Cannabis Health rounds up the latest research into the impact of cannabis on fibromyalgia.
There are thought to be around 1.5-2 million people in the UK currently living with fibromyalgia, a condition which causes chronic pain around the body, muscle stiffness and fatigue.
With no cure for the illness and symptoms severely affecting day-to-day life, research is focusing on therapeutic treatments – including medical cannabis.
In 2019, research published by Sagy, Schleider, Abu-Shackra and Novak showed that cannabis can help reduce fibromyalgia pain. The study of 367 patients found that pain intensity decreased when treated with medical marijuana, leading the team to state that “cannabis therapy should be considered to ease the symptom burden among those fibromyalgia patients who are not responding to standard care”.
Chaves, Bittencourt and Pelegrini further supported these findings in October 2020, concluding that phytocannabinoids can serve as an affordable yet well-tolerated therapy for fibromyalgia symptom relief and quality of life improvements.
After the randomised controlled trial, the researchers went as far as to suggest that the cannabinoid therapy “could become an herbal or holistic choice of medicine for treating fibromyalgia as part of Brazil’s public healthcare system”.
A study in Italy, published in February 2020, also demonstrated that medical cannabis improves the efficacy of standard analgesic fibromyalgia treatments.
Researchers concluded: “This observational study shows that medical cannabis treatment offers a possible clinical advantage in fibromyalgia patients, especially in those with sleep dysfunctions.”
Published in the Clinical and Experimental Rheumatology journal, the study followed 102 fibromyalgia patients who had not responded well to conventional treatments. These participants were given two forms of medical cannabis oil extracts and researchers then collected data over a six-month period from patients, who self-reported fibromyalgia symptoms, how well they slept, and feelings of fatigue, as well as depression and anxiety levels.
While only a third of fibromyalgia patients reported reduced symptoms of the disease overall, cannabis did improve overall quality of life for some. Fewer symptoms of depression and anxiety were found in around half of patients, too.
Despite fibromyalgia being more common amongst women – up to 90 per cent of sufferers are female – one study has found that cannabis may provide better pain relief for men.
The preclinical studies, conducted in 2016, compared the analgesic, subjective and physiological effects of active cannabis and inactive cannabis in male and female cannabis smokers under double-blind, placebo-controlled conditions, and measured pain response through the Cold-Pressor Test.
Among men, active cannabis significantly decreased pain sensitivity relative to inactive cannabis. However, in women, active cannabis failed to decrease pain sensitivity relative to inactive, indicating that in cannabis smokers, men exhibit greater analgesia compared to women.
Researchers concluded: “Sex-dependent differences in cannabis’ analgesic effects are an important consideration that warrants further investigation when considering the potential therapeutic effects of cannabinoids for pain relief.”
While further research is necessary, it is clear to see that medical cannabis can make a huge difference to treatment and relief of pain caused by fibromyalgia.
Fibromyalgia patients swap prescription drugs for CBD
Fibromyalgia patients are frequently substituting prescription medications for CBD products
Fibromyalgia patients are frequently substituting prescription medications for CBD products, according to a new study.
Findings published in the Journal of Pain, report that patients frequently acknowledge substituting CBD products for opioids, NSAIDS and other commonly prescribed medications.
Researchers with the University of Michigan Medical School surveyed 878 fibromyalgia patients who were currently using CBD.
Seventy-two percent of respondents reported deliberately substituting CBD products in place of other medications, specifically opioids, NSAIDS, benzodiazepines, and gabapentanoids.
More than half (53 percent) swapped CBD for opioids and 23 percent used it in place of benzodiazepines.
Among those who used CBD, the majority reported decreasing or stopping use of these pain medications all together.
The most common reasons for substitution were fewer side effects and better symptom management.
The authors noted: “Those who substituted reported larger improvements in health and pain than those who did not. Participants using CBD-cannabis reported significantly more substitutions than any other group and larger improvements in health, pain, memory, and sleep than other subgroups.”
Several other studies indicate that cannabinoids can provide relief to patients with fibromyalgia.
Data published in February reported that the long-term use of medical cannabis is linked to improvements in pain and other symptoms.
Can CBD help in treating rheumatoid arthritis and fibromyalgia?
Fibromyalgia patient Polly shares how CBD has helped alleviate her symptoms and the experts at Ardoa Organics explore the science behind it.
Cannabis has become a popular alternative to treat pain symptoms. Although scientific evidence surrounding the use of cannabinoids to control pain is sporadic, recent findings suggest cannabinoids may actually be beneficial in treating rheumatoid arthritis and fibromyalgia.
Cannabinoids can activate cannabinoid type 2 (CB2) receptors throughout the body to decrease the production of chemical messengers secreted by immune cells and as a consequence, reduce inflammation. Furthermore, cannabidiol (CBD) can have antiarthritic effects independent of cannabinoid receptors.
Apart from being able to control inflammation, cannabinoids can also reduce pain by activating central and peripheral CB1 and CB2 receptors, and CBD-sensitive non-cannabinoid receptor targets.
Cannabinoids may be a suitable treatment for rheumatoid arthritis, if we target the right receptors in the right place, and further studies should focus on determining the best combination of cannabinoids to be used.
More than 40 percent of people with multiple sclerosis (MS) reported using cannabis products last year according to a US national survey on pain in people with MS. Researchers from the University of Michigan found that those who used cannabinoids from the cannabis plant, including CBD and THC, were most likely to try them to help with chronic pain and sleep issues – the two common symptoms of the disease.
We talked to Polly, from Bristol, who has been using a premium multi-cannabinoid broad spectrum CBD oil for three months, about her CBD pain management journey.
What is your medical condition & how long have you been suffering?
I was diagnosed with fibromyalgia in 2016. I suffer from widespread muscle pain and cramps, fatigue and migraines.
Did you try CBD before?
I had tried a few from health food shops but they had little or rather no effect.
Did you use other medicinal products before?
I combined codeine, diazepam and ibuprofen as well as a range of holistic therapies like massage, physio, kinesiology with varying degrees of success.
How did you come across the oil that you are using at the moment?
A friend of mine talked about it on Facebook and was so enthusiastic about it that I thought “let’s give this a go now, I have nothing to lose.”
Are you combining the oil with any other medication?
No, the broad-spectrum CBD oil is all that I am taking now. It has basically replaced my other medications.
How long did it take to get the dose right and feel any positive effects from the oil?
It took me about 3-4 weeks to get the dosage right. But I did notice an improvement within a few days the first time I took it. I started with the lowest advised dose on day one and then upped the dosage till I got tangible results.
Are you taking the oil now on a daily basis?
I take the oil, in capsule form, three times a day. I take quite a high dose – five capsules per day – but that works best for me. With this oil, six capsules is the recommended maximum dose.
Have you had any negative experiences from the oil?
I have had no negative effects at all so far.
In addition to their current drug regimen, many fibromyalgia patients seek alternative ways to manage their pain, such as the use of medical cannabis.
Recently, a team of doctors and scientists from Italy published an interesting relevant study. They followed 102 fibromyalgia patients visiting their outpatient clinic at the Luigi Sacco University Hospital in Milan that did not respond to standard painkiller treatment.
The selected patients had received stable analgesic therapy for a minimum of three months.
Patients were told to start medical cannabis treatment slowly, beginning with a low night-time dose of Bedrocan (22% THC, 1% CBD) followed by Bediol (6.3% THC, 8% CBD) in the morning. Previously most studies tended to use nabilone, a single synthetic cannabinoid often sold as Cesamet. The best therapeutic potential (the famous ‘Entourage Effect’) comes from using the whole cannabis flower, as Bedrocan and Bediol do, which contains multiple cannabinoids.
As the authors of this study explain:
“This rationale lies behind the use of two different formulations in the present study: A higher THC/CBD ratio has more potent analgesic properties, but cannot be used in the morning for legislative concerns. On the other hand, a lower THC/CBD formulation can be taken in the morning since it is associated with less drowsiness.
It is clear that in general, since an ideal [medical cannabis treatment] formulation and dose is still under investigation for fibromyalgia, the treatment strategy is empirical and based on clinical experience.”
What were the study’s findings?
45.5% of the patients remained in a stable clinical condition according to the FAS scores
54.5% of the patients experienced more fatigue according to the FACIT-Fatigue scores
44% of the patients experienced better sleep quality and fewer disturbances according to the PSQI scores
33% of the patients experienced a significant clinical improvement according to the FIQR scores
42.4% of the patients experienced less anxiety according to the ZRS-A scores
50% of the patients felt less depressed according to the ZRDS-D scores
The only variable associated with an improvement in FIQR scores was the patient’s body mass index (BMI): Patients with a higher BMI required higher doses of cannabis.
By the end of the six-month treatment period, almost half of the patients had reduced or discontinued their analgesic treatment.
“[This study] showed that MCT offers a clinical advantage in terms of efficacy, especially for its effects on sleep and quality of life. However, further studies are required to establish the best therapeutic strategy in terms of posology, the THC/CBD ratio, and treatment duration.“
So, what does this mean for fibromyalgia patients?
This study suggests that for those with fibromyalgia, CBD alongside other cannabinoids could improve sleep and general mental health. Furthermore, it may also be possible to reduce or terminate other pain medications sufferers currently take.
Even though, according to this study, taking THC/CBD can help manage FM symptoms, sadly it looks unlikely to actually heal the condition. If you are considering adding broad spectrum CBD oil to your diet, please consult with your doctor as it may interact with your medication.
If you would like to learn more about Polly’s fibromyalgia journey, and similar experiences from other CBD users, you can find a selection of user stories on the Ardoa Organics blog.
Why sleep is vital for improving fibromyalgia symptoms
Dr Anthony Ordman, a leading UK Pain Specialist, explains why achieving proper restful sleep is so important for fibromyalgia patients and how cannabis medicines can help this happen.
Fibromyalgia is a long-term condition that causes pain all over the body and can completely destroy the patient’s quality of life.
Many fibromyalgia patients report it is the lack of ability to sleep properly that leads to the horrible brain fog, fatigue and ensuing depression that is one of most unpleasant symptoms of the condition.
“For me it was the insomnia, that came with the pain, that then led to everything spiralling out of control in a repetitive cycle.
“You were in pain so you couldn’t sleep, which would lead to fatigue and exhaustion, which again contributes to the level of pain you are in, which leads to anxiety and depression. The symptoms of fibromyalgia are like a runaway train that you just can’t stop.” – Steven, fibromyalgia patient.
Dr Anthony Ordman, senior clinical adviser and Hon. clinical director Integro Medical Clinics.
explains why achieving proper restful sleep is so important for fibromyalgia patients and how cannabis medicines can help this happen.
“Long-term stress and resulting poor sleep can cause neuro-chemical imbalances in the central nervous system, impairing the processing of sensations.
Then sensations become mis-interpreted, causing pain to be perceived by the brain, in the absence of actual incoming painful stimuli from the rest of the body. This results in abnormal amplification of pain signals, similar to a ‘pain volume control knob’ being turned up too high. At the same time, muscles throughout the body can become tight and go into painful spasm, adding to the pain syndrome.
“Research continues to determine the causes of fibromyalgia’s associated fatigue, non-restorative sleep, and thought and memory difficulty, but this must have to do with the fact that people with fibromyalgia often go for years without ever falling into deep, ‘stage 3 and 4’ sleep at night because of stress. This sleep abnormality may be the cause of the whole fibromyalgia syndrome in the first place.
“Normally, in the deepest stages of healthy sleep, the body undergoes deep muscle relaxation, and our brain stores the memories of the previous day while, at the same time, toxins are flushed out of the brain’s nerve cells.
“But if deep sleep doesn’t happen, night after night, then it’s not difficult to see that tight, painful muscles and brain-fog may occur, along with changes such as the spinal cord neuro-chemical imbalances already mentioned.
Potentially adding to this problem; if you treat insomnia and its ensuing anxiety with drugs like Zopiclone or other benzodiazepines, this doesn’t improve deep sleep, only sleep duration. Those drugs can end up causing the patient all sorts of problems, adding to brain-fog, and dependency.
There is no one conventional medicine to treat Fibromyalgia. Nerve pain medicines and anti-depressant medicines are often tried. These sometimes do help, but more often add their own side effects to the patient’s difficulties.
Most conventional pain medicines such as morphine, amitriptyline and gabapentin/pregabalin, which are available for long-term pain, do not really work effectively for pain in the body’s spinal cord and central nervous system.
By contrast, cannabis medicines have their main effect there. And, as I am now seeing, cannabis medicines can offer effective treatment for fibromyalgia, as they seem to re-balance and regulate the human body’s endocannabinoid system, to reduce pain and spasm, and restore more normal sleep patterns.”
“For me the massive change was being able to get a decent night’s sleep. Once you can sleep it allows you to recover and this in turn helps your mood and motivation. Cannabis medicines have allowed me to function on an absolute minimum of traditional pain medications.” – Debbie, fibromyalgia patient
Dr Ordman added: “Integro Medical Clinics Ltd always recommend remaining under the care and treatment of your GP and specialist for your condition while using cannabis-based medicines. The Integro clinical team would always prefer to work in collaboration with them.”
If you would like further information or to speak to Dr Anthony Ordman please contact Integro Clinics:
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