Welcome to our 14th episode of Medical Cannabis Now! Today we will be discussing Fibromyalgia, its associated symptomatology, and what patients can do to ease their pain, find better sleep, and improve their overall quality of life. There are both lifestyle and medical options that Fibromyalgia patients can keep in their toolbelt to find the best relief and we are excited to share them with you today.
What is Fibromyalgia?
Fibromyalgia is a chronic health condition that is characterized by widespread pain of muscles, ligaments, tendons, and nerves. The exact cause of fibromyalgia is unknown and many go undiagnosed. Current research suggests fibromyalgia stems from an issue with central pain processing in the brain, which can cause an increased sensitivity or perception of pain from a given trigger. It also suggests that there are disturbances in the neurotransmitter levels such as serotonin and dopamine. The pain can be different for each patient and can change intensity or location in the body on a daily and sometimes even an hourly basis.
People with fibromyalgia can experience other symptoms as well, which include fatigue, difficulty sleeping, lack of concentration often referred to as “fibro-fog”, mood swings, and gastrointestinal problems. A relatively common condition, it affects over 700,000 Canadians, with 80-90% of them women. There is currently a list of risk factors that are associated with fibromyalgia patients including:
- a stressful traumatic physical or emotional event, such as a car accident or repetitive injuries
- rheumatoid arthritis or other autoimmune diseases, such as lupus
- Problems with the central nervous system (CNS)
- Regulating painful stimuli, and
- Viral infections
A diagnosis of fibromyalgia can take time to confirm, as many of the symptoms resemble those of other conditions. These conditions first need to be ruled out before diagnosing fibromyalgia. Not only do patients use medical cannabis for the physical pain, but also for the anxiety of suffering from that pain and not having an understanding or proper explanation for years.
How do people typically treat Fibromyalgia?
Drugs may be recommended to treat certain symptoms. These may include over-the-counter pain relievers. However, the European League Against Rheumatism issued a recommendation against using non-steroidal anti-inflammatory drugs to treat fibromyalgia in their updated 2016 guidelines.
Antidepressants, such as duloxetine, or Cymbalta, or Savella, may help reduce pain. Anti-neuropathic medications, such as gabapentin also known as Neurontin, and pregabalin, or Lyrica, may also be prescribed. However, a review has suggested that patients often stop using these drugs because they are not as effective in relieving pain or because of their adverse side effects.
Many of our own patients with fibromyalgia report benefits from medical cannabis use, and it’s probably one of our top diagnoses at our clinic. Growing research shows that cannabis can manage certain symptoms of fibromyalgia, and this has been seen on a clinical level and in research. They’ve been shown to potentially alleviate fibromyalgia symptoms such as chronic pain, nausea, nerve pain, mood, and sleep.
A recent study from 2020 done in Italy followed just over 100 patients with Fibromyalgia that were not responding to traditional medications. These medications included central sedatives, such as opioids, anticonvulsants, nerve blockers, and antidepressants. The study found that nearly half of these patients were able to reduce or cease their use of painkillers. Additionally, over a third of patients found relief with respect to sleep, and anxiety.
Endocannabinoid Deficiency Syndrome
One hypothesis by doctors is that fibromyalgia can be related to clinical endocannabinoid deficiency syndrome. This syndrome is thought to be a hypofunction or deficiency of our endocannabinoid tone and levels of 2-AG, Anandamide and other cannabinoids in our bodies. Because we know the endocannabinoid system is pervasive throughout our organ systems, this deficiency may be the underlying cause of generalized symptoms seen in fibromyalgia and other conditions such as irritable bowel syndrome and migraines. These conditions often share the same symptomatology and typically respond positively to medical cannabis.
There is rarely one cure for any one condition and we strongly encourage patients to use medical cannabis not as the only treatment option, but as a part of their treatment plan. In fibromyalgia, it is important to take advantage of non-pharmaceutical interventions. The most common are massage therapy, chiropractic, physiotherapy, mindfulness practices, and exercise. Individually, they may only provide temporary relief, especially if you only attend one or two sessions. But as part of a plan, they can provide effective long-term healing. Many of our patients use medical cannabis as a natural medication to take the edge off or decrease the pain, increase their energy, and motivation to partake in these activities.
We recommend speaking with one of our cannabinoid-based medicine healthcare practitioners to further discuss your treatment with medical cannabis and we hope to see you soon.
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