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.
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.
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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Cannabis “significantly reduced” fibromyalgia pain – study
Cannabis was found to improve symptoms in patients with fibromyalgia, when used alongside prescription medication.
Medical cannabis has been linked to a reduction in pain and other symptoms in patients with fibromyalgia, according to new data published in the Journal of Cannabis Research.
An Italian researcher explored the long-term use of various types of cannabis preparations in 38 patients with treatment-resistant fibromyalgia.
Participants in the study consumed cannabis for up to twelve months in combination with their prescribed medications.
The author reported that “significant improvements were observed” following the initiation of cannabis therapy in most patients.
Medical cannabis therapy was found to “significantly reduce pain intensity”, with approximately half of the patients reporting a reduction in pain.
Most patients reporting response to therapy said their pain intensity had decreased by at least 50 percent.
Participants also reported a decline in their disability index and overall symptom severity.
The most common side effect experienced by participants was mental confusion, however no patients experienced serious adverse effects, with most who were responsive to medical cannabis reporting “no or mild side effects.”
Subjects also did not appear to develop long-term tolerance to the substance, as they had no need to increase their dosages of medical cannabis over the duration of the study.
The author concluded: “The current study revealed the positive effects of MC [medical cannabis] therapy in some patients with FMS [ fibromyalgia syndrome] and resistance to conventional treatment.
“Thus, cannabinoids may be considered for FMS treatment, although several side effects may still occur.
“Further studies are warranted to confirm these findings.”
The data supports a previous Italian study published last year, which demonstrated that medical cannabis improves the efficacy of standard analgesic fibromyalgia treatments.
Published in the Clinical and Experimental Rheumatology journal, the study followed 102 patients who had not responded well to conventional treatments and 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.
The study of 367 patients found that pain intensity decreased when treated with medical cannabis, 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”.
New study to explore effects of CBD on fibromyalgia
An upcoming study will explore how CBD can improve quality of life in fibromyalgia patients.
Researchers at The Parker Institute in Denmark will investigate if CBD can improve pain, sleep, function and quality of life in patients living with fibromyalgia.
The CANNFIB trial will include 200 patients, who will receive either cannabidiol or placebo over a period of 24 weeks and will be closely monitored for improvements in their condition and for potential side-effects.
Fibromyalgia is a serious chronic pain condition, often accompanied by sleep disturbances, fatigue and reduced quality of life.
There is no cure and current medical treatments, including opioids, often come with a number of debilitating side-effects of their own.
Medical cannabis is commonly used among patients, and while there is a wealth of anecdotal evidence, there are still gaps in scientific research for its efficacy and safety.
A US survey published last month found an estimated one-third of patients with fibromyalgia were using CBD for symptom management.
Investigators at the University of Michigan Medical School surveyed over 2,700 patients, with 32 percent saying they were current consumers of CBD, generally reporting turning to the cannabinoid because they had experienced inadequate relief from conventional medications.
An Italian study, published in February 2020, followed 102 patients who had not responded well to conventional treatments.
These participants were given two forms of cannabis oil extracts and researchers 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.
Participants of the CANNFIB trial will be given a 10mg daily dose of CBD to start, this will be increased every third day until the maximum dosage of 50mg is reached.
They will remain on a 50mg daily dosage of CBD for 24 weeks.
The study will measure pain intensity, sleep quality and duration, activities of daily living and health-related quality of life, among other outcomes.
“Fibromyalgia is a serious chronic pain condition which is often accompanied by sleep disturbances, fatigue and disability and reduced quality of life,” wrote the study’s authors.
“There is no cure and treatments are based on relieving symptoms and maintaining function. The currently available medical treatments are not helping many patients, and many get side-effects.”
They added: “Medical cannabis is sought after among patients and many use this medication unlicensed, although it is not properly documented if it works or is safe. Therefore, it is necessary to investigate the effects and safety of medical cannabis in a properly designed randomised trial.
“Participants will be closely looked after for improvements in their condition and for potential side-effects to ensure safety.”
Read more about the CANNFIB trial here
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