Medical Cannabis for Fibromyalgia: A New, Promising Alternative for Treatment
Fibromyalgia is a highly challenging chronic pain disorder that affects many millions of individuals worldwide, manifested in widespread musculoskeletal pain, overall weakness, sleep disturbances, and cognitive difficulties.
Current pharmaceutical treatments leave much to be desired, and many patients look for unconventional methods of treatment.
A recent pilot study of low-dose medical cannabis in people with fibromyalgia has brought new hope that this therapy can bring tremendous relief to the suffering.
Understanding Fibromyalgia and the Current Difficulties in Treatment
It is a heterogeneity of disorder represented by chronic pain, diffused all over the body, accompanied by other major symptoms such as fatigue, sleep disturbances, cognitive dysfunction—generally called “fibro fog”—presented in hyperalgesia and difficulties of mood expressed as anxiety and depression.
The diagnosis of fibromyalgia is not easy; it takes time and can require many visits to doctors before finally a diagnosis, which may take up to two years, can be obtained.
Women seem to be more predominantly affected in a female-to-male ratio of about 3:1.
Almost all current treatments need to be multidisciplinary. These involve pain medications that use opioids, antidepressants, anticonvulsants, and muscle relaxants.
Among treatments nowadays are also numerous non-pharmacological therapies, including exercise, cognitive behavioral therapy, and stress reduction. However, all these techniques bring limited relief to the majority of patients.
Side effects from medications and even dependence on some of them complicate treatment. That makes both patients and doctors look for safer and more efficient ways of treatment—that is where medical cannabis steps in.
The complexity of fibromyalgia means that there’s rarely a treatment that fits one size for all.
Many patients cycle through a myriad of medications and therapies searching for that often-elusive combination that can offer meaningful symptom relief without intolerable side effects.
The chronic nature of the disorder also denotes the fact that long-term management strategies are very important, thus adding another layer of complexity to treatment decisions.
In addition, the “invisible” nature of fibromyalgia presents the basis for frustration and misconception. Patients might look totally fine from the outside yet be experiencing extreme pain and fatigue.
This puts pressure on personal relations that are important to those experiencing symptoms of FM and makes it difficult for them to get understanding and necessary adjustments from their families, employers, or school administrations.
The Pilot Study. A Test Use of Low-Dose Cannabis for Fibromyalgia.
A pilot study lasting 6 months, conducted by researchers at San Carlo Hospital in Potenza, Italy, sought to establish the efficacy of low-dose medical cannabis for patients with fibromyalgia who had responded poorly to other traditional treatments.
The patients included 30 adults, of whom there were 24 women and 6 men, with a median age of 50.5 years. Each had previous diagnoses of fibromyalgia and suffered from pain refractory to treatments.
The medical cannabis used for the treatment was Bedrocan®, a standardized product containing 22% THC and <1% CBD. This medication was administered to patients at an initial dosage of 100 mg/day in the form of a herbal tea. In a few non-responders, this was increased to 200 mg/day after one month.
Quality of life has been assessed by means of a short-form health questionnaire.
Results were promising at 6 months. The median pain score decreased from 8 to 4 significantly after the treatment period.
This means a 50% reduction in pain intensity for most of the patients. More impressive is the fact that 96.67% of patients had an improved pain scores.
It’s worth noting that these results are particularly promising given the study population.
80% of the participants started with extreme levels of pain, previously resistant to all other treatments. This would mean, therefore, that even in the case of patients with quite stubborn symptoms of fibromyalgia and resistant to treatment, medical cannabis might be effective.
The obvious first question with any new therapy is that of safety.
Of the initial 32 participants in this study, 2 withdrew due to side effects from psychomotor agitation, and the remainder were tolerating the treatment well; of those completing the study, none reported any adverse effects.
Placing the Results into Context: A Systemic Review
On the basis of this certain, the authors based their systematic review on the results of other clinical studies about cannabis use in fibromyalgia. In general, ten clinical trials published from 2000 to 2023 with a total of eight observational studies and two randomized controlled trials were included.
Several important trends were noted in this systematic review. In multiple studies, medical cannabis was found significantly to reduce pain intensity in patients with fibromyalgia.
This is consistent with a reduction in pain, as was seen in the pilot study. Several studies also measured improvements in quality of life, again overlapping in content with the pilot study findings and transcending to both physical and mental well-being.
Additional benefits seen in some studies in this review include better quality sleep, sleep improvements, and improved mental health symptoms of anxiety and depression.
The review also observes that the majority of the pre-existing studies are in small samples—thereby, indicating a need for more organized and robustly built prospective clinical trials with larger sample sizes.
Discussion, Implications, and Directions for the Future
This small pilot study contains several important insights that point toward the potential of medical cannabis use for fibromyalgia treatment.
Firstly, the efficacy results are promising. Taken overall, low-dose medical cannabis probably provides impressive pain relief and quality of life improvements for most patients with fibromyalgia who otherwise responded poorly to other treatments.
This could be a major breakthrough for all those patients who are still seeking an effective way to manage their symptoms.
In fact, the safety profile looks very promising for this study.
This is particularly encouraging compared to many traditional painkillers that carry risks of dependence, cognitive impairment, and other side effects.
These results should be tempered by the fact that larger, longer-term studies are needed in order to ascertain adequate assessments regarding the safety of medical cannabis for patients with fibromyalgia.
Of particular interest in this study was the dosing used. Since some other trials expressed significantly higher dosages, these researchers used a relatively low dosage of cannabis for their study—100-200 mg/day, to be specific.
This could indicate that low dosage might keep symptoms under good control with less prominent side effects and tolerance.
As such, the optimal treatment in chronic pain management is a delicate balance between efficacy and side effects; this paper provides important data about approaches using low doses.
The form of administration also opens up some interesting potentials for a smoke-free alternative that will be more appealing and more accessible to many patients, especially those who have qualms against inhaled cannabis products.
Patients described the preparation and use of the infusion as easy, which may lead to better treatment adherence over time. Although results are very promising, there does need to be an awareness of the limitations of the study and that further research is necessary.
This research provides much hope to the millions of people who suffer from fibromyalgia.
Medical cannabis, though not a magic bullet, seems quite helpful in containing such a painful disorder. With increased understanding and regulation change, cannabis may emerge to be one of the more important tools in the fibromyalgia treatment arsenal.
