Fibromyalgia Pain Relief: Can CBD Oil Help?

What is fibromyalgia?

Fibromyalgia is a chronic condition characterized by pain throughout the body, specifically in the muscles, tendons and ligaments. Often, patients with fibromyalgia suffer from fatigue, excessive sleeping, headaches, memory and concentration problems, and mood disorders such as depression and anxiety. Emotional stress and physical exertion are usually poorly tolerated and worsen the symptoms of the disease.

It is estimated that, worldwide, fibromyalgia affects around 1 in 20 people. Women of childbearing age are the population in which this condition is most prevalent. Women are seven times more likely to develop fibromyalgia. The probability of the disease appearing increases with age, and it is common to present between the ages of 30 and 60. However, it can also affect children and the elderly.

What causes fibromyalgia?

The causes and specific processes that lead to the onset of fibromyalgia are not known. Studies show that people with fibromyalgia present changes in the nervous system, specifically in the pathways that transmit and receive pain signals. These patients have an increased sensitivity to pain, and therefore feel pain in situations that other people would not feel.

Fibromyalgia tends to run in families, so it is considered likely that genetic factors contribute to its onset, but little is known about the genes involved. Researchers believe that, in the expression of the disease, some environmental factors are also involved, such as stress levels. The existence of diseases that cause pain, such as rheumatoid arteritis, and mental illnesses, such as anxiety or depression, may also increase the onset of fibromyalgia.

How is fibromyalgia diagnosed?

Despite being known for several decades, diagnosing fibromyalgia continues to be a major challenge, mainly because there are no specific laboratory analyzes or medical tests for the disease.

Fibromyalgia is considered a diagnosis of exclusion. Doctors exclude all other causes of pain, fatigue, mood disturbances and sleep disturbances before considering a diagnosis of fibromyalgia as a potential cause of symptoms, resulting in a significant delay in diagnosis.

The invalidation of the patient's symptoms and the lack of awareness and adequate knowledge of the disease on the part of doctors have also proven to be causes of delayed diagnosis. Adequate training of the clinical staff can significantly reduce the time it takes to diagnose fibromyalgia.

According to a survey carried out in 2010, the average time for a diagnosis of fibromyalgia is 2.3 years after the first presentation to a health service. During this period, patients see, on average, 3.7 doctors until they get a diagnosis. People with fibromyalgia have severe physical limitations and a poor quality of life in general, and delays in diagnosis increase patients' frustration.

Furthermore, there are studies that show an association between delay in diagnosing fibromyalgia and a worse response to different treatment options. This means that faster diagnosis and treatment can yield better health outcomes and quality of life for patients with fibromyalgia.

Is fibromyalgia curable?

There is no known cure for fibromyalgia, so treatment focuses on relieving symptoms. As there is no clear knowledge regarding the mechanisms of this disease, there is also no specific and targeted therapy.

Fibromyalgia is often treated by rheumatologists, but there are other healthcare professionals involved, such as mental health professionals, physical therapists, pain management specialists, and others.

The treatment plan for a person with fibromyalgia may be a combination of medication, psychotherapy, and self-care and self-management techniques, such as physical exercise or activities that promote relaxation.

Several medications can help manage fibromyalgia symptoms by relieving pain, reducing fatigue and promoting sleep. Often, patients with fibromyalgia are prescribed more than one type of medication.

Antidepressants: drugs that treat depression can also work in the case of fibromyalgia, even if there is no depression. Some antidepressants increase the concentration of serotonin and norepinephrine in the brain, helping to relieve pain, improve sleep and mental health, improving quality of life.
Anticonvulsants: Antiepileptic medications can reduce pain and stiffness, as well as promote improved sleep. These drugs work by interfering with pain transmission signals to the brain.
Painkillers: These medications are often prescribed to people with fibromyalgia. Anti-inflammatory pain relievers are not usually effective because fibromyalgia does not cause tissue inflammation, but they can help with other painful conditions that coexist with fibromyalgia.

There is no single treatment for fibromyalgia symptoms, and treatments that work for some will not necessarily work for others. You may need to try several treatments to find a suitable combination. Even so, many patients report only partial relief of symptoms, and medication side effects are common.

Some people also resort to alternative therapies, but there is no evidence that these therapies result in any effect. However, some of these, such as Yoga, Tai Chi, guided hypnosis or meditation therapies, can be considered self-care strategies, and bring some benefits.

Cannabis for fibromyalgia: CBD or THC

CBD is one of more than 100 cannabinoids produced by cannabis. THC is the cannabinoid responsible for the alteration of consciousness that cannabis is famous for. Both THC and CBD have great therapeutic potential, but CBD has gained importance in recent years, largely due to the lack of psychotropic effects.

Commercially available CBD products are almost exclusively produced from cannabis plants with a THC content of less than 0.3%, often referred to as hemp. Therefore, CBD products, in general, do not have the potential to generate any intoxicating effect.

The effectiveness of CBD in fibromyalgia

The cannabis plant has been used in medicine for thousands of years and, in recent decades, a lot of research has been done in the area of medicinal cannabis. In recent years, research has been directed towards the study of certain cannabinoids in particular, namely CBD, and benefits associated with this compound have been found.

The endocannabinoid system is a biological system involved in the regulation of various functions and processes such as sleep, mood, appetite, pain, etc. Studies show that CBD can help reduce chronic pain by interacting with receptors in the endocannabinoid system and several neurotransmitters.

A 2020 literature review concluded that CBD may, in some contexts, have benefits in relieving chronic pain, improving sleep, and reducing inflammation. Another review published in 2020, on CBD and mood disorders, found several studies that suggest that CBD has properties that can help reduce symptoms of depression, anxiety, and psychosis.

Cannabis is widely used to induce relaxation and promote improvements in sleep, mood and appetite, and research in these areas continues to be in-depth. Efficacy in relieving chronic pain is one of the most researched properties, and several years of clinical trials support the short-term use of cannabis for the treatment of neuropathic pain.

Cannabis studies in fibromyalgia

Currently, there are no published studies on fibromyalgia that only look at the effects of CBD, but there are several studies that look at the effect of cannabis on fibromyalgia. The results are not always consistent, but there are positive indicators regarding the use of cannabis to treat fibromyalgia.

In 2019, a study was published suggesting that the lack of endogenous cannabinoids in the body may be the cause of chronic pain syndromes, including migraines, irritable bowel syndrome and fibromyalgia. A 2017 study argues that CBD can counteract the hypersensitivity of cells surrounding nerves in people with chronic pain, including those with fibromyalgia.

A 2020 publication states that as global cannabis consumption trends increase, data points to a positive effect of cannabis on fibromyalgia are increasing. A 2019 randomized study looked at the effects of CBD and THC in people with fibromyalgia. The result was a decrease in pain assessment of around 30% when compared to the placebo group.

Another 2019 study looked at hundreds of people with fibromyalgia and concluded that cannabis was a safe and effective treatment for the condition. At the start of the study, 52.5% of participants described their pain levels as high. At the 6-month follow-up, only 7.9% reported high levels of pain.

A review of the literature, published in 2023, concluded that cannabinoids such as CBD and THC may play an important role in managing key symptoms of fibromyalgia, such as pain, sleep quality, mood, libido and appetite, being , therefore, a valid treatment option.

Although much more research is needed in this area, as the authors of these studies state, surveys suggest that a significant percentage of patients with fibromyalgia use cannabis to relieve pain.

Although this association may be confused by the relief of other comorbidities associated with fibromyalgia, a large proportion of patients report improvements, both in terms of pain and increased quality of life, through the use of cannabis and CBD products.

CBD Treatment Options for Fibromyalgia

CBD products can help manage symptoms associated with fibromyalgia. There are several CBD products on the market that contain trace amounts of THC, thus avoiding the psychotropic effects associated with cannabis.

It is important to be informed regarding the different types of products, but also the appropriate dosages and administration methods. Some of the most popular CBD products used by people with fibromyalgia include:

CBD Oils

CBD oil allows CBD to be consumed orally or sublingually. CBD oil applied under the tongue is one of the most popular and effective ways to use CBD. In this way, CBD is absorbed into the oral mucosa, allowing rapid and effective absorption into the bloodstream. CBD oil can also be swallowed directly, in which case it is processed in the body in a similar way to CBD edibles.

CBD Edibles

CBD edibles are swallowed and processed in the digestive system and metabolized by the liver. This means that the absorption of CBD into the bloodstream is not as quick and effective as in the case of sublingual use. On the other hand, CBD tends to remain in the bloodstream for longer, resulting in longer-lasting effects.

CBD Topicals

CBD creams, lotions and balms are applied to the area where symptoms are sought. CBD is absorbed through the skin, but is not able to reach the bloodstream, providing localized pain relief through interaction with cannabinoid receptors. Massaging CBD topicals into affected spots can help alleviate fibromyalgia pain.

CBD Flower

CBD flowers are typically smoked or inhaled. In this way, CBD reaches the lungs, where it is directly absorbed into the bloodstream, very quickly and effectively. This method has the disadvantages of the short duration of its effects and difficult dosing.

Strategies to relieve fibromyalgia symptoms

When living with fibromyalgia, changes to your daily routine may be necessary to help alleviate symptoms and improve quality of life.

Physical exercise

Physical exercise is one of the pillars of fibromyalgia treatment. Although pain and fatigue can make exercise difficult, it is very important to stay physically active through a proper exercise plan. Research shows that regular exercise is one of the most effective factors in combating fibromyalgia symptoms, and even moderate levels are beneficial.

Relaxation

It's important to set aside some time to relax, or practice relaxation techniques. Stress can worsen symptoms or make them appear more frequently, and can increase the chances of developing depression.

Several options help promote relaxation, such as guided meditations, books, or deep breathing techniques. It's important to find time every day to relax, and doing so before bed can contribute to a better night's sleep.

Education, support and therapy

People with fibromyalgia should learn more about the disease so they can manage their symptoms more effectively and make informed decisions about their treatment options.

Finding a support group with other people dealing with the condition, or dedicated organizations, can be key to getting relevant advice and recommendations. Furthermore, having a support network and being able to talk to someone who knows what you are going through is important for managing difficult times.

If emotional problems arise, it is essential to consult a mental health professional. Research shows that therapies such as acceptance and commitment therapy and cognitive behavioral therapy can reduce pain, improve sleep and help deal with negative thoughts and feelings.

Sleep habits

Persistent fatigue is one of the most troublesome symptoms of fibromyalgia. The following strategies can contribute to a better night's sleep and help reduce tiredness.

Create a relaxing sleep environment and establish a sleep routine.
Go to bed and get up at the same times every day.
Reserve your bed for sleeping, avoiding watching television, reading or using your cell phone.
Keep the room comfortable and in a dark, quiet and cool environment.
Avoid stimulants, such as caffeine and nicotine, and avoid alcohol consumption.
Relax before bed. Avoid working or exercising before bed, opting for relaxing activities, such as meditating or taking a hot bath.
Manage energy levels throughout the day. Some days, some tasks may simply require too much energy. Expending too much energy can result in a worsening of fibromyalgia symptoms.

The Future of CBD for Fibromyalgia

Today, the diagnosis of fibromyalgia continues to be a challenge, in part because it is based on non-specific clinical characteristics, and due to a lack of in-depth understanding of the disease by doctors.

Fibromyalgia can be profoundly disabling due to the intensity and chronicity of symptoms, especially in cases of late diagnosis. Unfortunately, available therapies do not always produce the desired results, and people look for alternatives to relieve symptoms.

For people with fibromyalgia, it is very important to introduce healthy routines into their daily lives, such as physical exercise, relaxation techniques, good sleep hygiene strategies and psychotherapy. These activities must be adjusted so that they provide pleasure to the person who performs them, encouraging their long-term continuation.

Regarding CBD, there is evidence that it can help combat some symptoms associated with fibromyalgia, but more clinical research is needed. If you want to start taking CBD, check with your doctor about potential interactions with medications. Also important, find out about the products you want to purchase, and about the appropriate CBD dosages and routines for your situation.