The question of how medical cannabis can help with fibromyalgia is a serious consideration for many people living with this condition.
Fibromyalgia is a chronic pain syndrome. It is very hard to treat effectively, and to date, it is impossible to cure. There are thought to be over 1.5 million people with fibromyalgia in the UK alone.
A syndrome affecting so many understandably creates widespread interest and research amongst the health professionals and patients. However, the causes of Fibromyalgia, as yet, remain unknown.
What do we understand?
What we do understand is that, it affects the soft tissue, and causes widespread pain and fatigue. In addition to this, sufferers experience what is commonly referred to as fibro-fog.
Fibro-fog is a combination of headaches, forgetfulness, and a lapse in the ability to concentrate.
Other symptoms include irritable bowels, sensitivity to environmental factors, and diarrhea.
As a result, living with fibromyalgia can be unpredictable, stressful and at times debilitating.
Until recently, patients have been prescribed pharmaceutical medicines; exercise, and behavioural therapies to treat their symptoms. Some sufferers also opt for acupuncture.
While these treatments are successful for some, there remains a great number of patients reporting the ineffectiveness of their medical plan.
Understandably, patients have began seeking alternatives. The recent availability of cannabis-based supplements has created huge interest. As a result we are now seeing consistent anecdotal evidence that patients with fibromyalgia are finding great success treating their symptoms with medical cannabis.
The wide availability of cannabis-based alternatives appears to have opened up new windows of hope for fibromyalgia patients. We will now look at how and why symptoms respond favourably to medical marijuana.
What is fibromyalgia?
Fibromyalgia Syndrome is a chronic condition that induces profound fatigue, and widespread, long-lasting pain. The condition is extremely common, in fact, just as common as rheumatoid arthritis. Some estimates suggest as many as one in 20 people are affected, and symptoms are found in seven times more women than in men. The most common age group where fibromyalgia typically develops is known to be between 30 and 50, nevertheless the condition does not discriminate against age, and can occur in both the young and old too.
Cases of fibromyalgia differ in severity of symptoms. Some people report a tiredness and dull aching or burning sensation. In other words, they are able to maintain their daily lives, hold down a job, care for their family, and so forth.
However, a great deal of patients are living with more extreme exhaustion, and constant flu-like symptoms that prohibit them from leading a ‘normal’ and active life.
The name fibromyalgia was pieced together using the terms ‘fibro’, ‘my’ and ‘algia’. Fibro represents fibrous tissues, my refers to muscles and algia meaning pain.
Conditions with a collection of symptoms, like fibromyalgia, are known as a syndrome.
Syndromes differ from specific diseases in that the latter are usually well understood, and are more straight forward to treat.
The list of symptoms connected with fibromyalgia is extensive, and this leads to greater difficulty in deciding on the best treatments for the patient.
A medical condition labelled as chronic is defined as one that lasts three months or more. A chronic condition is persistent in its effects, and forces the patient to adjust to its demands.
Most chronic illnesses persist throughout a person’s life, and are not cured completely. These types of illnesses can be recognized by common characteristics such as—complex causes, long length of illness, and stretched out latency periods. Latency period refers to the time between the causes and the effects. So a person with fibromyalgia may have developed the condition a long time before feeling any of the symptoms. Fibromyalgia Syndrome embodies all three of these characteristics.
What causes fibromyalgia?
As previously stated, the physiological causes of fibromyalgia remain unknown. Years of research have uncovered very little into the root cause of this condition. Nevertheless, some interesting insights and correlations into the behaviour of people with fibromyalgia have been found.
Quality of sleep
The quality of sleep experienced by a large proportion of people suffering from fibromyalgia is believed to hold key significance. The fact that most are deprived of deep, restorative sleep has led to further research into the reasons behind this.
Researchers have identified a deficiency in serotonin in the central nervous system. As a result, this triggers an imbalance of something called substance P, which is a spinal fluid that transmits pain signals.
The outcome of these imbalances is a disordered sensory processing system. It is believed that this causes the brain to register pain inaccurately. For example, a slight ache or stiffness in the body of a person not living with the syndrome will barely notice it on their radar. Yet, the same ache or stiffness in someone with fibromyalgia creates a degree of pain that could be off the scale!
With this in mind, current studies focus heavily on how to improve the quality of sleep.
When looking at fibromyalgia patient histories, a connection has been made between developing symptoms post trauma.
For example, falls; car accidents; childbirth; viral infection, and emotional experiences have all been linked as catalysts in this syndrome.
Stress is the common factor binding all these physical and emotional events.
There is some argument that some people are more likely to develop fibromyalgia due to the genes inherited from their parents. Science is yet to prove this theory, and therefore we are still unable to ascertain groups of people 100 percent more likely to be predisposed to the condition. Of course a breakthrough in this area could be of great significance, and would allow science to move forward considerably.
Due to the fact that the cause cannot be pinpointed, fibromyalgia becomes both hard to diagnose, and to treat. The other hugely complex factor is that patients present with a wide-ranged list of symptoms. Symptoms that are not only inconsistent with another sufferers, but also ones that present as other well known illnesses.
As previously mentioned, the list of symptoms fibromyalgia patients experience is far from concise. In addition to widespread pain and chronic fatigue sufferers may experience:
- Increased sensitivity to pain
- Irritable bowel syndrome (IBS)
- Muscle stiffness
- Difficulty sleeping
- Cognitive disturbance—memory and concentration lapse, muddling words
- Nausea and diarrhea
Although sufferers of fibromyalgia are deprived of a cure to treat the causes of the syndrome, there are treatments to help alleviate the symptoms.
Focus is very much on the individuals’ management of their fibromyalgia. It has been proven that the most effective form of treatment for fibromyalgia is embracing a number of techniques that allow the patient to cope with the syndrome.
Somewhat experimental in many cases, there are a variety of medicines prescribed to patients in an attempt to treat their symptoms. Sufferers can often find themselves needing to try several different medications before finding one that suits them best.
Unfortunately, in a lot of cases, the medicines themselves can trigger further symptoms for the patient.
Examples of medicines someone with fibromyalgia might be prescribed are:
- Antidepressants—used to help relieve pain by boosting levels of the chemicals known as neurotransmitters. There are side effects associated with antidepressants, such as anxiety; weight gain; drowsiness, and nausea. These medications can also be hard to come off of.
- Painkillers—ranging from simple ones such as paracetamol to stronger ones such as codeine or tramadol. These medications can be addictive, and their effectiveness dissipates over time.
- Muscle relaxants—Diazepam or something similar may be prescribed to help sufferers with muscle spasms and stiffness. This medication also has the added bonus of aiding good sleep patterns. However, GPs only like to prescribe these kinds of medicines in short courses as again, they can be addictive.
- Antipsychotics—also known as neuroleptics are prescribed to relieve long-term pain. With this in mind, they are considered to be relative in the treatment of fibromyalgia, although, as yet there is not enough research to prove this. Some GPs will prescribe in small doses and short term, although it is certainly not commonplace.
- Anticonvulsants—normally used to treat epilepsy anticonvulsants such as pregabalin and gabapentin are used to help improve pain in some fibromyalgia patients. Side effects associated with this medicine are dizziness, drowsiness, weight gain, and edema.
Cognitive behavioural therapy (CBT)
This is a talking therapy that centres around pinpointing how fibromyalgia sufferers think about their condition. Talking therapies can help change the way a patient thinks about their fibromyalgia, which can assist in tackling the issues in a more positive and confident light.
A positive mental attitude is regarded as highly influential in the patient's management of symptoms. Positivity of thought will importantly lead to an increased secretion of the happy hormones into the brain.
This is another talking therapy helping the patient understand and come to terms with thoughts and feelings. This includes thoughts and feelings with regard to the fibromyalgia condition itself. In addition, psychotherapy will focus on all other relevant life experiences that may have triggered or impacted the syndrome.
Psychotherapists are trained to teach relaxation techniques, as well as counsel the sufferer on the issues caused by fibromyalgia; an undoubtedly crucial support system, which many patients gain a huge amount from.
Alongside pharmaceutical intervention, a more holistic approach is certainly agreed to compliment the successful treatment of fibromyalgia symptoms.
A great deal of patients will seek relief from complementary treatments such as acupuncture; massage; manipulation, and aromatherapy.
From a purely scientific perspective there is no evidence to suggest that these methods provide any long term assistance. Irrespective of this, what is undeniable is that a great deal of patients who opt for alternative treatments feel more relaxed and less stressed.
The relaxation techniques involved are designed to help reduce tension and stress in the mind and body. As a result some symptoms are relieved, and the syndrome is easier to cope with.
Exercise and diet have been found to be effective in reducing some symptoms related to fibromyalgia. Namely pain, IBS, stress, and sleeping patterns.
Omitting certain foods from the diet and including more of certain food types seems to provide some relief from IBS.
Engaging in physical activity, we know, produces endorphins, and these chemicals increase the neurotransmitters that assist our brain in recognising pain accurately.
This extensive list of symptoms and treatments just goes to show that each case of fibromyalgia is unique. It highlights how far we are from getting the concrete answers needed to treat its causes. What we do know is that fibromyalgia is a deeply complex syndrome, and no one individual treatment benefits or suits all.
A fibromyalgia patient may apply one or several of these treatments to their daily life. They may receive a good deal of relief from a combination of therapies, or they may find that they simply cannot find anything that really helps. The side effects and symptoms of the medical treatments may have created more harm for you than good. The pain and fatigue may be too great to even consider tackling exercise!
Countless fibromyalgia patients, whose lives have been changed beyond recognition by the syndrome, were beginning to feel there simply was never going to be a solution.
So, when all of a sudden the world began shouting loudly about the virtues of cannabis, the fibromyalgia sufferer listened with interest.
Could this natural growing plant really withhold part of the answer?
CBD and Fibromyalgia
It is important to bear in mind that the cannabis plant in its entirety possesses significant therapeutic properties. Arguably, it is the cannabinoids combined that provide the greatest benefit. It stands to reason that isolating one specific chemical can harm the potential or portray an inaccurate picture of the medical efficacy of the plant.
Unfortunately, due to the current B classification of cannabis in the UK, research institutes risk funding should they conduct and report any real analysis of cannabis as a whole.
As a result, we are focussing on just one cannabinoid in the treatment of fibromyalgia symptoms; CBD. (Small amounts of CBG—usually less than one percent—may also be present in CBD oil. CBD, in fact, begins its life as CBG—but that deserves a blog of its own. It is considered a minor cannabinoid, however it is widely thought to provide its own healing properties, and is certainly worth consideration).
CBD, contained in the correct format, is the only part of the cannabis plant that is entirely legal in the UK. As UK citizens we are permitted to purchase, sell, and be prescribed CBD-based products. However, that is not to say we can legally grow, or sell the bud that the oil is extracted from. We cannot.
The revelation of cannabidiol (CBD) for many fibromyalgia patients has been uncontainable.
Rightly so, as more patients than ever before report relief of symptoms that no previous interventions had touched.
What is CBD?
The cannabis plant contains hundreds of phytocannabinoids and CBD is a critical member of this family. A naturally occurring property of cannabis, yet, until recently, CBD was barely mentioned; its counterpart THC stealing the show.
However, studies of CBD (that originally began decades ago, and were shelved due to prohibition) were recently revisited.
Research uncovered potential success in the treatment of many different symptoms of chronic illness, disease, and mental health.
Whilst this research remains inconclusive, it is certainly agreed that the cannabinoid CBD is harmless. As such, many countries have adapted their cannabis laws to allow the sale and medical prescription of CBD products.
Moreover, there are now mountains of anecdotal evidence supporting the researchers who say CBD is an effective health supplement. Consequently, people suffering with a whole range of symptoms, are willing to give it a go.
How does CBD work?
CBD essentially enhances the endocannabinoid system (ECS). A system naturally present in the human body; CBD attaches itself to the receptors in the body; CB1 and CB2.
These neurons travel to the places in the body that need the extra cannabinoids. External cannabinoids such as CBD behave exactly as endogenous cannabinoids produced in the body do.
CB1 receptors are primarily located on nerve cells in the central nervous system. They are also found in some of the most commonly used organs and tissues. This is known as the peripheral nervous system, and includes the spleen, white blood cells, endocrine gland, and parts of the reproductive, gastrointestinal, and urinary tracts.
CB2 receptors are situated on the immune cells i.e. as white blood cells, tonsils, and the spleen.
The immune system relies on CB2 receptors to regulate cytokine release. It is the CB2 neuron that research is particularly interested in with regard to potential anti-inflammatory, and anti-cancer effects.
The ECS strives to maintain our bodies’ homeostasis. It is this balance that provides us with a feeling of well being and good health, physically and mentally.
How CBD can treat symptoms of fibromyalgia
When we look at both the symptoms of fibromyalgia, and how CBD responds in the body, we can begin to gather a clearer understanding of why patients are experiencing such positive relief. Endocannabinoids are used throughout the brain and body to help regulate memory, appetite, inflammation, and much more. Here are just a few ways in which we believe strengthening the ECS assists in relieving symptoms of fibromyalgia.
The chronic pain experienced by fibromyalgia patients is believed to be connected to the body's natural inflammatory response.
This response seems to veer off-course in fibromyalgia sufferers suggesting their bodies are lacking substantially in the cannabinoids our bodies naturally produce.
So although the pain the patient feels is very real, the reason behind it could be due to a flawed communication system.
A diminished supply of cannabinoids results in an ineffective cannabinoid system. The CB1 receptors around the central nervous system rely upon the cannabinoids to transfer accurate messages to the brain, and back again to the source of the pain. One is useless without the other, like a locked door without the key.
Introducing external cannabinoids into the ECS provides an increase in the number of neurotransmitters. This opens up the pathways of communication between the central nervous system and the region of inflammation. Once the number of neurotransmitters traveling to the brain increases, the pain decreases as the brain registers it accurately.
It is believed that the cloudy brain sufferers report to feel is also as a result of inflammation in the brain. So, again here CBD is reported to significantly improve the memory, and concentration difficulties associated with brain fog.
An increase in serotonin has an accumulative effect on the body. It is a chemical that has a wide variety of functions and contributes greatly to wellbeing and happiness.
Serotonin transmits messages between nerve cells. This chemical has a significant role to play in constricting smooth muscles, and is the precursor for melatonin, which regulates the body's sleep-wake cycles and the internal clock.
Additionally, alongside the central nervous system, serotonin effects appetite, the emotions, and motor, cognitive, and autonomic functions.
It is clear to see how a deficiency in serotonin could greatly impact the symptoms a fibromyalgia sufferer is experiencing. Therefore using CBD to increase the amount produced will have an exponential effect on the relief of symptoms associated with these areas.
While CBD is not a first-line fibromyalgia treatment, it can certainly play a part in a long-term recovery plan. Many patients have found regularly vaping CBD, at certain points during the day, has assisted considerably in achieving a level of pain that they can cope with. They also report a marked difference in restorative sleep, and regaining more consistent sleep patterns.
These, plus the many other associated health benefits of CBD, are allowing fibromyalgia patients to lead more fulfilling and active lives once again.
Lastly, if you have an existing condition, and are considering CBD as a health supplement, please ensure you consult with your GP first.
Sourcing high quality CBD products is essential. Any reputable supplier will be able to provide you with the origins of the CBD they are selling and the lab reports detailing how the plant was farmed, and by what means the oil was extracted. Always do your research and never be afraid to ask questions.