CBD and fibromyalgia: potential benefits and uses
Fibromyalgia is one of those conditions that is rarely talked about, but it affects a large number of people. According to recent reports, the use of cannabidiol (CBD) products, and especially CBD creams and CBD oils, to treat fibromyalgia has been rising among people who live with this condition.
To mark World Fibromyalgia Day, here on the Cannactiva blog we will talk a little more about it and explain the potential of CBD for fibromyalgia.
What is fibromyalgia?
Fibromyalgia is a complex chronic condition that affects almost 2% of the world's population, with a higher prevalence in women (1). It is characterised by multiple symptoms, such as chronic widespread pain, fatigue, sleep disturbances and cognitive impairment (2).
Treatment of fibromyalgia mainly targets the symptoms, and therapy consists of a combination of medicines (analgesics, antidepressants, anticonvulsants), physiotherapy, exercise and stress management techniques.
Because many people with fibromyalgia do not find enough relief with conventional treatments, or want to avoid the unwanted effects of certain medicines, CBD and other cannabinoids have emerged as possible alternatives for pain relief.
Cannabis for pain
The cannabis plant contains various cannabinoid compounds with therapeutic potential. The best known of these are tetrahydrocannabinol (THC) and cannabidiol (CBD). Both THC and CBD have been investigated to determine their efficacy in treating chronic pain, with highly variable results (3).
The scientific evidence on the use and effectiveness of cannabis in chronic pain disorders is growing, especially in rheumatic diseases (4, 5). However, clinical data on the use of cannabinoids for fibromyalgia are limited (6).
CBD and fibromyalgia
Cannabidiol (CBD), a non-psychoactive compound derived from the hemp plant, has shown efficacy in treating some of the symptoms of fibromyalgia as perceived by users, according to a survey carried out in 2021 (11).
Little is known about the mechanisms involved in the pain relief that CBD might bring to people with fibromyalgia. However, there is evidence that CBD can help relieve some of the symptoms related to this condition. Overall, CBD appears to have a great effect on improving the quality of life of people who live day to day with the various symptoms associated with fibromyalgia (14).
CBD dosage for fibromyalgia
So far, no effective dose of CBD for fibromyalgia has been established, and survey-based scientific reports vary widely in the dose reported. Some researchers have even suggested that THC is more promising than CBD for treating fibromyalgia.
For this reason, it has been suggested that, if CBD oils are used, the most effective would be those with a minimal percentage of THC, which are full spectrum CBD oils, rather than pure or broad spectrum CBD. In cannabis, the components work better when they act in synergy with other cannabinoids, something we already discussed when talking about the benefits of full spectrum CBD oil.
Although some studies have reported that patients experience improvements in chronic pain with CBD treatment (12), one study showed no reduction in pain with a CBD-rich cannabis product (13). However, in this latter study, the authors stated that the result may have been due to the use of a very low dose of CBD.
Safety and tolerability of CBD for fibromyalgia
CBD has a favourable safety profile compared with many traditional treatments for fibromyalgia. Common side effects include drowsiness, dizziness and gastrointestinal upset, which are usually mild and short-lived. However, possible interactions between CBD and medicines should be considered, as CBD can inhibit the cytochrome P450 enzymes involved in the metabolism of various medicines.
You should see a doctor before trying CBD or any cannabinoid to relieve fibromyalgia, especially if you are taking other prescription medicines.
How long does CBD take to work for fibromyalgia symptoms?
The time CBD takes to work can vary depending on how it is taken (oil, capsules, topical creams, etc.), the dose and the body's individual response, as well as other factors such as reduced stress and lifestyle. Some users report feeling relief within minutes, while others may need several days or weeks of continuous use to notice a significant improvement.
Can CBD cause dependence or serious side effects?
CBD is not addictive and generally has mild, short-lived side effects, such as drowsiness and dizziness. However, on rare occasions, some people may experience more serious side effects. It is always advisable to start with low doses and increase them gradually, under the supervision of a health professional.
Because many people with fibromyalgia do not find complete relief with conventional treatments, or want to avoid the unwanted effects of these medicines, they have looked for alternatives such as CBD and other cannabinoids.
THC and fibromyalgia
The therapeutic effectiveness of THC-rich cannabis in treating the pain associated with fibromyalgia has been reported by several studies (7, 8). It has also been suggested that THC has a positive effect on appetite and mood (9). However, there are currently no standardised clinical recommendations.
THC-rich cannabis is not well accepted by all fibromyalgia patients because of the risk of feeling “high”, so many look for other options, such as CBD.
Although THC is known to be an effective analgesic, combining it with CBD, which has anti-inflammatory and analgesic properties, could enhance its effects, making cannabis a stronger option for pain relief (10).
What is the difference between CBD and THC in the treatment of fibromyalgia?
CBD is a non-psychoactive compound that can help relieve pain and inflammation without causing the “high” associated with THC, another cannabinoid that does have psychoactive effects. Some people find relief using CBD alone, while others may benefit more from a combination of both compounds.
Conclusion
The legalisation of cannabis products, together with the scientific and empirical evidence on the effectiveness of THC and CBD in treating fibromyalgia, continues to evolve. CBD appears to be suitable for relieving some of the symptoms of this condition. On the other hand, pain relief with THC has been documented to a greater extent. However, there is a theory that cannabis products containing both THC and CBD could be of greater benefit for conditions involving chronic pain, such as fibromyalgia.
For now, it is important to bear in mind that using CBD appears to improve overall quality of life and, for this reason, it could in future become a viable complementary therapy for people with fibromyalgia, always with professional advice and supervision.
Note: This is an informative article and is not intended to prevent, diagnose or treat any disease. Its content may complement, but must never replace, the diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines and are intended for external use. New relevant scientific evidence may have emerged since the date of publication. Speak to your doctor before using CBD. The therapeutic approach must always be personalised and depends on professional assessment.
Frequently asked questions
How is cannabis taken for fibromyalgia?
People who use cannabis to treat fibromyalgia with positive results usually use medical cannabis, with THC, although the use of CBD products has recently been growing in popularity. It is usually inhaled, using bongs, joints and vaporizers. The second most popular option is concentrates, such as oils, while the topical route is the least used (15). In general, routes of administration and doses vary greatly and depend largely on the user, as well as on their experience and previous exposure to cannabis.
How can CBD help with fibromyalgia?
Some research teams have proposed that CBD helps with fibromyalgia thanks to a range of benefits, such as improvements in insomnia, anxiety, cognition and mood (13).
Can CBD cure fibromyalgia?
No, CBD does not cure fibromyalgia. However, current scientific evidence indicates that it could help relieve some of the symptoms associated with this condition, such as chronic pain, including neuropathic pain, anxiety and sleep problems.
What is the best way to take CBD to treat fibromyalgia symptoms?
So far, there are no clinical studies that have used CBD specifically to treat fibromyalgia. However, one study found that vaporised CBD from flower containing 9% CBD and less than 1% THC produced minimal analgesic effects (13). Despite this, some people have reported benefiting from the effective use of CBD in managing their fibromyalgia symptoms. There is no single best way to take CBD, as effectiveness can vary from person to person. Some common forms include sublingual oils, capsules, edibles and topical creams. The choice depends on personal preferences and the specific symptoms you want to treat.
References
- Heidari, F., Afshari, M., & Moosazadeh, M. (2017). Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis. Rheumatology international, 37(9), 1527–1539. https://doi.org/10.1007/s00296-017-3725-2
- Clauw D. J. (2009). Fibromyalgia: an overview. The American journal of medicine, 122(12 Suppl), S3–S13. https://doi.org/10.1016/j.amjmed.2009.09.006
- Fitzcharles, MA., Baerwald, C., Ablin, J. et al. Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis). Schmerz 30, 47–61 (2016). https://doi.org/10.1007/s00482-015-0084-3
- Gonen, T., & Amital, H. (2020). Cannabis and Cannabinoids in the Treatment of Rheumatic Diseases. Rambam Maimonides medical journal, 11(1), e0007. https://doi.org/10.5041/RMMJ.10389
- Katz-Talmor, D., Katz, I., Porat-Katz, B. S., & Shoenfeld, Y. (2018). Cannabinoids for the treatment of rheumatic diseases - where do we stand?. Nature reviews. Rheumatology, 14(8), 488–498. https://doi.org/10.1038/s41584-018-0025-5
- Skrabek, R. Q., Galimova, L., Ethans, K., & Perry, D. (2008). Nabilone for the treatment of pain in fibromyalgia. The journal of pain, 9(2), 164–173. https://doi.org/10.1016/j.jpain.2007.09.002
- Habib, G., & Avisar, I. (2018). The Consumption of Cannabis by Fibromyalgia Patients in Israel. Pain research and treatment, 2018, 7829427. https://doi.org/10.1155/2018/7829427
- Sagy, I., Bar-Lev Schleider, L., Abu-Shakra, M., & Novack, V. (2019). Safety and Efficacy of Medical Cannabis in Fibromyalgia. Journal of clinical medicine, 8(6), 807. https://doi.org/10.3390/jcm8060807
- Kogan, N. M., & Mechoulam, R. (2007). Cannabinoids in health and disease. Dialogues in clinical neuroscience, 9(4), 413–430. https://doi.org/10.31887/DCNS.2007.9.4/nkogan
- Vučković, S., Srebro, D., Vujović, K. S., Vučetić, Č., & Prostran, M. (2018). Cannabinoids and Pain: New Insights From Old Molecules. Frontiers in pharmacology, 9, 1259. https://doi.org/10.3389/fphar.2018.01259
- Boehnke, K. F., Gagnier, J. J., Matallana, L., & Williams, D. A. (2021). Cannabidiol Use for Fibromyalgia: Prevalence of Use and Perceptions of Effectiveness in a Large Online Survey. The journal of pain, 22(5), 556–566. https://doi.org/10.1016/j.jpain.2020.12.001
- Schilling, J. M., Hughes, C. G., Wallace, M. S., Sexton, M., Backonja, M., & Moeller-Bertram, T. (2021). Cannabidiol as a Treatment for Chronic Pain: A Survey of Patients' Perspectives and Attitudes. Journal of pain research, 14, 1241–1250. https://doi.org/10.2147/JPR.S278718
- van de Donk, T., Niesters, M., Kowal, M. A., Olofsen, E., Dahan, A., & van Velzen, M. (2019). An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain, 160(4), 860–869. https://doi.org/10.1097/j.pain.0000000000001464
- Berger, A. A., Keefe, J., Winnick, A., Gilbert, E., Eskander, J. P., Yazdi, C., Kaye, A. D., Viswanath, O., & Urits, I. (2020). Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia. Best practice & research. Clinical anaesthesiology, 34(3), 617–631. https://doi.org/10.1016/j.bpa.2020.08.010
- Sexton, M., Cuttler, C., Finnell, J. S., & Mischley, L. K. (2016). A Cross-Sectional Survey of Medical Cannabis Users: Patterns of Use and Perceived Efficacy. Cannabis and cannabinoid research, 1(1), 131–138. https://doi.org/10.1089/can.2016.0007
