Bone healing is a complex biological process that depends on balanced inflammation, healthy bone-forming cells, and proper signaling between tissues. This review explores how cannabinoids interact with the endocannabinoid system, a network of receptors found throughout the body—including in bone tissue—that helps regulate bone formation and remodeling. Researchers examined laboratory studies, animal models, and available clinical data to better understand how compounds such as cannabidiol (CBD) and tetrahydrocannabinol (THC) may influence fracture healing and spinal fusion outcomes. (PMC)

The evidence suggests cannabinoids can affect both osteoblasts (cells that build bone) and osteoclasts (cells that break down bone), meaning they may influence how bones repair themselves after injury or surgery. Preclinical studies frequently show neutral or beneficial effects, with activation of certain cannabinoid receptors—especially CB2—and CBD exposure associated with improved bone repair processes and enhanced bone formation in experimental models. However, human clinical findings are more mixed. Some retrospective studies link chronic or high-dose cannabis use, particularly THC-dominant exposure, with slower bone union or increased risk of incomplete spinal fusion, highlighting the importance of dosage, cannabinoid ratios, and patient factors. (PMC)

Overall, the review concludes that cannabinoids represent an emerging area of interest in orthopedic and fusion medicine, but clear clinical guidelines do not yet exist. Differences between laboratory results and human outcomes suggest cannabinoids may have dose-dependent effects, meaning certain compounds or controlled therapeutic use could support bone healing while excessive or uncontrolled exposure may interfere with recovery. The authors emphasize that future clinical trials are needed to determine safe dosing strategies and clarify how cannabinoids might best be used alongside modern bone-healing treatments. (PMC)

Source

Urreola G, et al. The Cannabinoid Pharmacology of Bone Healing: Developments in Fusion Medicine (August 2025) Available through the National Library of Medicine (NIH): https://pmc.ncbi.nlm.nih.gov/articles/PMC12383948/