Fibromyalgia is a condition associated with widespread chronic pain and sleeping disorders. Over 1 million Australians have it and struggle to find effective medicines to manage their symptoms.¹
There is some evidence that shows promise for medicinal cannabis for fibromyalgia treatment. It may prove beneficial as an alternative medicine for alleviating the symptoms.
Join us as we learn more about this painful condition and the potential benefits of integrating cannabis into the treatment program.
Understanding fibromyalgia
A study in 2011 highlighted using medical cannabis to treat the symptoms of fibromyalgia.² It showcased the beneficial effects of cannabinoids on alleviating stress and pain and improving sleep and restfulness.
To understand how cannabis for fibromyalgia may be beneficial, knowing about the disorder, its symptoms, and its aetiology is important.
What is fibromyalgia?
Fibromyalgia is a chronic disorder that increases pain sensitivity. It causes tenderness and aches throughout your body accompanied by fatigue, insomnia, and memory issues.³
Evidence shows that women and middle-aged people are the most susceptible to developing the disorder.³
Many comorbidities increase your risk of getting fibromyalgia, such as:
- Ankylosing spondylitis
- Rheumatoid arthritis
- Irritable bowel syndrome
- Chronic back pain
- Depression or anxiety
- Systemic lupus erythematosus (lupus)
- Osteoarthritis
Heredity is also a factor that increases your chances of getting fibromyalgia4.
There’s no cure for fibromyalgia yet.⁴ Doctors and healthcare providers typically recommend a combination of treatments, such as exercise, medications, and therapy.
What are the symptoms of fibromyalgia?
Two major symptoms characterise fibromyalgia. The first is chronic pain that spreads throughout your body or at specific points. It typically affects the following areas with an aching, throbbing, or burning sensation:
- Arms
- Head
- Legs
- Back
- Buttocks
- Abdomen
- Chest
The second is sleep disorders like insomnia or fatigue. You may have difficulty sleeping or feel an overwhelming tiredness.
These are the other key ailments you may encounter:
- Feeling tingling or numbness in your arms and legs
- Digestive issues like constipation or bloating
- Stiffness in your joints and muscles
- Tenderness to the touch
- Increased sensitivity to noise, temperature, light, and odours
- Struggling to concentrate, think clearly, or remember things
What causes fibromyalgia?
There’s no definitive answer to what causes fibromyalgia. Ongoing studies are actively investigating the aetiology, such as brain inflammation, abnormal pain processing, genetic components, neuro-chemical imbalances, and the role of stress hormones.¹,⁵
Many patients diagnosed with fibromyalgia have pre-existing medical conditions like rheumatoid arthritis. It’s difficult to diagnose or research if you have other physical or mental health issues. It’s challenging to determine the origin of the symptoms.
Most findings indicate a malfunctioning of the central nervous system (CNS) and dysfunction in its interaction with the peripheral nervous system (PNS). ¹
The CNS includes the spinal cord and brain and is responsible for receiving, processing, and responding to sensory information. ¹
The PNS is everything else, and it sends information from parts of your body to your brain. It also carries out commands from your brain to different areas of your body. ¹
Symptoms of fibromyalgia occur throughout the body when the interplay between the CNS and PNS doesn’t function properly.
In 2018, several authors, including Penny J. Furness, conducted an online survey. Its goal was to determine what patients with fibromyalgia believed caused their disorder.⁶
The conclusion was that patients believed traumatic events (physical or emotional) and stress triggered their fibromyalgia. ⁶
Developing a better understanding of what triggers fibromyalgia and the symptoms you get is integral in forming treatments.
Medical cannabis is an alternative medicine that may have promising results in managing symptoms.
Cannabis and its components
Cannabis consists of over 100 different cannabinoids.⁷ Of these, two are the most studied, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC and CBD interact with your endocannabinoid system, stimulating the receptors in your brain. This system plays a significant role in regulating many physiological processes, including mood and pain perception.⁸
These two compounds both have different uses and effects:
- THC: It’s the primary psychoactive compound responsible for the “high” cannabis users are familiar with. It reduces inflammation and alters your pain perception. ⁹
- CBD: The key to medical cannabis, it gives you most of the same benefits as THC without the high. CBD acts directly on your brain’s pain receptors, reducing discomfort. It’s also thought to moderate and decrease some of the negative effects of THC.⁹
Medical cannabis for fibromyalgia treatment may be effective thanks to the potential effects of THC and CBD. It may alleviate pain, help you sleep, improve your mood, and even aid your digestive system.⁸,¹⁰
Medical cannabis
Medical cannabis refers to using the plant, either whole and unprocessed, or extracts from it to treat symptoms of illness. Some of its therapeutic benefits may have the potential to treat conditions with symptoms relating to pain and sleep disorders.¹¹
The connection between your endocannabinoid system and cannabis suggests an influence in managing the major symptoms of fibromyalgia. ⁸
Much of the clinical experience and case studies conducted with cannabis produced inconclusive results. The research methods, products, and doses all varied, making it challenging to safely and accurately prescribe it.
Doctors only recommend medicinal cannabis for fibromyalgia when approved treatments fail to manage the symptoms and conditions.¹²
Medical cannabis is legal Australia-wide but is an ‘unapproved’ medicine. Doctors must gain approval to prescribe it from the Therapeutic Goods Administration (TGA).¹²
Medical cannabis products
When doctors decide you’re at the point where approved treatments aren’t effective, there are many medical cannabis products available.
Medical cannabis products are either extracted from the plant or produced synthetically in a lab. They fall into three key categories:¹³
- Isolate (either THC or CBD).
- Full-spectrum (containing a wide range of cannabinoids, typically high in THC and CBD, with lower levels of minor phytocannabinoids).
- Broad-spectrum (containing a wide range of cannabinoids, excluding THC)
Here is a list of the most common medicinal products available:¹³
- Medical cannabis plant (for vaporising)
- Chewables
- Edibles
- Crystals
- Lozenges
- Creams
- Capsules
- Oil
- Tinctures
- Oro-mucosal sprays
Conditions aided by cannabis
There’s some evidence that shows its benefits in treating certain conditions and symptoms.
Four conditions show various improvements resulting from the use of medical cannabis: ¹²
- Epilepsy: CBD reduced seizure frequency by over 50% in half of the patients experiencing paediatric-onset drug-resistant epilepsy. The studies highlighted its benefits when paired with other medications in treating or eliminating seizures.¹²
- Multiple sclerosis (MS): Nabiximols, a cannabis extract medicine containing equal parts THC and CBD showed effectiveness for treating symptoms of MS. Half the studies resulted in it helping to reduce pain, spasticity, sleep, and bladder issues.¹²
- Chronic non-cancer pain: Some evidence shows cannabinoids being effective in reducing neuropathic pain. Most of these studies focus on using THC or THC-rich extracts paired with other pain medicines.¹²
- Chemotherapy-induced nausea and vomiting in cancer (CINV): Some studies showed evidence that medical cannabis products helped relieve symptoms of nausea and vomiting.¹²
Clinical evidence supporting cannabis for fibromyalgia
Experts conducted many studies surrounding the use of cannabis for fibromyalgia. Most of them involved the use of the flower, either smoking or vaporising it.
Not enough studies focus on other medical cannabis products. Despite the inconsistencies, many show some evidence of producing positive effects on various fibromyalgia symptoms.
Cannabis for fibromyalgia pain treatment
A comprehensive review by the National Academies Press (NAP) showcased substantial evidence supporting medical cannabis for chronic pain treatment.¹⁴
Researchers published it in 2017, highlighting the therapeutic and health effects of the plant for various symptoms and conditions. On average, patients showed significant results in pain reduction after several weeks.¹⁴
A study published in 2022 included 296 Australian participants dealing with chronic pain. The group consisted of patients with arthritis, fibromyalgia, neuropathic pain, and musculoskeletal pain.¹⁵
All participants were given varying THC and CBD medical cannabis products, resulting in significant discomfort alleviation.¹⁵
A more recent study published in 2023 involved 55 Australian participants with chronic pain. Researchers treated them with three medical cannabis products varying in THC and CBD content. Results showed a significant lessening of pain and improved quality of life. ¹¹⁶
These studies show that there is some evidence that cannabis for fibromyalgia pain treatment may be effective. Further research is necessary to reach a conclusive decision.
Medical cannabis for fibromyalgia sleep problems
A review done in 2022 showed that there may be potential for cannabinoids to treat certain sleep disorders. Patients with insomnia could fall asleep faster. ¹⁷
In 2010, a study investigated Nabilone’s effect on patients with fibromyalgia experiencing chronic insomnia. This synthetic cannabinoid drug proved effective in improving their sleep quality and restfulness. ¹⁸
Few cases focus on cannabis for fibromyalgia sleep disorder treatment. Some show promise for improving sleep in patients experiencing chronic insomnia.
Medical cannabis for other fibromyalgia symptoms
There is some evidence that cannabis shows promising results in treating other symptoms of fibromyalgia. Most of it comes from observational studies and surveys.
Cannabis may be beneficial for treating other symptoms, like:
- Sensory overload
- Muscle stiffness
- Constipation
Practical considerations for patients and healthcare providers
Medical cannabis for fibromyalgia symptom management may be effective, but there are other factors to consider.
It’s important to know the basics of medical cannabis before using it, such as its side effects and general cautions.
What are the side effects of medicinal cannabis?
Most prescription drugs come with a fair share of side effects and medical cannabis is no exception. Its adverse effects vary depending on the product and the individual.
CBD-rich products produce fewer side effects than high-THC ones. The strong doses of CBD required for conditions like chronic pain result in patients encountering some adverse effects.
There’s a variety of known side effects you may encounter from medical cannabis (THC and CBD) use, such as:¹²
- Vertigo
- Nausea and vomiting
- Decreased or increased appetite
- Fatigue or sedation
- Diarrhoea
- Dry mouth
- Fever
Medical cannabis products high in THC display side effects that may include:¹²
- Depression
- Hallucinations
- Convulsions
- Psychosis
- Cognitive distortion
- Feeling high or dissatisfied
- Confusion
- Paranoid delusions
General cautions
There are several precautions to consider before or while using medical cannabis:¹²
- Patients shouldn’t drive or operate machinery while using medical cannabis.
- Medical cannabis isn’t always appropriate for people who currently or previously experienced psychotic disorders.
- It’s not appropriate for women who are pregnant or breastfeeding.
- Patients are more likely to experience adverse effects if they have neurological conditions.
- Doctors should carefully monitor sensitive and elderly patients they’re treating with medical cannabis.
- Doctors must monitor the interactions between medicinal cannabis and other treatments.
- Doctors must assess liver functioning before stopping or continuing treatment.
It’s always best to start with a low dose of CBD or THC and increase over time.¹⁹
Learn about cannabis for fibromyalgia with PlantEd
Evidence shows medical cannabis for fibromyalgia treatment may effectively alleviate symptoms in people.
There are still concerns surrounding the safety of prescribing medical cannabis. The lack of information on the aetiology of fibromyalgia adds risk to the process.
More research on medical cannabis is necessary. Its legality in Australia means the number of studies is likely to increase in the future.
Join our community to stay up-to-date on changes in the medical cannabis environment. Learn more about this alternative medicine and its uses.
References
- What Is Fibromyalgia–Fibromyalgia Australia. fibromyalgiaaustralia.org.au/patients/what-is-fibromyalgia/.
- Fiz, Jimena, et al. “Cannabis Use in Patients with Fibromyalgia: Effect on Symptoms Relief and Health-Related Quality of Life.” PLoS ONE, vol. 6, no. 4, 21 Apr. 2011, p. e18440, www.ncbi.nlm.nih.gov/pmc/articles/PMC3080871/, https://doi.org/10.1371/journal.pone.0018440.
- “Marijuana for Fibromyalgia: Benefits, Research, and Alternatives.” Www.medicalnewstoday.com, 17 Dec. 2018, www.medicalnewstoday.com/articles/315348.
- NIAMS. “Fibromyalgia.” National Institute of Arthritis and Musculoskeletal and Skin Diseases, 5 Apr. 2017, www.niams.nih.gov/health-topics/fibromyalgia.
- Information, National Center for Biotechnology, et al. What Is Known about the Causes of Fibromyalgia? Www.ncbi.nlm.nih.gov, Institute for Quality and Efficiency in Health Care (IQWiG), 8 Mar. 2018, www.ncbi.nlm.nih.gov/books/NBK492983/.
- Furness, Penny J, et al. “What Causes Fibromyalgia? An Online Survey of Patient Perspectives.” Health Psychology Open, vol. 5, no. 2, July 2018, p. 205510291880268, https://doi.org/10.1177/2055102918802683. Accessed 18 Jan. 2020.
- CDC. “What We Know about Marijuana.” Www.cdc.gov, Centers for Disease Control and Prevention, 10 Sept. 2021, www.cdc.gov/marijuana/what-we-know.html.
- Strand, Natalie H., et al. “Cannabis for the Treatment of Fibromyalgia: A Systematic Review.” Biomedicines, vol. 11, no. 6, 1 June 2023, p. 1621, www.mdpi.com/2227-9059/11/6/1621, https://doi.org/10.3390/biomedicines11061621. Accessed 20 June 2023.
- Healthline. “What’s the Difference between CBD vs. THC?” Healthline, 20 July 2020, www.healthline.com/health/cbd-vs-thc#_noHeaderPrefixedContent.
- “Role of Cannabis in Digestive Disorders.” European Journal of Gastroenterology & Hepatology, vol. 29, no. 2, 1 Feb. 2017, pp. 135–143, pubmed.ncbi.nlm.nih.gov/27792038/, https://doi.org/10.1097/MEG.0000000000000779.
- “Medical Marijuana for Fibromyalgia.” Healthline, 9 Mar. 2021, www.healthline.com/health/fibromyalgia/marijuana-fibromyalgia.
- Goods, Therapeutic. “Guidance for the Use of Medicinal Cannabis in Australia: Patient Information.” Therapeutic Goods Administration (TGA), 23 June 2023, www.tga.gov.au/resources/resource/guidance/guidance-use-medicinal-cannabis-australia-patient-information.
- “What Products Are Available?” The University of Sydney, www.sydney.edu.au/lambert/how-to-get-medicinal-cannabis/what-products-are-available.html.
- National Academies of Sciences, Engineering, and Medicine. The Health Effects of Cannabis and Cannabinoids. Washington, D.C., National Academies Press, 31 Mar. 2017, www.nap.edu/read/24625/chapter/7.
- Schubert, Elise A, et al. “Medicinal Cannabis for Australian Patients with Chronic Refractory Pain Including Arthritis.” British Journal of Pain, 20 Dec. 2022, p. 204946372211471, https://doi.org/10.1177/20494637221147115. Accessed 25 Jan. 2023.
- O’Brien, Kylie, et al. “Medicinal Cannabis for Pain: Real-World Data on Three-Month Changes in Symptoms and Quality of Life.” Drug Science, Policy and Law, vol. 9, 1 Jan. 2023, p. 205032452311725-205032452311725, https://doi.org/10.1177/20503245231172535.
- Maddison, Kathleen J, et al. “Is There a Place for Medicinal Cannabis in Treating Patients with Sleep Disorders? What We Know so Far.” Nature and Science of Sleep, vol. Volume 14, May 2022, pp. 957–968, https://doi.org/10.2147/nss.s340949.
- Ware, Mark A., et al. “The Effects of Nabilone on Sleep in Fibromyalgia: Results of a Randomized Controlled Trial.” Anesthesia & Analgesia, vol. 110, no. 2, Feb. 2010, pp. 604–610, https://doi.org/10.1213/ane.0b013e3181c76f70.
- Jugl S, Goodin A, Brown JD. Climbing the Evidence Pyramid: Dosing Considerations for Medical Cannabis in the Management of Chronic Pain. PubMed [Internet]. 2023 May 1;6(1):41–5. https://doi.org/10.1159/00053025.