Fibromyalgia is one of the most common pain disorders in the United States affecting up to 12 million people, the majority of whom are women. The origins of fibromyalgia may be genetic, or there may be triggers such as an injury or trauma. Though widespread pain in any part of the body is a primary symptom of fibromyalgia, the disease also causes psychological distress, sometimes referred to as “fibro fog.” There are currently three U.S. Food and Drug Administration (FDA)-approved medications to treat fibromyalgia, but there is no cure.
As cannabis has been used to treat pain, could the plant help relieve some of the debilitating muscle stiffness and headaches associated with fibromyalgia?
Research Overview
Science is at the genesis of research to establish whether cannabis can treat a variety of painful ailments, including fibromyalgia. Though studies are limited, there have been some encouraging findings regarding cannabis as more than a pain management option for fibromyalgia.
The Studies
Alleviating pain may be the most pressing concern for a fibromyalgia patient, but addressing the root cause of any disease is ultimately more vital. Some studies have suggested that fibromyalgia sufferers have an underlying dysfunction of their endocannabinoid systems. Correcting this dysfunction with cannabis may be useful for both pain management and pinpointing the possible origin of the disease.
In a 2016 review for Cannabis and Cannabinoid Research, Ethan B. Russo wrote, “If endocannabinoid function were decreased, it follows that a lowered pain threshold would be operative, along with derangements of digestion, mood, and sleep among the almost universal physiological systems subserved by the endocannabinoid system.”
Therefore, the pain that fibromyalgia patients experience may be traced, in part, to measurable decreases in the body’s endocannabinoid function. This doesn’t mean that restoring balance to the endocannabinoid system (ECS) is a cure for fibromyalgia, but it could lessen the pain associated with the disease.
Also, a 2018 study published in the Journal of Clinical Rheumatology surveyed 26 fibromyalgia patients in Israel. The patients were given medical cannabis for a period of about 11 months, after which researchers learned that half of the patients had stopped taking their other prescription medication. The scientists concluded that “Medical cannabis treatment had a significant favorable effect on patients with fibromyalgia, with few adverse effects.”
A larger 2018 study, published in Pain Research and Treatment reported questionnaire responses from 383 Israeli fibromyalgia patients. Of the respondents, 84 percent reported use of cannabis to treat their fibromyalgia, and 94 percent of these individuals claimed to experience pain relief. Depression and anxiety were also greatly reduced in individuals who used cannabis.
“Only 12 percent of all cannabis users in our study reported adverse effects, compared to 94 percent reporting adverse effects from other pain meds prior to cannabis use,” wrote George Habib and Iris Avisar, the co-authors of the study. “Most cannabis-related adverse effects were mild and transient such as eye or throat irritation. … Nearly 85 percent of the patients either completely stopped taking any other pain medications or reduced the dosage of other meds. This reflects the advantage of cannabis over other meds in alleviating pain in addition to its favorable effects on sleep and mood.”
The two studies share several key points in common: Many cannabis users reported improvement of their fibromyalgia symptoms, cannabis had minimal side effects, and at least half of the patients stopped taking their prescription medications.
However, pain is a subjective issue, and the improvements experienced by the fibromyalgia patients in these studies may be perceived benefits. At the same time, perceived benefits can offer powerful physical and psychological comfort to those who experience them.
Patient Perspectives
Colorado resident Teri Robnett has suffered from fibromyalgia for more than three decades and has been using cannabis to manage her symptoms since 2009.
“It completely changed my life,” Robnett told the Denver Post, claiming that cannabis has been the only medicine to treat her fibromyalgia without major side effects.
In 2018, 32-year-old Carly Barton became the first person in the United Kingdom to receive a cannabis prescription for pain management. Barton survived a stroke in her 20s and was subsequently diagnosed with fibromyalgia. Desperate to ease her chronic pain, Barton reluctantly turned to cannabis.
“That was the point where I realized that I had no idea about medicine at all and that what we had been told about it was incorrect — really this plant has got the ability to completely take my pain away,” Barton said.
Since she started taking cannabis, Barton has abandoned her morphine and fentanyl prescriptions, now relying entirely on medical marijuana to treat her pain.
Actor Morgan Freeman also cites marijuana as a healing factor for his fibromyalgia pain.
“I have fibromyalgia pain in this arm, and the only thing that offers any relief is marijuana,” Freeman shared in a 2015 interview with the Daily Beast. But do physicians agree with patient accounts regarding cannabis and fibromyalgia pain relief?
What the Experts Say
Many medical experts are still on the fence about prescribing cannabis to their fibromyalgia patients.
“It’s a tricky pain because people have a higher rate of comorbidity with other conditions, such as depression, and the data [are] not clear if marijuana is good for treatment in fibromyalgia itself,” said Dr. Ajay D. Wasan, vice chair of pain medicine at the University of Pittsburgh Medical Center. “We definitely need to have medical marijuana studies in specific pain conditions — people think we can use it for everything, these pain conditions are different in their biology, physiology, and responses to treatment.”
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Since there is no cure for fibromyalgia and the disease can be difficult to treat, some physicians have expressed the necessity of going beyond current prescription medications, such as pregbalin, which can cause a host of side effects.
“Fibromyalgia is devastating for those who must live in its grip. There is much we do not understand. We need innovative, ‘out of the box’ solutions that change the face of this disease,” said Dr. Dan Bennett, an interventional spine and pain surgical physician in Denver and chairman of the National Pain Foundation.
Based on emerging research and anecdotes, cannabis could be that innovative, “out of the box” solution to bring relief to fibromyalgia patients.
The Bottom Line
The outlook is hopeful for treating fibromyalgia with cannabis medicine, and further research could validate what many patients have already experienced.
