptors are densely located at the synaptic terminals of sympathetic nerves’ connections directly to bone cells. The activation of these bone CB1 receptors inhibits the release of adrenaline hormones and homeostatically modulates the formation of bone tissue. The body must be able to attain an ideal balance between sympathetic (fight or flight) and parasympathetic (rest, recovery) nervous system activity to prevent age-related bone loss and osteoporosis. 

Researchers have demonstrated that the activation of CB2 receptors stimulates bone formation and inhibits bone resorption. Additionally, the lack of CB2 receptors accelerates age-related bone loss. Data exhibits CBD can improve fracture healing because of its interaction with CB2 receptors influencing the cross-linking enzymes in bone remodeling following internal damage (osteoporosis, osteopenia) and external damage (fractures, contusions). This identifies an essential role of the ECS in maintaining the integrity of the bone mass and bone density following fractures and in common age-related bone loss. 

This research is key in my chiropractic clinical practice. Research in the ECS modulation of the autonomic nervous system overlaps research in CHIROPRACTIC stating the spinal adjustments are able to directly influence the activity of the brain and central nervous system and modulating sympathetic stress tone and parasympathetic relaxation tone over all organs. The impact of the human endocannabinoid system in maintaining homeostasis is congruent with autonomic nervous system modulation of homeostasis of bone metabolism.

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This article is not meant to diagnose, treat, or mitigate any sort of disease, conditions, cancer or pathology. Please consult with your physician if you have questions about CBD and bone metabolism, fracture healing, or osteoporosis.