Medical cannabis (THC) Perthes disease treatment

Perthes disease is a childhood hip condition that can lead to chronic pain, stiffness and early arthritis in adulthood. Medical cannabis treatments may help eligible patients to alleviate associated symptoms, including hip pain, sleep disturbances and mood-related issues.

What is Perthes disease?

Perthes disease is also known as Legg-Calvé-Perthes disease, after the three doctors who first described it back in 1910. 

Estimated to affect approximately 1 in 9000 children, the condition is brought on by the blood supply to the femoral head (the ball at the top of the thigh bone) becoming temporarily disrupted. This causes the bone to soften and potentially collapse.

While the blood supply does normally recover on its own, it doesn’t always heal in the right way. 

Say the femoral head heals in an irregular shape, for instance. The joint may never fit together as it should, resulting in a wide range of problems later on in life. 

In fact, this has been suggested in research already, with one long-term follow-up study finding that every Perthes disease patient being followed past the age of 50 showed signs of severe hip osteoarthritis. 

In other words, while Perthes disease may start in childhood, its effects can carry well into adult life.

Who does Perthes disease affect in the UK?

Perthes disease is a relatively rare childhood hip condition that results in approximately 500 new cases in the UK each year. 

However, despite its rarity, the UK is estimated to have a higher incidence of Perthes disease than any other country in the world. 

During childhood, you are more likely to develop Perthes disease if you: 

• are a boy

• are aged between 4 and 10 years

• experience symptoms in only one hip

• have a family history of Perthes disease

While Perthes disease is diagnosed in childhood, the long-term effects that affect adults later on in life often go overlooked. 

Many previous Perthes disease patients won't even connect the hip pain, stiffness or early arthritis they're now living with to a condition they had decades earlier. 

But it could be a sign of a related condition, known as adult post-Perthes hip disease.

What is the difference between childhood Perthes disease and adult post-Perthes hip disease?

Perthes disease and adult post-Perthes hip disease may sound like similar conditions, but there are some key differences between the two. 

The main difference is when the conditions occur: Perthes disease is a childhood condition, whereas post-Perthes hip disease can impact those same patients years later, as a long-term consequence of the hip not fully recovering.

In simple terms, childhood Perthes disease is the active phase of the condition, where the blood supply becomes disrupted, the bone is affected, and it gradually heals over time. 

For many children receiving the right level of care, the hip will recover well. But for others, it can lead to certain related issues later on. 

One of these issues is adult post-Perthes hip disease, which can develop years or even decades later. 

While some patients often believe it might be the original Perthes disease coming back, it’s not. It’s simply a consequence of the joint healing in an irregular shape during childhood.

What symptoms does Perthes disease cause?

During childhood, the main symptoms of Perthes disease include having a limp, pain in the groin, thigh or knee (especially after activity), and reduced movement in the affected hip.

This changes slightly in adulthood, where the symptoms of adult post-Perthes hip disease tend to look more like osteoarthritis and can lead to several other related issues:

• Deep, aching hip pain that worsens with activity

• Stiffness and reduced mobility

• Lower back pain

• Sleep disturbances

• Fatigue

• Low mood and anxiety

What treatments are currently available for Perthes disease?

If you had Perthes disease as a child, you may have recovered from it without needing any type of treatment at all. 

However, if you experienced painful symptoms that impacted your overall quality of life, you may have been offered treatments like physiotherapy or even surgery to help.  

If you then experienced painful related symptoms later on in life, you’ll have likely been recommended a wide range of options to help you manage your symptoms. 

Here are some of the most common treatments offered to help manage the symptoms Perthes disease can cause in adults: 

 

These treatments may be effective at managing the symptoms of adult post-Perthes hip disease and helping you stay active for longer. But they don't work perfectly for everyone and, in some cases, may lead to certain side effects.

Finding the right type of treatment will also vary depending on factors like your age, how much the joint has been affected and how severe your symptoms are. 

Have a look at our dedicated patient stories page to learn more about the potential role treatments like prescribed medical cannabis could have on your symptoms.

Can medical cannabis treatment help with Perthes disease symptoms?

Prescribed medical cannabis may help some eligible patients manage certain symptoms associated with adult post-Perthes hip disease. 

That said, the key word here is ‘eligible’. 

Medical cannabis doesn’t target the underlying cause of Perthes disease or undo the changes caused to your hip joint as a child. So it shouldn’t be seen as a cure or standalone treatment. 

Some patients report that taking medical cannabis for the symptoms related to adult post-Perthes hip disease may help to:

• manage chronic pain

• get a better night’s sleep

• improve your mood

• reduce your reliance on other forms of treatment 

A medical cannabis prescription for Perthes disease should only ever be considered as one part of a wider approach, alongside other conventional treatments like physiotherapy, lifestyle changes and surgery. So, make sure to speak to a medical professional before adding it to your treatment plan.

How does the endocannabinoid system relate to Perthes disease?

The endocannabinoid system (ECS) is our body’s built-in signalling network that helps us manage a wide variety of processes. 

From how we perceive pain to regulating our mood, the ECS relies on two main receptors, called CB1 and CB2. 

CB1 receptors are mainly found in the central nervous system, whereas CB2 receptors are more commonly associated with immune cells.

The ECS is particularly relevant for post-Perthes hip pain because of how the symptoms develop and the impact that cannabinoids, like tetrahydrocannabinol (THC) and cannabidiol (CBD), can have.

By targeting these same CB1 and CB2 receptors, these cannabinoids may help to influence how pain signals are produced and processed. 

How do THC and CBD impact Perthes disease?

THC has been shown to act more directly on the CB1 receptors that gate pain signals as they travel through the nervous system. Meanwhile, CBD is better known for its anti-inflammatory properties. 

Working together, the two may help to alleviate the pain and inflammation that often drive the onset of several symptoms in adult Perthes disease patients, such as osteoarthritis.

What does research say about medical cannabis and Perthes disease?

Put simply, not much. 

There are currently no studies that have specifically looked into the relationship between medical cannabis and Perthes disease. This is likely due to the fact that the condition appears and often goes away during childhood, once the blood supply has returned. 

It’s also a rare condition, so it is unlikely to have been funded by research in the same way as other related conditions.  

That said, there is a whole host of broader evidence on medical cannabis and chronic pain more generally, as well as some of the main symptoms that Perthes disease can lead to later on in life.

Here’s a quick breakdown of the most relevant findings to have been published over recent years. 

 

As you can see, none of the research included above looked at Perthes disease directly. Instead, it focuses more on two symptoms that tend to influence Perthes disease patients later on in life: chronic pain and early osteoarthritis.

All in all, the findings show a lot of promise, but there’s still a long way to go. 

This is why medical cannabis should never be seen as a first-line treatment. It should only ever be offered on an individual basis, utilising a clinician-led approach.

What forms of Releaf medical cannabis can be prescribed for Perthes disease?

Finding the right type of medical cannabis to help manage your Perthes disease symptoms will depend on several factors, including your exact symptoms, medical history and what you’re looking to achieve long-term. 

You may also have a preferred method of administration, which will need to be taken into account by your consultant to ensure it meets your needs. 

At Releaf, the main forms of prescribed medical cannabis we can offer to eligible patients include oils, capsules, pastilles, dried flower for a vaporiser and THC vapes. 

Keen to learn more about the differences between these methods of administration? Take a look at our knowledge hub to discover detailed guides on each type. 

Am I eligible for UK medical cannabis treatment for Perthes disease?

Medical cannabis has been legal to prescribe in the UK since November 2018, on the condition it’s been approved by a specialist at a CQC-regulated private clinic. That includes us at Releaf, where we have gained a reputation for being the most-trusted UK medical cannabis clinic. 

For Perthes disease specifically, there are certain eligibility criteria you’ll need to meet to qualify for treatment. This includes: 

How does the Releaf prescription process work? 

If you’d like us to assess your suitability for medical cannabis, the best place to start is by using our medical cannabis eligibility checker. 

If this finds that you’re eligible, you’ll be able to book a consultation with one of our specialists, who can then discuss your condition, needs and symptoms, before taking you through the options available. 

Should you decide to move ahead with a medical cannabis prescription, you’ll be joining a welcoming community of Releaf patients and gaining access to high-level, CQC-regulated care. 

You’ll also be given the option to sign up for Releaf+, a bespoke membership where you’ll receive your very own medical cannabis card, travel certificates and access to Releaf Protect, a 24/7 hotline for legal support.

To learn more about how our process works, including answers on pricing, or the different types of medical cannabis strains and other medical cannabis treatment options, simply contact our team.

FAQs on medical cannabis for Perthes disease

Perthes disease is a complicated condition, and there’s not a lot of information available to adults living with the symptoms it can cause later on in life. So, we're here to help by answering some of the questions we’ve previously been asked.

How does medical cannabis for post-Perthes hip pain compare with long-term opioid use?

Opioids offer many patients an effective way of easing their pain over the short term, but they’re also associated with an increased likelihood of dependence and may lead to certain side effects, such as sleepiness, confusion and ‘brain fog’. 

A medical cannabis prescription may be considered if a patient is concerned about the risks involved with taking opioids for pain relief. 

Ultimately, finding the right type of medication will come down to the conversations you have with your doctor or medical specialist, and what you’re looking to achieve.

Can I access medical cannabis while on the waiting list for hip replacement surgery?

Yes, this is possible for eligible patients with Perthes disease. 

Medical cannabis may be prescribed to help manage your symptoms as part of a wider plan while you wait for your surgery date to come through, but it cannot replace the need for the surgery. 

Will medical cannabis improve my hip mobility as well as my pain?

Taking medical cannabis won’t change the structure of your hip joint or directly restore the reduced movement you’ve been experiencing as a result of previous Perthes disease. 

But some patients do find that the improved pain control and sleep that medical cannabis can provide helps make it easier to keep active and attend physiotherapy sessions, indirectly supporting and improving mobility.

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