Medical Marijuana and the treatment of Fibromyalgia

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Cannabis receives a lot of attention as an effective treatment of pain, insomnia, nausea, and many more symptoms associated with this condition. Could cannabis be the future of fibromyalgia treatment?

Fibromyalgia is a condition characterized by widespread pain and a variety of other debilitating symptoms that can severely affect a patient’s ability to live a normal life and may lead to serious mental health conditions like depression or anxiety.

It currently affects around 10 million people in the U.S. and an estimated 3-6% of the world population, making it one of the most common chronic pain conditions around.

UNDERSTANDING FIBROMYALGIA

Fibromyalgia is a long-term condition characterized by causing widespread musculoskeletal pain as well as fatigue and problems with sleep, memory, and mood.

For a long time, fibromyalgia patients were told that the symptoms they were experiencing were “all in their head,” seeing as there were no obvious physical causes for their pain. But, thanks to new research, fibromyalgia is now recognised as a very real and potentially debilitating condition.

Today there is a growing consensus among the medical community that fibromyalgia is caused by an incorrect processing of pain signals in the brain and spinal cord, causing patients to experience painful sensations more intensely.

What causes this incorrect processing of signals, however, is not clear. Fibromyalgia symptoms can sometimes occur after a physical trauma, surgery, infection or significant psychological stress. Symptoms can also build up gradually with no clear trigger.

Women are up to 6 times more likely to suffer from fibromyalgia than males. But there is some also evidence that fibromyalgia may be genetic. Relatives of a patient with the condition, for example, are believed to be more at-risk of developing fibromyalgia themselves.

Stress is also believed to be an important precipitating factor in the development of fibromyalgia. This is because fibromyalgia can also be related to other stress-related conditions like chronic fatigue syndrome, posttraumatic stress disorder, irritable bowel syndrome and more. It is also strongly related to depression, although the exact relationship between the 2 conditions is highly debated.

SYMPTOMS OF FIBROMYALGIA

Patients generally describe fibromyalgia as causing deep stabbing pains across the body. Other symptoms of the condition include:

  • Incapacitating fatigue
  • Insomnia
  • Muscle cramps, especially in the legs
  • Joint pain
  • Headaches
  • Concentration and memory problems
  • Tender points around the body that, when touched, cause extreme pain
  • Muscle twitches
  • Problems urinating
  • Nausea

FIBROMYALGIA DIAGNOSIS

In order to be diagnosed with fibromyalgia, patients previously had to be sensitive in at least 11 of the 18 possible tender points and have experienced widespread pain in all 4 quadrants of the body. However, these diagnostic criteria have since changed.

Today, a patient can be diagnosed with fibromyalgia after experiencing widespread pain for at least 3 months with no underlying medical condition that could be responsible for causing said pain.

Apart from this, doctors may also want to rule out other possible conditions before making a fibromyalgia diagnosis. They’ll generally do this via blood tests to look at things like:

  • Complete blood count
  • Erythrocyte sedimentation rate
  • Cyclic citrullinated peptide test
  • Rheumatoid factor
  • Thyroid function

THE EMOTIONAL BURDEN OF FIBROMYALGIA

It is important to remember that fibromyalgia goes much deeper than just causing widespread pain.

A common symptom of fibromyalgia is cognitive dysfunction (often called “fibrofog”), which can be characterized by:

  • Impaired concentration
  • Problems with short and long-term memory
  • Short-term memory consolidation
  • Impaired speed of performance
  • Difficulties multi-tasking
  • A diminished attention span

This “fibrofog” can have a huge effect on a patient’s ability to get on with their daily lives, often affecting their ability to deal with work or family responsibilities. This, in turn, may affect a person’s mood, and can ultimately lead to serious mental health conditions like anxiety and depression.

In fact, both anxiety and depression are often associated with fibromyalgia, often caused by the stress of dealing with the condition on a daily basis.

HOW IS FIBROMYALGIA TREATED?

There is no cure for fibromyalgia, nor is there a universally accepted method for treatment. Like many complex conditions, the way patients experience fibromyalgia can vary and treatment plans, therefore, need to be tailored to the individual experience of a patient.

Treatment usually involves both prescription medication, as well as therapies such as behavioral intervention and exercise.

The medications commonly used to help treat fibromyalgia include:

  • Pain relievers are used to relieve the painful symptoms of the condition. These can include both over-the-counter and prescription painkillers
  • Antidepressants are also used to help relieve pain and fatigue. Muscle relaxants may also be used to help with sleeping issues
  • Anti-seizure medications can also be used in fibromyalgia treatment in order to relieve pain

The therapies used to treat fibromyalgia include physical therapy, occupational therapy, and counseling. Some patients also turn to alternative therapies like acupuncture, massage therapy, and yoga and tai chi, for relief

CANNABIS AND FIBROMYALGIA

Cannabis and cannabis-derived medications have received a wide variety of attention for their ability to relieve symptoms like pain, insomnia, nausea, and much more. Seeing that these are symptoms associated with fibromyalgia, cannabis seems like it may be an effective treatment method for fibromyalgia patients.

In fact, according to a 2014 survey by the US National Pain Report of over 1,300 patients with the disease, medical marijuana was ranked the most effective drug for treating fibromyalgia symptoms. It outranked all other FDA approved drugs for treating the disorder.

Participants were asked to rank the medications as either very effective, slightly effective, or not effective at all for treating their symptoms. The 3 drugs approved by the FDA (Cymbalta, Lyrica and Savella) were only found to be very effective by an average of 9% of patients. Cannabis, on the other hand, was voted very effective by 62% of all participants who had tried it.

The survey respondents mentioned that cannabis was effective at relieving both the physical and mental symptoms associated with the disease. Some did mention, however, that cannabis’ effects didn’t last long and left them feeling “foggy.”

However, the evidence for cannabis as a treatment method for fibromyalgia isn’t just anecdotal. There is a growing body of empirical evidence from laboratory studies and clinical trials that support these findings.

Fibromyalgia is characterized by widespread pain. Cannabis has been found to be a very effective painkiller. In 1997, a study from the European Journal of Pharmacology found that the endocannabinoid system is actively involved in managing pain, and since then more studies have shown that certain compounds found in cannabis can effectively help relieve pain.

The main cannabinoids though to be involved in managing pain are THC and CBD, but others may also be involved. It is believed that once these compounds enter our bodies they help suppress pain signals in the brain and central nervous system. How they do this is complicated and not completely clear.

Cannabis has also been shown to be an effective sleep aid. A 2010 paper published in the Canadian Medical Association Journal, for example, found that smoked cannabis effectively helped improve sleep and relieve painful symptoms in patients with post-traumatic or postsurgical neuropathic pain

The study found that a single inhalation of 25 mg of 9.4% tetrahydrocannabinol cannabis taken three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated by participants.

Cannabis pain and insomnia relieving properties can, therefore, be an effective way of dealing with the pain and insomnia caused by fibromyalgia.

Furthermore, some patients with this condition may also experience nausea (either due to the condition itself or as a possible side-effect of medication). Cannabis has also been found to help relieve nausea and vomiting caused by chemotherapy, and might, therefore, qualify as an effective treatment of this symptom for fibromyalgia patients as well.

CANNABIS, FIBROMYALGIA, AND THE FUTURE

There is strong evidence that medical marijuana can help fibromyalgia patients find effective relief from symptoms such as pain, insomnia or sleep issues, and nausea.

It is important to note, however, that cannabis cannot cure the condition. Instead, it can help alleviate the symptoms caused by the condition.

In many parts of the US, fibromyalgia is a qualifying condition under various medical cannabis programs. These include:

  • Arkansas
  • Illinois
  • North Dakota
  • Ohio

Chronic pain is a qualifying condition in many more states, including Alaska, Arizona, California, Colorado, Delaware, and much more. Outside of the US, medical cannabis is legal to some extent in places like Chile, Canada, Australia, Argentina, Croatia, and more.

To find out how to access medical cannabis for fibromyalgia in your area, make sure to consult your local authorities.

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