Fibromyalgia is a chronic debilitating condition that includes symptoms of chronic diffuse pain, sleep disturbance, migraine headaches, fatigue, joint pain and irritable bowel-type symptoms. Patients may have all or just some of these symptoms. Myofascial Pain Syndrome (MPS) is considered a subtype of fibromyalgia. It appears that all patients with these conditions suffer a heightened perception of pain thought to be due to abnormal processing of pain signals in the central nervous system. The mainstay of treatment is medication, primarily pain relievers such as NSAIDs and opiates, pregabalin (antiepileptic), duloextine (antidepressant), muscle relaxants and sleep aids.
An endocannabinoid deficiency or dysregulation has been hypothesized to be a possible cause of fibromyalgia symptoms. Studies have not completely elucidated this theory, but there is some evidence of abnormal endocannabinoid levels in patients with fibromyalgia. Recent studies show that fibromyalgia patients have increased levels of glutamate, an excitatory neurotransmitter that can cause inflammation and damage when it accumulates. Fibromyalgia patients have been found to have higher blood levels of pro-inflammatory compounds, which indicates abnormal inflammation may play a role.
Several studies have investigated the effectiveness of cannabinoid treatment in fibromyalgia patients.
- A small group of fibromyalgia patients who received daily doses of THC and no other pain medications reported a significant reduction in daily recorded pain.
- The synthetic cannabinoid called nabilone improved symptoms in 40 patients with fibromyalgia in a randomized, double-blind, placebo-controlled trial.
- A recent study from Spain reported that fibromyalgia patients who used cannabis had a statistically significant reduction in pain and stiffness, enhancement of relaxation, and improved sleep with an increased feeling of well being.
I have evaluated hundreds of patients with fibromyalgia in my medical practice. Many are not finding relief with conventional medications or are having adverse side effects that make the medications intolerable. The majority are able to discontinue use of prescription medications, as cannabis is effective in treating pain, mood, insomnia and inflammation. Patients find success with THC-rich cannabis, CBD-rich cannabis and/or CBD+THC cannabis products depending on individual preference and response. Many patients prefer CBD-rich cannabis during the day, as there is no psychoactivity, and THC at night to promote better sleep. I encourage patients who find relief with THC-rich cannabis to also include some CBD in their regimen for added anti-inflammatory effects. Different methods of cannabinoid delivery depend on a patient’s personal preference. Vaporizing or sublingual oil will have a much quicker onset than edible cannabis products.
Cannabis varieties reported to be helpful in these patients are CBD-rich strains, such as AC/DC, Harlequin, and Cannatonic, as well as those that contain the following terpenoids: β-Caryophyllene (anti-inflammatory and analgesic), pinene (anti-inflammatory) and linalool (analgesic and relaxing).
If you want to learn more about how the world’s most misunderstood plant is healing everything from chronic pain to epilepsy, pick up a copy of Cannabis Revealed today.
Kaufmann, Ines, et al. “Anandamide and neutrophil function in patients with fibromyalgia.” Psychoneuroendocrinology 33.5 (2008): 676-685.
Harris, Richard E., et al. “Dynamic levels of glutamate within the insula are associated with improvements in multiple pain domains in fibromyalgia.” Arthritis & Rheumatism 58.3 (2008): 903-907.
Wang, Haili, et al. “Circulating cytokine levels compared to pain in patients with fibromyalgia—a prospective longitudinal study over 6 months.” The Journal of rheumatology 35.7 (2008): 1366-1370.
Schley, M., et al. Delta-9-THC based monotherapy in fibromyalgia patients on experimentally induced pain, axon, reflex flare, and pain relief. Current Medical Research and Opinion (2006) 22: 1269-1276
Skrabek, R., et al. Nabilone for the treatment of pain in fibromyalgia. The Journal of Pain (2008) 9: 164-173
Fiz, J., et al. Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life. Public Library of Science One (2011) 6: e18440