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Fibromyalgia

What is fibromyalgia – and can cannabis help?

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One treatment which is growing significantly in terms of both research and usage is cannabis.

With around one in 20 people in the UK and an estimated three to six per cent of the world’s population diagnosed, fibromyalgia is one of the most common pain conditions in the world. 

Anyone can develop fibromyalgia – it affects around seven times as many women as men but can develop in either gender at any age – though its wide-ranging symptoms can make it a difficult condition to diagnose.

Alongside chronic pain, those affected may suffer with extreme tiredness, muscle stiffness, headaches, irritable bowel syndrome and problems with mental processes such as memory and concentration – all of which can be attributed to a number of other ailments. 

While the exact cause of the condition is unknown, it’s thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system processes pain messages carried around the body. In many cases, it can be triggered by a physically or emotionally stressful event such as injury, giving birth or the death of a loved one. 

Unfortunately, there is no known cure for fibromyalgia and no remedy to get rid of pain entirely. Instead, patients search for methods to alleviate symptoms, with many opting for a combination of treatments.

One which is growing significantly in terms of both research and usage is cannabis.

The remedy has long been associated with pain relief and as evidence of its benefits mounts, many fibromyalgia patients are choosing to give products such as gels and capsules a try. 

In 2019, a study of 367 patients found that pain intensity decreased when treated with CBD. This was supported by Chaves, Bittencourt and Pelegrini in 2020, with the team finding that phytocannabinoids can serve as an ‘affordable yet well-tolerated therapy’ for symptom relief and quality of life improvements.  

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As usage rises, professionals are coming round to the idea of CBD as a prescribed treatment in fibromyalgia, and in 2018 Carly Barton of Brighton became the UK’s first fibromyalgia patient to receive a prescription for medical cannabis. Prior to that, she, along with thousands of others, had been paying up to £2,500 for three months’ treatment. 

Despite many sufferers being reluctant to exercise for fear of aggravating symptoms, it’s another effective way to alleviate pain. Aerobic, resistance and stretching exercises have all been known to relieve pain and stiffness, increase strength and improve mobility in patients, while relaxation exercises such as yoga and t’ai chi can help with difficulty sleeping. 

Research has repeatedly backed up these claims and shown that regular aerobic exercise can improve pain, function and overall quality of life, with a 2017 study stating that “aerobic and muscle strengthening exercises are the most effective way of reducing pain and improving global wellbeing in people with fibromyalgia and that stretching and aerobic exercises increase health-related quality of life”.

While regular painkillers may provide some benefits to fibromyalgia symptoms, one of the most commonly prescribed medications for the condition is antidepressants. The medication is known to boost the levels of certain chemicals (neurotransmitters) that carry messages to and from the brain, and with low levels of neurotransmitters thought to be a factor in fibromyalgia, it’s believed that this boost may ease the widespread pain associated with the condition. 

Many professionals also believe that talking therapies, such as cognitive behavioural therapy (CBT) and counselling, are an effective way to manage symptoms and improve low mood associated with fibromyalgia.  

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Fibromyalgia

CBD for fibromyalgia pain – where to start?

Studies are indicating that CBD could be a helpful tool in managing symptoms of fibromyalgia.

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Woman taking CBD oil for fibromyalgia pain
CBD could be a helpful tool in managing some of the symptoms of fibromyalgia.

Increasing numbers of studies indicate that CBD could be a helpful tool in managing some of the symptoms of fibromyalgia, but knowing where to start can be daunting.

Fibromyalgia, a condition characterised by widespread pain, brain fog and sleeping issues, is notoriously difficult to treat.

Over-the-counter and prescription medications are often the first port of call, but these can be accompanied by unwanted side effects that may leave sufferers feeling worse.

Evidence is growing that cannabidiol (CBD) could be the answer to fibromyalgia patients’ prayers, with a number of studies into the effects of CBD showing a clear correlation between its use and a reduction in pain, along with improved sleep.

Fibromyalgia: A banner advert for the medical cannabis clinic

One such study, published in the Journal of Cannabis Research, clearly pointed to a reduction in pain and other symptoms in patients with fibromyalgia.

An Italian researcher explored the long-term use of various types of cannabis in 38 patients with treatment-resistant fibromyalgia. Participants consumed CBD for up to 12 months, in conjunction with their prescribed medications.

The author reported that “significant improvements were observed” following the initiation of cannabis therapy in most of the patients.

Anecdotally, too, increasing numbers of people are turning to CBD to ease their fibromyalgia symptoms, especially those for whom traditional treatments have failed, or who are uncomfortable being reliant on prescription medication.

A 2020 survey by the National Fibromyalgia Association found that more than a third of women with CPP, the pelvic pain common in fibromyalgia patients, used CBD for pain relief, better sleep and to treat anxiety.

A US study, meanwhile, discovered that more than 70 per cent of fibromyalgia patients were using CBD as an alternative to opioid medications.

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How to use CBD for fibromyalgia

Nowadays, there are a variety of different ways to use CBD, from food and drinks to topical remedies, and even pillows, candles and make-up.

However, the most common (and practical) ways to take it to ease fibromyalgia symptoms are through edibles and tinctures.

Edibles are when CBD oil has been used as an ingredient in baked goods, gummies, drinks or chocolates.

They may take longer to take effect, but when they do, the effects tend to last longer, which may make them a popular choice for those suffering chronic pain.

However, some experts urge caution when it comes to taking CBD edibles because dosing can be unreliable.

Tinctures, on the other hand, are made by soaking cannabis flowers in alcohol for an extended period of time. This process extracts the CBD into a more concentrated form than found in most CBD oil products. Tinctures are taken by the drop, and can be used on their own or mixed with food or a drink.

CBD is also available in topical treatments, such as balms or creams, which may be beneficial if the pain is concentrated in a particular location. It can also be found in bathing products, which have the added benefit of relaxing the body ahead of bedtime, hopefully increasing the chances of a good night’s sleep.

Before taking CBD in whatever form, there are some things to be aware of.

Firstly, the advice is always to start low and go slow. This means taking a very small amount infrequently, gradually increasing it until you find what gives you the result you’re hoping for.

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Secondly, as with all other natural products, there is the potential for adverse reactions when taken with other medications, especially those that come with grapefruit warnings, such as certain blood thinners. These warnings indicate that certain medications should not be taken with products containing grapefruit.

However, as long as guidance is followed, CBD, with its well-documented anti-inflammatory and calming properties, could be well worth trying to ease a number of debilitating fibromyalgia symptoms in one product.

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Fibromyalgia

CBD guides: Could CBD help the symptoms of long covid and fibromyalgia?

A study reported that 30 per cent of patients with Long Covid met the diagnosis criteria for fibromyalgia

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Long Covid: A woman on the couch feeling unwell

The Office for National Statistics reveals that 1.3 million people in the UK are estimated to have Long Covid. We ask if CBD could help the symptoms.

Long Covid is a series of symptoms that persist for weeks after the initial infection. As part of the survey, 325,000 people were asked to record their own symptoms. The results recorded shortness of breath, extreme tiredness and brain fog among others. Fatigue was the most common symptom with 51 per cent of participants stating they were struggling with extreme tiredness.

Long Covid: A banner advert for The Medical Cannabis Clinics

Similar symptoms have also been noted in patients diagnosed with fibromyalgia.

In a study from late 2021, it was reported that 30 per cent of patients with Long Covid met the diagnosis criteria for fibromyalgia. The survey included responses from 600 patients who had recovered from COVID infection but were now struggling with their symptoms post-infection.

The survey was based on the American College of Rheumatology’s Survey Criteria for Fibromyalgia, as well as its Fibromyalgia Impact Questionnaire. It suggested that inflammation to the lining of the blood vessels or immune system post-infection could be the cause. Interestingly, the survey results revealed that men were more likely than women to develop symptoms in line with fibromyalgia. Fibromyalgia is thought to affect more women than men.

As Long Covid is a relatively new condition, there are not as many studies as there are for fibromyalgia. We ask if CBD could help the overlapping symptoms of both.

Inflammation

Inflammation is a response from the body when it is under extreme stress. Patients with Long Covid experience a cytokine storm which is an extreme inflammatory response. If the body releases too many cytokines into the system, it can lead to acute respiratory distress syndrome (ARDS).

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This inflammation can lead to severe pneumonia making breathing difficult. Research has shown that CBD may reduce a number of the inflammatory cytokines associated with Covid such as IL-6 or interleukin (IL)-2.

A pre-Covid study on animals with asthma also showed that CBD could potentially reduce cytokine production making it easier for them to breathe. The same study also revealed that it had an effect on pulmonary fibrosis which is a thickening of the blood vessels and scarring leading to long term breathing complications.

Patients with fibromyalgia may also experience inflammation. Studies show CBD may help to reduce the level of painful inflammation. One study found that CBD may prevent the hypersensitivity of cells in the surrounding nerves for people experiencing chronic pain.

Fibromyalgia: A row of three bottles of oil sitting on a shelf with a cannabis plant in the background

Fatigue

With both conditions, fatigue is reported to be one of the most common symptoms. Fatigue is a response to the body attempting to fight a viral infection such as Covid. In Fibromyalgia, this can range from mild tiredness to severe exhaustion with flu-like symptoms.

CBD may help with sleepiness or reduce anxiety or stress which may interfere with sleep.

A study examined if CBD could help sleep or anxiety. Researchers took 72 participants with anxiety and poor sleep. They were given 25 mg of CBD in a capsule daily. Within the first month, 79.2 per cent reported lower anxiety levels while 66.7 per cent reported better sleep as a result.

Headache

A lack of sleep, pain and fatigue can combine to create intense headaches. Migraine headaches can cause sensitivity to light, an upset stomach, loss of appetite and you may even feel sick. Viral infections such as Covid can make existing migraine attacks worse and they may be more frequent or last longer than usual.

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Fibromyalgia may cause stiffness in the neck or shoulders which leads to headaches or migraines.

A study from 2016 found that CBD may help with migraine pain relief. The study took place at two medical cannabis clinics in Colorado. The patients used medical cannabis that had a percentage of CBD but also contained THC. The results showed that 48 patients reported that it had helped to reduce the number of headaches they experienced and the frequency. A further 24 patients found that it stopped their headaches.

 

Long Covid: a pile of masks on a green background

Depression

Depression and anxiety are common with both conditions.

Coping with the long-term effects of a new diagnosis or worrying about what life may be like in the future.

CBD may have a positive interaction with the hormone, serotonin in our brains. Serotonin is involved with a lot of different functions in our bodies but it impacts a person’s happiness and emotional well-being. Low serotonin levels are associated with depression. A review of existing studies showed that CBD may have anti-stress effects that could reduce depression.

Terpenes

Some terpenes are also thought to have potential benefits for patients with Long Covid. Terpenes give plants their smell and taste. Different terpenes can be found in CBD or cannabis strains and are thought to be associated with certain health benefits. Pine needles are a great example of a terpene.

Beta-caryophyllene which can be found in hops, cloves and rosemary also interacts with the CB2 receptors in the body. Due to its interaction with this receptor, it may have anti-inflammatory, antiviral, and immunomodulatory properties.

As a result, it may help with infection, immunity, and inflammation. All of which are experienced by those with Long Covid.

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Myrcene is another terpene commonly found in thyme and lemongrass that may be helpful for fibromyalgia. It is a powerful anti-inflammatory and also, may help with sleep issues.

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Fibromyalgia

Could medical cannabis help fibromyalgia?

We examine the science surrounding medical cannabis for fibromyalgia

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: A person writing on a medical notepad prescribing medical cannabis

Fibromyalgia can be a debilitating and extremely painful condition. We examine if medical cannabis could offer some help with symptoms.

Fibromyalgia is a condition that causes pain, fatigue brain fog and causes difficulty sleeping. It also causes memory problems and headaches. It is estimated that may be around 1.5 to 2 million people in the UK with the condition. It is thought to affect more women than men.

There is currently no cure for fibromyalgia but some patients have turned to CBD and cannabis for relief from their symptoms.

Fibromyalgia: A banner advert for The Medical Cannabis Clinics

Pain decrease

One study that tested Bediol, which contains both THC and CBD on patients with fibromyalgia reported a 30 per cent decrease in pain in comparison to those who took a placebo. Bediol is a high-THC variety of cannabis.

Chronic pain studies

A review of studies on THC and CBD for pain found that in twenty-eight trials that were mostly linked to multiple sclerosis, revealed it may help chronic pain.

Sleep studies

One study reported the effects of cannabis in 56 participants, predominately women, with fibromyalgia. The group were split between those who did and did not use cannabis. After two hours of using cannabis, they reported a decrease in pain or stiffness and felt sleepier. There was also an improvement in mental health scores.

Fibromyalgia and inflammation

A new study on patients diagnosed with fibromyalgia and other inflammatory rheumatic diseases, reports a reduction in pain levels following medical cannabis use. The study surveyed 319 patients about their use of medical cannabis products. Those with fibromyalgia accounting for 82 per cent of the group, reported a mean pain level reduction of 77 per cent. They also reported sleep quality improvement of 78 per cent.  According to the results, the THC concentration, duration of consumption, and dose had potentially significant effects on pain reduction. Only the duration of consumption had an independent significant effect on sleep quality improvement.

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A close up of a medical cannabis oil and dropper

Whole plant cannabis

A new review suggests that whole-plant cannabis may provide relief or improve different symptoms experienced by fibromyalgia patients. Researchers examined scientific papers specific to either the use of cannabis or synthetic cannabinoids in fibromyalgia patients. They reported that cannabis or cannabinoids may help with various symptoms and are safe for use in treatment.

The research focused on 313 studies that investigated Nabilone, Dronabinol, Bedrocan, Bediol and Bedrolite.

How do I get medical cannabis?

In the UK, medical cannabis must be prescribed by a doctor. There are a number of clinics around the country that offer medical cannabis for fibromyalgia patients.

A person can self-refer themselves for a consultation at a clinic through the websites. Prior to the consultation, a patient will be asked to gather their notes and information from their GP about their condition which outlines their treatment. Clinics can offer in-person appointments or over Zoom. It may depend on distance or COVID-19 restrictions.

Once a person has been assessed by a doctor, their case is usually examined by a multi-disciplinary team who decide if cannabis may be the right option. If it is, the clinic will speak to the patient about the different options available before sending their prescription to a pharmacy.

The pharmacy will then post the cannabis to the patient. Follow-up appointments will be made at different intervals to discuss the effects of cannabis.

How much does medical cannabis cost?

The cost for a prescription will vary on what type of prescription it is and how much is ordered.

Different clinics or pharmacies may have varying prices for oils or flower. There will also be different prices for initial consultations and follow-up appointments. It is worth checking with the clinic how much they charge for all of these before committing to a consultation. Also, some clinics may have access programs in place to help patients on lower incomes.

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Medical cannabis is not widely available on the NHS yet.

 A collection of CBD bottles and cannabis leaves on a white background

What is the best way to take medical cannabis?

This varies from person to person depending on a number of factors. Medical cannabis is usually available in flowers that can be vaped, oil that can be taken orally or topicals that are applied to the skin.

Personal preference may mean that a person prefers vaping to oils because of the taste or topicals rather than flower. For some, taking oral oils may be a problem or they dislike the taste. In selecting a product, it is worth noting what you prefer or switching to another method if the original doesn’t suit you.

Your doctor may also be able to advise you on methods and also what strength of product is needed.

How do I know if medical cannabis works for my fibromyalgia?

Keeping a journal can help with making any notes about changes you experience. It is also helpful to keep a record so that you can let your doctor know at a follow-up appointment if you have experienced anything negative.

Your follow-up appointments will usually involve speaking to a doctor about your cannabis journey. It may also include filling in questionnaires about how you feel physically or mentally. These are designed to highlight any changes which may require your medication to be adapted.

Interested in CBD for fibromyalgia? Read more in our CBD guides about how it could help with symptoms

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