Fibromyalgia

Fibromyalgia and Medical Cannabis

Definition

Fibromyalgia is a rheumatic condition characterized by muscular and/or musculoskeletal pain, tenderness and stiffness at specific points of the body, especially tendons, bones, ligaments and muscles.

Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for Fibromyalgia

High

Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help

THC, CBD and CBG may be of use, although THC alone may not be enough. Pinene and beta-caryophyllene may also be particularly useful, as could linalool and myrcene at night time.

Medical Cannabis Pros

Chronic pain, IBS & migraine is often associated with fibromyalgia, and cannabis can help with such symptoms. Like these other conditions, fibromyalgia may be a result of an endocannabinoid deficiency.

Some fibromyalgia patients found cannabis to have favourable effects.

There are few medications available for fibromyalgia, and cannabis could be of particular use.

Medical Cannabis Cons

Evidence for the efficacy of cannabis for fibromyalgia is mixed at the moment. Higher quality evidence is needed.

As fibromyalgia also causes extreme fatigue, this must be taken into account when choosing a strain or product

More About the Condition

Fibromyalgia is an extremely difficult condition to treat, partially because so little is known about its causes. There are several conditions linked to fibromyalgia, including depression, post-traumatic stress disorder, anxiety and chronic pain.

Similar to myalgic encephalomyelitis, some hypothesise that fibromyalgia is developed as a response to a previous viral or bacterial infection that has caused long-term inflammatory responses. There are several other aspects to fibromyalgia, including improper processing of pain signals by the central nervous system (CNS), chronic pain, extreme sensitivity to pressure, light & temperature, gluten intolerance, numbness & tingling, irritable bowel syndrome (IBS), migraine, restless leg syndrome (RLS) and bladder problems. Conditions that present themselves similarly to fibromyalgia include polymyalgia rheumatica, rheumatoid arthritis, osteoarthritis and thyroid disease.

Between 2% and 8% of the United States’ population are believed to suffer from fibromyalgia. Around 10 million people in the US are affected by fibromyalgia. Both environmental and genetic factors are thought to cause fibromyalgia. Around 10 million people in the US are affected by fibromyalgia.

Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and milnacipran and the CNS depressant pregabalin (Lyrica) are most commonly prescribed for those suffering from fibromyalgia. Other than these medications, treatment programmes often include plenty of rest, exercise and diet changes, as so little is understood in how to treat fibromyalgia effectively. Sometimes, opioids are prescribed for those in extreme pain. However, they have little efficacy when it comes to fibromyalgia, and could end up adding to the pain rather than getting rid of it, in the form of addiction.

Cannabis could well help for some of the symptoms of fibromyalgia, especially chronic pain and insomnia. However, the evidence is mixed and, whilst some symptoms can be effectively treated, not all of them necessarily are. Yet, when looking at the sorts of symptoms associated with fibromyalgia (e.g. IBS, migraines, restless legs), there seems to be at least average-if-not-strong evidence that cannabis could help with them. This suggests that fibromyalgia may be associated with a disrupted endocannabinoid system in some, but have other factors in its development in others.

Quotes from Experts

“The mean amount per month of cannabis consumed was 31.4±16.3g, and 80% of cannabis consumers (CC) smoked pure cannabis or cannabis mixed with tobacco. Pain relief was reported by 94% of CC, while 93% reported improved sleep quality, 87% reported improvement in depression, and 62% reported improvement in anxiety.” Source: George Habib, Irit Avisar, ‘The Consumption of Cannabis by Fibromyalgia Patients in Israel‘, Pain Research and Treatment, vol. 2018, Article ID 7829427, 5 pages, 2018. https://doi.org/10.1155/2018/7829427

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