A GUIDE TO CANNABIS AND CBD FOR FIBROMYALGIA
Learn the research and use of Cannabis and CBD for fibromyalgia.
WHAT IS FIBROMYALGIA?
Fibromyalgia is a neurological disorder that is described as widespread (full body) pain. This pain is accompanied by fatigue, sleep, memory and mood issues. It is considered a neurological disorder because researchers believe the cause of the pain is from the way the brain processes pain signals (ie. is associated with the neurons).
Doctors have not determined a direct cause. Symptoms sometimes occur after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single causal event.
- Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache. To be considered widespread, the pain must occur on both sides of the body as well as above and below the waist.
- Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain. Many people also have other sleep disorders, such as restless legs syndrome or sleep apnea.
- Feeling tired and weak
- Difficulty concentrating (sometimes called “fibro fog”)
- Memory problems
- Gastrointestinal problems (such as constipation, diarrhea and irritable bowel syndrome)
- Bladder dysfunction
- Excessive sensitivity to loud sounds, bright light and smells
- Temperature sensitivity
TREATMENT FOR FIBROMYALGIA – TRADITIONAL PRESCRIPTIONS VS CANNABIS
There is no cure for this disorder so treatment plans aim to manage the symptoms. Doctors recommend remaining physically active. This can often be challenging when experiencing pain and lack of sleep, therefore these symptoms are targeted first.
Cannabis can help those with pain stay active. Read an article on our website written in collaboration with Liv at CannaCentric about her experience with fibromyalgia and how cannabis helped her to stay active.
Doctor’s may also prescribe other drugs that aren’t specifically approved for fibromyalgia, for example over the counter pain medications or muscle relaxants.
Why would antidepressants and anti-seizure medications be used for fibroymalgia?
Antidepressants normally aim to improve mood through the increase in serotonin. These antidepressants are reported to also help with pain through the same mechanism.
Anti-seizure medication effects neuron firing therefore can have a positive effect on nerve pain.
Problems associated with medications – Is Cannabis a better choice?
The Apollo Cannabis clinic in Toronto reports that opioids are used in approximately 30% of cases, with a positive effect on pain. But these medications carry the same dangers and side effects commonly associated with them. Opioids are often quite addictive and can lead to physical dependency that is difficult to break. (Another article about managing addictions to medications like opioids with cannabis will be coming soon).
Each fibromyalgia drug discussed above has its own side effects, ranging from mild to serious, so even those these medications can be effective there may be other treatments that can be just as effective with less significant side effects. One of these treatments may be cannabis. We already know that it helps to manage chronic pain, sleep disorders, and there is evidence that it may even be effective for nerve pain like that associated with peripheral neuropathy.
FIBROMYALGIA AND CANNABIS – WHAT THE RESEARCH SAYS
We already have already discussed the evidence that supports Cannabis, especially CBD, as a safe and easy way to treat chronic pain, check out this previous article here. But studies specifically looking at the more complex symptoms associated with fibromyalgia are preliminary.
- A study in Israel in 2018, followed a group of individuals for 10-12 months who used cannabis to treat their symptoms of fibromyalgia. All of the participants reported experiencing significant improvements. 50% of participants stopped taking any other medications. (source)
- A 2011 Spanish study, Cannabis Use in Patients with Fibromyalgia, found that cannabis can be effective in reducing pain. They interviewed 56 fibromyalgia patients, 28 of which were cannabis users. The cannabis users all reported a reduction in pain and stiffness and had a much better score in well-being, sleep and relaxation, compared to non-users. (source in resources)
- A 2007 study by Dr. Ethan Russo, found that cannabis eases the pain caused by damaged nerves. This is promising for individuals with fibromyalgia because nerve damage is thought to be one of the main causes of pain. (source in resources)
- A study from Brazil in 2013, found that analgesic properties (the pain killing effects) of marijuana are also effective in promoting sleep, reducing pain and joint stiffness. While improving physical functions and quality of life of fibromyalgia patients. (source in resources)
Also consider that one of the treatments currently approved for fibromaylgia is anti-seizure medication. This is another good indicator of the potential effectiveness of cannabis for fibromyalgia. This is because CBD has been FDA approved as a treatment for epilepsy. And it appears to be a more effective treatment for epilepsy in than prescription medication, in some cases. (source) Read our article on epilepsy and Cannabis here.
HOW TO USE, DOSING AND WHERE TO BUY- CANNABIS AND FIBROMYALGIA
Now that we are seeing more and more clinical research that is supporting the effectiveness of cannabis for various health problems and diseases those who do not support the use of cannabis are focusing on the possible damaging effects of smoking. This isn’t a problem because they are many alternative, easy and safe methods for consumption. These include:
- Tinctures that can be taken sublingually (under the tongue) or added to your favourite foods or drinks
- Topicals that can be added directly to the skin at the site of the pain or inflammation
- Edibles like capsules, gummies or cookies that can come pre-dosed. Or cooking oils that you can add directly to your favourite meals. (check out the blog section of our website for many amazing cannabis recipes posted weekly)
There is no universally accepted dosage for CBD but there are few things to consider when figuring out the right dose:
- the concentration of the product
- and the route of consumption.
Consult a physician when possible and always start with a small dose and gradually increase until the most effective dose is found. (source)
Check out this suggested dosage calculator from Honest Marijuana based on weight and pain severity. Note: this is only a suggested dosage and you should still consult with your doctor before using CBD for your pain or any other issues.
If you still need some help with figuring out the correct dosage for you check out Honest Marijuana’s dosage calculatorinformation on their website.
BEST STRAINS FOR FIBROMYALGIA TREATMENT
A combination of THC and CBD is likely the best starting point for treating the symptoms associated with fibromyalgia. THC and CBD affect the endocannabinoid system slightly differently, therefore a combination is more likely to effect a wider range of symptoms.
At Envy we recommend starting with a small dose and working your way up slowly. As well as experimenting with different concentrations to find what is most effective for you and your specific symptoms. A lot of people find the 1:1 THC/CBD Tincture to be their favourite choice, especially for during the day as the CBD helps to reduce the psychoactive effects of the THC and allows for clear cognitive functioning. Though there are other options like 3:1 CBD/THC Tincture or 300mg CBD Tincture.
Also, take into consideration the time of day and the symptoms you’re targeting when choosing the best strain. Typically indicas are best for evenings, with the highest dose and highest strength right before bed to help with sleep. While sativas, and sativa hybrids, are the typical choice during the day for the more energizing effects.
RX Mary Jane also has a great guide by a person suffering from fibromyalgia and how they use cannabis in their daily routine to help manage their pain and other symptoms.
Fiz J, Durán M, Capellà D, Carbonell J, Farré M; Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life; PLoS One; April 2011; 6(4):e18440
Russo EB; Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions?; Neuro Endocrinology Letters; February-April 2004; 25(1-2):31-9
Nascimento SS, DeSantana JM, Nampo FK, Ribeiro EAN, Silva DL, Araújo-Júnior JX, Almeida JRGS, Bonjardim LR, Araújo AAS, Quintans-Júnior LJ; Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review; Journal of Evidence-Based Complementary & Alternative Medicine; Jun 201