Cbd oil benefits for fibromyalgia

Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia

Fibromyalgia is a complex disease process that is as prevalent as it is poorly understood. Research into the pathophysiology is ongoing, and findings will likely assist in identifying new therapeutic options to augment those in existence today that are still insufficient for the care of a large population of patients. Recent evidence describes the use of cannabinoids in the treatment of fibromyalgia. This study provides a systematic, thorough review of the evidence alongside a review of the seminal data regarding the pathophysiology, diagnosis, and current treatment options. Fibromyalgia is characterized by widespread chronic pain, fatigue, and depressive episodes without an organic diagnosis, which may be prevalent in up to 10% of the population and carries a significant cost in healthcare utilization, morbidity, a reduced quality of life, and productivity. It is frequently associated with psychiatric comorbidities. The diagnosis is clinical and usually prolonged, and diagnostic criteria continue to evolve. Some therapies have been previously described, including neuropathic medications, milnacipran, and antidepressants. Despite some level of efficacy, only physical exercise has strong evidence to support it. Cannabis has been used historically to treat different pain conditions since ancient times. Recent advances allowed for the isolation of the active substances in cannabis and the production of cannabinoid products that are nearly devoid of psychoactive influence and provide pain relief and alleviation of other symptoms. Many of these, as well as cannabis itself, are approved for use in chronic pain conditions. Evidence supporting cannabis in chronic pain conditions is plentiful; however, in fibromyalgia, they are mostly limited. Only a handful of randomized trials exists, and their objectivity has been questioned. However, many retrospective trials and patient surveys suggest the significant alleviation of pain, improvement in sleep, and abatement of associated symptoms. Evidence supporting the use of cannabis in chronic pain and specifically in fibromyalgia is being gathered as the use of cannabis increases with current global trends. While the current evidence is still limited, emerging data do suggest a positive effect of cannabis in fibromyalgia. Cannabis use is not without risks, including psychiatric, cognitive, and developmental as well as the risks of addiction. As such, clinical judgment is warranted to weigh these risks and prescribe to patients who are more likely to benefit from this treatment. Further research is required to define appropriate patient selection and treatment regimens.

Keywords: CBT; SNRI; SSRI; chronic pain; depression; myalgia.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Conflict of interest statement

Declaration of Competing Interest The authors have no conflicts of interest to disclose.

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CBD Oil for Fibromyalgia: Is it Effective, Safe, or Legal?

Further research is needed to prove its effectiveness

Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more.

David Ozeri, MD, is a board-certified rheumatologist. He is based in Tel Aviv, Israel, where he does research at Sheba Medical Center. Previously, he practiced at New York-Presbyterian Hospital.

CBD oil is getting a lot of popular attention as a potential treatment for fibromyalgia. So far, we don’t have a lot of research on it, but we do have some — and it’s promising.

Still, a lot of people don’t really understand what CBD oil is or how it works, and it tends to be wrapped up in the controversy over medical marijuana. That can make people hesitant to try it. There’s also a lot of confusion over whether it’s legal—but there are also some positive changes on that subject.

What Is CBD Oil?

CBD stands for “cannabidiol,” which comes from the cannabis plant. Yes, the cannabis plant is where we get marijuana. However, CBD oil doesn’t have any psychoactive properties, which means it doesn’t get you high.

The substance responsible for the high associated with marijuana comes from a different substance, which is called THC (tetrahydrocannabinol.) Growers who want to maximize the plant’s high use breeds and techniques that focus on higher THC levels. Meanwhile, cannabis that’s grown for hemp is generally richer in CBD than THC, and that’s where CBD is derived from.

CBD that’s extracted from cannabis is being used for a lot of medical purposes, and you can find a lot of impressive-sounding claims online. Are they true? From a scientific standpoint, the answers are more like “possibly” and “some of them appear to be” than a firm “yes,” and it depends on which claims you’re looking at.

People are using CBD oil for a lot of different medical purposes, including:

  • Chronic pain and inflammation
  • Pain from glaucoma
  • Epilepsy, especially in children
  • Social anxiety disorder
  • Insomnia
  • Bipolar disorder
  • Multiple sclerosis
  • Parkinson’s disease
  • Schizophrenia
  • Movement problems from Huntington’s disease
  • Assistance with smoking cessation
  • Stopping the growth of cancerous tumors
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As of mid-2018, CBD oil is not FDA-approved for any conditions. Research in the United States is in the early stages, though, since for decades, legal restrictions made it extremely difficult to study the medical benefits of marijuana or any of its components. We may see applications submitted to the agency as research continues to move forward.

CBD oil is used in various ways. You can smoke it, swallow capsules, use it under the tongue, in spray or drop form, and topically.

Research for Fibromyalgia

General CBD research is in its infancy, so research on CBD for fibromyalgia could be considered embryonic. We just don’t have much to go on right now. A 2016 survey of the literature concluded that there’s not enough evidence to recommend any cannabis-based treatments for fibromyalgia or other rheumatic conditions.

However, this topic is likely to get a lot of future attention, for several reasons.

First, we have a pain epidemic in the U.S., and fibromyalgia is a major contributor to that. Current treatments just aren’t good enough for most of us, so there’s an enormous financial incentive to find something that’s better at relieving our pain and other symptoms.

We also have an opioid addiction and overdose epidemic. Studies have demonstrated that when a state legalizes marijuana, the number of opioid prescriptions drops. That’s good news for healthcare providers looking for safer pain treatments, law enforcement agencies struggling to control the tide of illegal opioid use, and lawmakers looking for solutions to the opioid problem.

CBD oil is believed to be effective against pain and inflammation, and, in its pure form, it’s generally regarded as safe.

Finally, while anecdotal evidence certainly isn’t scientific proof of anything, we have an abundance of it from people with fibromyalgia who say CBD helps them, and you can bet that when patients who have hard-to-treat conditions tell their healthcare providers something works, it piques their interest.

As for the scientific motivations behind further study, consider that CBD is believed to help relieve:

  • Pain
  • Insomnia
  • Anxiety

When it comes to fibromyalgia symptoms, those three are significant.

A 2017 paper published in Expert Opinion on Therapeutic Targets suggested CBD as a possible way to diminish the activity of brain cells called glia, which leads to central sensitization. That’s a major feature of fibromyalgia and other central sensitivity syndromes such as chronic fatigue syndrome, irritable bowel syndrome, and migraine.

Fibromyalgia also involves something called endocannabinoid deficiency. That’s the system that deals with your body’s natural endocannabinoids as well as cannabis products that you may take in. That makes cannabis products a promising treatment.

A 2016 review published in Cannabis and Cannabinoid Research found evidence that CBD is effective in migraine and irritable bowel syndrome, which are related to fibromyalgia. It also stated that some cannabis-based treatments appeared effective for fibromyalgia. The authors stated that CBD is often preferable to patients due to the high and other effects associated with THC.

Some have suggested that CBD can fight inflammation. Fibromyalgia isn’t currently classified as an inflammatory condition, but research suggests that at least some cases may involve inflammation of a body-wide web of connective tissue called the fascia. If that’s accurate, it could be one more reason CBD should be considered.

Side Effects

We don’t have a full picture of the possible side effects of CBD. Some reported side effects include:

  • Changes to liver enzymes used to process drugs
  • Dry mouth
  • Low blood pressure
  • Lightheadedness
  • Drowsiness
  • Increased tremor in Parkinson’s disease, at high doses
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These effects are possible but require more study, according to the World Health Organization:

  • Alteration of hormonal levels
  • Immune system stimulation at low levels, and immune suppression at higher levels

Addiction and abuse don’t appear to be problems with CBD, and it appears to have a low toxicity level meaning that it takes a lot to overdose.

Non-Drug Fibromyalgia Treatments

Fibromyalgia treatments other than medications include:

Is CBD Oil Legal?

You’d think the question, “Is CBD legal?” would be answerable with a simple yes or no. It hasn’t been, and while it’s getting easier to answer that question, it’s still not cut-and-dried (nor is the question of whether or not CBD oil can result in a positive drug test).

You’ve long been able to find a lot of claims by hemp growers and CBD sellers that their product is legal in all 50 states as long as it contains less than 0.3 percent THC. However, a 9th Circuit Court of Appeals ruling disagreed.

Enter the 2018 Farm Bill. This piece of legislation was wildly popular in both the Senate, where it was passed in June of 2018, and the House, where it was passed in December of 2018 and signed into law soon after. It re-classified hemp as a legal agricultural product, which makes CBD products legal at the federal level.

In states where marijuana and/or CBD is legal, there’s no longer a clash between state and federal law. That’s a win for those wanting to take CBD products medicinally.

However, some states have specific laws on the books banning hemp products. So what does the Farm Bill mean for those states?

Technically, federal law overrules state law. That doesn’t mean that those states will stop arresting and trying people on CBD charges, though, especially if they want to challenge the new federal law. If you’re in one of those states, be safe and talk to an expert about any possible trouble you could get into for using CBD products.

The website ProCon.org has information about which states have laws specific to CBD oil. A site called Governing maintains a map of where marijuana is legal in some form.

A Word From Verywell

Certainly, you have a lot to consider when it comes to any treatment, and even more so when it comes to CBD. Consider the pros and cons—including the legal ones—carefully. Be sure to discuss this option with your healthcare provider to make sure you’re safe, and, as with any treatment, watch for side effects.

With legal changes in-store and more research coming, expect things to change rapidly when it comes to CBD oil and other cannabis-based treatments. We’ll likely know a great deal more about the effectiveness and safety of these products a few years from now.

Frequently Asked Questions

There’s no single answer for this question. Everyone needs to try different treatments and see what works for them.

Common fibromyalgia painkillers include:

    – Cymbalta (duloxetine), Savella (milnacipran), amitriptyline
  • Anti-seizure drugs – Lyrica (pregabalin), Neurontin (gabapentin)
  • Opioids (despite a lack of evidence that they’re effective) – Vicodin (hydrocodone/acetaminophen), OxyContin (oxycodone) and related products

Fibromyalgia needs a customized treatment regimen and there’s no “best” treatment that’s been identified. Three drugs are FDA-approved for fibromyalgia—Lyrica (pregabalin), Cymbalta (duloxetine), and Savella (milnacipran)—but many other drugs and supplements are used to treat this condition.