CBD (cannabidiol) is no better than placebo in alleviating arthritic pain, according to a recent randomized controlled trial in the journal Pain. Researchers in Denmark divided 136 people with hand arthritis or psoriatic arthritis into two groups—one that was given CBD tablets, the other a placebo tablet, for 12 weeks.

The CBD group took 10 milligrams once daily for two weeks, after which the dose was doubled and then, after four weeks, tripled in those not experiencing significant pain relief. Both groups were encouraged not to change their usual analgesic medications.

At the end of the study period, results from 129 of the remaining participants were analyzed. Both groups reported decreases in pain intensity compared to baseline, as measured by a subjective pain rating scale (the placebo effect hard at work!)—but there were no differences between the groups. There was also no difference between the groups in reported sleep quality (poor sleep has been linked to increased pain).

Many people turn to CBD for pain relief, despite the lack of good-quality evidence of its effectiveness, especially for CBD alone (separate from THC, the psychoactive component of the cannabis plant from which CBD also comes). Still, scientists have proposed that CBD may act on receptors involved in inflammation and pain-sensing systems (nociception), and a limitation of the study is that it may not have used a high enough CBD dose to achieve sufficient blood levels for this to occur. Moreover, it’s possible that other CBD formulations would have proved more effective. The strengths of the study, however, are its gold-standard design, the large number of participants, and its relatively long duration.