Cannabis, pain and fibromyalgia

I have a question about cannabis, pain and fibromyalgia. Is therapeutic cannabis an option?

I am 54 years old and have been diagnosed with fibromyalgia . I am in pain most of the day and almost no treatment has been effective. I have read that cannabis could help me get better and would like to know your opinion. Thank you very much.

Originally posted in SR 2.0 . Reviewed 20/2/22

Fibromyalgia is a musculoskeletal disease that causes persistent pain, extreme fatigue, muscle stiffness. Also, there are also other symptoms such as psychological distress, sleep difficulties, headaches, and forgetfulness.

This condition is  controversial. Some physicians do not believe that this is a «disease» due to the lack of physical, laboratory, or imaging test alterations,. But others disagree and state that there are still no laboratory markers available

There are different hypotheses about  the triggers of fibromyalgia. The widely accepted theory considers that physical and mental stress, psychological and social factors, are the main causes. Other authors think that certain viruses or vaccines may be the cause.

In any case, most experts agree that the mechanisms of fibromyalgia involve a decreased pain threshold in the brain. And also an increased sensitivity of the body’s pain receptors.

The fact has led some researchers to hypothesize that  a deficiency of endogenous cannabinoids could cause fibromyalgia. These molecules contribute to the control and regulation of pain in vertebrates.

This hypothesis is still under investigation. But some studies have found elevated levels of anandamide, one of the cannabinoids naturally occurring in the body, in fibromyalgia patients.

Several studies have examined the efficacy of cannabinoid-based treatments for fibromyalgia. In 2006, a study showed improvement in a subgroup of patients treated with oral delta-9-THC in doses between 2.5 and 15 mg.

Another synthetic cannabinoid called Nabilone proved some benefits in at least two small clinical trials . However, some patients did not tolerate the medication well, and others did not experience any relief.

Recently, some studies suggest that vaporized marijuana or THC-rich cannabis oil may be an effective treatment for fibromyalgia. In any case, more research is needed to confirm these findings.

In fibromyalgia, no treatment is completely effective in a majority of patients. Some individuals improve with different types of drugs. Medications available include anti-inflammatory medications, analgesics, corticosteroids, antidepressants, and antiepileptics. Psychological and non-pharmacological therapies are useful, too.

Therefore,  cannabinoids may provide benefits for certain individuals. But there is need of more research determine their overall efficacy and safety for the treatment of fibromyalgia.