Middle-aged woman suffering from back pain

Key points

  • Fibromyalgia is often a life-long condition characterised by increased pain perception, extreme tiredness, and muscle stiffness. Patients who suffer from the condition also develop comorbidities such as anxiety, depression, and insomnia.
  • Although widespread in the UK, the mechanisms behind fibromyalgia remain unclear. Current treatment involves administering pain and depression medications. However, many patients report that these medications either cause side effects or do not alleviate their symptoms.
  • Cannabis has been found to alleviate symptoms in patients with fibromyalgia, including pain and depression. Recent studies show that many patients prefer medical cannabis over other medications because it is more tolerable and causes fewer side effects.
  • In addition, cannabis has been found to be an effective treatment for insomnia, which is common in patients with fibromyalgia. Furthermore, medical cannabis has been shown to improve the quality of life and reduce stress in patients with fibromyalgia.
  • As an emerging treatment option, cannabis is still in the early stages of research. However, medical cannabis treatment can provide patients with an alternative therapeutic route. Patients should speak with their doctor about whether cannabis could be a suitable treatment for them.

Fibromyalgia is a chronic condition that affects millions of people in the UK. In fact, the latest statistics suggest that nearly 2.9 million people suffer from the condition, diagnosed and undiagnosed.

The main symptoms of fibromyalgia include increased sensitivity to pain, constant fatigue, and problems with mental processes (among others). These can be debilitating and cause a person to lose their ability to function properly. Aside from these physical ailments, the condition can lead to other mental health problems like anxiety and depression.

Despite the prevalence of fibromyalgia, it is a poorly understood condition. Most patients live with the condition chronically – meaning they have to deal with it for the rest of their lives. The condition is not fatal, but it significantly affects a person’s quality of life.

Pain medication treatment remains the most widespread way to control symptoms. Patients also receive antidepressants to help with mood disorders along with fibromyalgia. Unfortunately, these can cause severe side effects, which then affect compliance.

In recent years, there has been growing interest in using cannabis-based therapies for fibromyalgia treatment. This article will explore the use of cannabis for fibromyalgia treatment and give insight into whether this is a good option for patients.

What is fibromyalgia: symptoms, causes, and diagnosis

Fibromyalgia is a chronic condition that causes widespread pain, tenderness and extreme fatigue. The condition affects millions of people worldwide and can be extremely debilitating. Fibromyalgia can make simple tasks like walking or sleeping an exhausting struggle, causing many sufferers to lose their jobs or even end up homeless.

Fibromyalgia tends to be more common in women than men, but anyone can develop the condition. The condition’s onset can be sudden or gradual, often triggered by physical trauma. Most patients begin noticing symptoms at ages 35 to 50. However, many people experience no obvious trigger at all.

Symptoms of fibromyalgia

Fibromyalgia is a debilitating chronic pain condition that can cause significant symptoms. Typically, these include:

  • Increased sensitivity to pain in muscles and tissues
  • Tenderness in the upper chest and back areas, including the neck, arms, and legs
  • Constant fatigue
  • Frequent and random headaches
  • Irritable Bowel Syndrome (IBS)

Fibromyalgia and comorbid conditions

Fibromyalgia is a condition highly influenced by psychological and social factors. Psychiatric comorbidities among fibromyalgia patients occur at rates as high as 30%-60%.

The following psychiatric conditions occur at a higher rate in fibromyalgia patients than in the general population:

  • Depression
  • Anxiety disorders
  • Panic disorders
  • Posttraumatic Stress Disorder (PTSD)

Aside from mental health issues, sleep disturbance is also prevalent in fibromyalgia patients. It is estimated that as many as 80% of people with fibromyalgia experience sleep problems, which may contribute to poor quality of life and chronic pain in these individuals.

Studies also show a link between fibromyalgia and rheumatoid diseases like rheumatoid arthritis, systemic lupus erythematosus (SLE), and vasculitis. The two conditions cause similar symptoms, making it difficult for a doctor to diagnose one over the other (or both).

What causes fibromyalgia?

The exact cause of fibromyalgia is unknown, but researchers believe it is a disorder that develops when the central nervous system and peripheral nervous system become dysregulated. This means that your brain may not send the right signals to your body’s pain receptors, causing you to feel more pain than someone without fibromyalgia.

Genetics also play a role in the development of fibromyalgia to make things more complicated. Researchers have discovered that people with a family history of fibromyalgia are more likely to develop it, as well as other chronic pain conditions.

Various factors cause fibromyalgia to set off. These may include:

  • physical stress
  • injury
  • arthritis
  • spine issues

How is fibromyalgia diagnosed?

Doctors diagnose fibromyalgia based on a patient’s symptoms and medical history. They may also perform a physical exam to rule out other conditions that cause similar symptoms. If you are diagnosed with fibromyalgia, your doctor will likely recommend identifying the triggers that can worsen your symptoms.

Since pain is associated with other conditions, doctors may need to ask patients to describe the sensation felt. This helps doctors differentiate fibromyalgia from other pain-inducing conditions such as arthritis, muscle strain and nerve damage. Furthermore, blood tests may be ordered to rule out other conditions, such as kidney disease, diabetes and lupus.

Generally, the main conditions for fibromyalgia diagnosis include the following:

  • Pain symptoms plus comorbid conditions such as fatigue and cognitive decline
  • Symptoms that continue for more than three months
  • No other health conditions that could explain the pain and other conditions

Current treatment options for fibromyalgia

Macro of tablets with prescription bottles against a dark background

There are no known cures for fibromyalgia; however, there are therapies that could help manage symptoms. The most common treatment option for this syndrome is neuropathic medication. These drugs treat nerve pain and can be prescribed as antidepressants, anti-seizure medications or antiepileptic drugs.

There are two main medications currently approved for fibromyalgia:

  • Lyrica (pregabalin) – This medication targets overactive nerves in pain perception. It is used to treat nerve pain and other symptoms of fibromyalgia. It may also be prescribed for seizures, anxiety disorders, and restless legs syndrome.
  • Cymbalta (duloxetine) – This medication treats fibromyalgia by acting on serotonin levels in the brain and spinal cord. It also treats major depressive disorder, anxiety disorders, and diabetic peripheral neuropathy.

Doctors may also prescribe patients anti-depressants and sleep medication to help with fibromyalgia symptoms. Despite their widespread use in pain treatment, opioids should not be taken for fibromyalgia. Opioid-based drugs can increase pain sensitivity and make it harder for patients to find relief from their symptoms.

Lifestyle remedies for fibromyalgia

In addition to prescribed medications, a number of lifestyle remedies can help fibromyalgia patients. These include:

  • Exercise – Many people with fibromyalgia find that regular exercise helps them feel less pain and fatigue. The type of exercise that works best for you may depend on the patient’s symptoms, but generally, aerobic exercises like swimming, walking or cycling have been shown to be helpful. Physical activities remain one of the more consistent lifestyle therapies for the condition.
  • Cognitive behavioural therapy (CBT) – CBT is a type of psychotherapy that can help patients manage their symptoms by changing how they think about their condition. It aims to help people understand how their thoughts and behaviours affect pain, fatigue, and other fibromyalgia symptoms.
  • Massage therapy – Massage has been shown in some studies to help improve the quality of life for fibromyalgia patients. Self-massage can be a good option for people with fibromyalgia. Massage may help reduce pain, improve sleep quality, and boost mood.
  • Mindfulness – Mindfulness has been shown to help reduce stress caused by the condition. Mindfulness-based stress reduction has been shown to reduce symptoms of fibromyalgia in several studies.

Medical cannabis and fibromyalgia: Why are people turning to cannabis?

Gloved hand filling up glass jar bottle with cannabis CBD oil mixture for oral medical use

More and more people are turning to medical cannabis for fibromyalgia. The question is, why?

To understand why cannabis is becoming an increasingly attractive option, it helps to understand the pitfalls of current treatment options.

While medication can help the symptoms of fibromyalgia, many patients are put off by the side effects. Drugs like pregabalin (Lyrica) and gabapentin (Neurontin) can cause dizziness, weight gain, lethargy and swelling.

Serotonin and norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) can cause dizziness, nausea, weight gain and dry mouth. Antidepressants like amitryptiline (Elavil) and nortriptyline (Pamelor), which are also used to treat fibromyalgia symptoms, have similar side effects.

Medical cannabis, however, has been reported to cause fewer side effects. In a study published in the Journal of Pain, researchers found that patients who used medical cannabis to treat their fibromyalgia symptoms experienced less pain and stiffness than those who took prescription drugs. They also reported that cannabis was more effective at reducing fatigue and depression.

Many patients find that using CBD oil helps them manage their pain better than other medications without interactions with standard drugs they may be taking. However, it’s important not to rely solely on cannabis as the sole treatment method. Patients should always consult their medical provider when considering any new treatment.

How does medical cannabis work: THC, CBD, and the ECS

Cannabis has been historically used to treat various conditions, including pain, inflammation, and nausea. Recent studies have increased support for the use of cannabis in the clinical setting thanks to new methods to better isolate the therapeutic compounds found in the plant.

Medical cannabis interacts with the central nervous system (CNS) via several pathways, including the endocannabinoid system (ECS). The ECS is a group of receptors found throughout the body and brain. When activated by compounds like THC and CBD, these receptors send signals to various organs in the body via neurotransmitters:

  • Tetrahydrocannabinol (THC) – The most well-known cannabinoid, THC is the psychoactive component of cannabis. It binds to CB1 receptors and causes pain receptors to calm down, thus causing reduced feelings of pain. THC is also known for its mood-alleviating properties, which is why people often use it to address mood disorders like depression and anxiety.
  • Cannabidiol (CBD) – CBD is the other well-known cannabinoid, and it’s known for its non-psychoactive properties. CBD does not bind to receptors. Instead, it induces chemical changes in the body that are analgesic (pain-relieving).

Cannabinoids can mitigate the many symptoms of fibromyalgia

Senior woman in pain and suffering sitting by the window in the hospital.

Cannabinoid-based treatment for fibromyalgia has been the subject of interest in recent years. Medical cannabis has been shown to help relieve pain, improve sleep, and reduce anxiety and depression. Because patients with fibromyalgia require holistic treatment, cannabis can be used as part of a comprehensive fibromyalgia treatment plan.

Medical cannabis has been used to treat chronic pain caused by fibromyalgia as well as other conditions

The use of cannabis to treat chronic pain is well-documented in the medical literature. Cannabis has been shown to be an effective treatment for chronic pain, and many studies are showing that it’s a safer alternative to prescription medication.

For instance, a 2015 study published in the Journal of Pain found that chronic pain patients who used cannabis daily for one year reported a 64 per cent reduction in pain and an improved quality of life compared to those who didn’t use cannabis. Other research has shown that medical cannabis can be effective at treating neuropathic pain, which people with fibromyalgia often experience.

Anecdotal evidence suggests that CBD, in particular, can help improve pain perception in fibromyalgia patients. Survey data is backed by clinical findings, such as the 2018 study published in the Journal of Clinical Rheumatology.

The researchers administered medical cannabis to 30 patients, and all reported improved outcomes. Out of 30 patients, half of them stopped talking about other fibromyalgia medications altogether. Whether reduced pain is caused by a reduction in inflammation or other mechanisms, such as the analgesic effects of cannabinoids, is still unclear.

Medical cannabis may improve the quality of life in fibromyalgia

Patients with fibromyalgia also report reduced anxiety and depression, which are common comorbidities of fibromyalgia. Medical cannabis treatment is often used to treat anxiety and depression. Many patients report that the use of medical cannabis has helped them reduce their reliance on other medications for these conditions.

A study published in the European Journal of Pain investigated the effects of medical cannabis on fibromyalgia symptoms. The researchers found that patients experienced an improvement in their quality of life and reduced pain, stiffness and fatigue. Patients also reported less anxiety and depression after using medical cannabis for four weeks.

Consistent with other findings, a 2022 Arthritis Care & Research study found that medical cannabis may be a useful treatment strategy for patients. The researchers noted: “Our current findings are consistent with observations of pain relief, improved sleep, and alleviation of symptoms of anxiety and depression in other studies among patients with chronic pain using medical cannabis.”

Medical cannabis oil for fibromyalgia lacks major side effects

Unlike other medications, cannabis has a wide margin of safety, meaning that even when used at high doses, it is unlikely to cause adverse effects. A 2019 observational study published in the Journal of Clinical Medicine concluded that medical cannabis is a “safe and effective alternative for the treatment of fibromyalgia symptoms.”

In the study, the researchers examined 367 fibromyalgia patients over six months. The authors noted: ” We found a significant improvement in pain intensity and significant improvement in patients’ overall quality of life and fibromyalgia-related symptoms after six months of medical cannabis therapy.”

Conclusion

When exploring the benefits of medical cannabis for fibromyalgia, it is important to understand that this treatment could be an excellent option for patients. The research will continue to evolve, and more studies will help our understanding of how cannabis can treat some symptoms of fibromyalgia, such as pain, sleep issues and depression.

If you’re considering medical cannabis treatment for fibromyalgia, it is essential to include your physician in the discussion. At the Medical Cannabis Clinics, our medical team can help you navigate the legal, medical and financial aspects of your treatment plan. Contact us today to learn more!

Frequently Asked Questions (FAQs)

What is the most effective treatment for fibromyalgia?

The most effective treatment for fibromyalgia is still unknown. Many people find that combining lifestyle changes, stress management techniques and medicines can help reduce symptoms.

How long does it take for CBD to work for fibromyalgia?

One 2018 clinical study found that patients who took medical cannabis for about ten months to a year experienced significant improvement in fibromyalgia symptoms.

Are cannabinoids effective for fibromyalgia?

Cannabinoids may be effective for fibromyalgia. A 2017 review of evidence found that medical cannabis may help reduce pain in people with fibromyalgia and improve mood and sleep quality.

References

https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia
https://www.sciencedirect.com/science/article/abs/pii/S1521689620300781
https://www.healthline.com/health/fibromyalgia/marijuana-fibromyalgia
https://journals.lww.com/jclinrheum/Abstract/2018/08000/Medical_Cannabis_for_the_Treatment_of_Fibromyalgia.3.aspx
https://www.mdpi.com/2077-0383/8/6/807
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430597/
https://www.nhs.uk/conditions/fibromyalgia/
https://www.frontiersin.org/articles/10.3389/fphar.2018.01259/full
https://www.jpain.org/article/S1526-5900%2815%2900837-8/pdf
https://pubmed.ncbi.nlm.nih.gov/35876631/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890993/