Managing Fibromyalgia Syndrome with medical cannabis
A largely invisible illness, Fibromyalgia Syndrome is a chronic condition that affects thousands of Canadians. Here’s how medical cannabis may help.
Fibromyalgia Syndrome (FMS) is a very real and painful condition affecting approximately two percent of Canadians, or nearly 80,000 people. Managing the varying symptoms of FMS usually includes self-management tools such as regular exercise for reduced pain and stiffness along with better sleep techniques, such as avoiding excess caffeine. Some pharmaceutical approaches have included antidepressants and even antiepileptic drugs, but the results and effectiveness of these prescriptions have been mixed. Medical cannabis offers patients another option for Fibromyalgia symptom management—namely improved sleep, reduced pain, and improved mood.
A chronic condition, FMS is currently understood as a central sensitivity syndrome—a family of disorders that share common underlying causes and clinical symptoms that often overlap. Other central sensitivity syndromes one might have alongside FMS include migraines and tension headaches, Chronic Fatigue Syndrome, Interstitial Cystitis, Irritable Bowel Syndrome, Post-traumatic Stress Disorder (PTSD), among many others. FMS patients may also have other chronic painful diseases such as rheumatoid arthritis, systemic lupus erythematosus (lupus), and ankylosing spondylitis.
The theory is that FMS patients have a hypersensitive central nervous system that results in abnormal pain processing. This manifests in widespread bodily pain, in addition to pain caused by things not usually painful (e.g. a hug) or an exaggerated pain response to other stimuli (e.g. bumping into the counter). Another way to explain FMS is to imagine a fire alarm screaming through the house every time the oven is turned on—an extremely sensitive pain processing system will send pain signals throughout the body causing the experience of pain, even when there is minimal pain threat.
An emerging theory suggests FMS and its related family of disorders could be partially due to clinical endocannabinoid deficiency, which may explain why medical cannabis could be helpful for symptom management.
Widespread pain is the hallmark of FMS, but this condition has a range of symptoms that can change day to day, or even be affected by weather. A broader list of symptoms associated with FMS includes:
Sleep disturbances and poor sleep
Mood disorders such as irritability
Trouble concentrating and brain fog, a.k.a. “fibro fog”
Difficulty with memory
Headaches, both tension and migraine
Gastrointestinal issues: constipation, diarrhea and Irritable Bowel Syndrome
Excessive need to urinate
High sensitivity to loud sounds, bright light, smells and temperature
Vulvodynia, a.k.a. “genital fibromyalgia”
Anxiety or depression, sometimes brought on by chronic pain
There is also an emerging concept called “fibromyalgianess” that considers the varying nature of pain thresholds as well as these other symptoms. A patient with less severe symptoms, for example, may not have an official fibromyalgia diagnosis yet may still respond well to a fibromyalgia symptom management approach.
The theory that FMS may be partially caused by a deficiency in endocannabinoids, the body’s naturally occurring cannabinoids, may explain why early data points to medical cannabis as a possible treatment option. By stimulating the endocannabinoid system with medical cannabis, it’s thought that abnormal pain processing systems of FMS patients are brought closer to normal functioning levels—like resetting the motherboard. While the research is still very early, this could explain why early clinical studies have found medical cannabis beneficial for managing multiple FMS symptoms at once, such as pain, sleep, and mood disorders.
Interestingly, a 2014 survey of over 1,300 people with FMS demonstrated medical cannabis outweighed traditional pharmaceuticals for symptom relief. Of the respondents, 62 percent said medical cannabis was “very effective” for their symptom management. (But keep in mind this was an online survey and not an official clinical study.)
Because there is currently no cure for FMS, the focus is on treatment for symptom management and improving patient quality of life. A combination of pain-relieving and stress-relieving therapies is usually the route suggested by healthcare providers. This includes exercise, massage or chiropractic treatments, good sleep habits, psychotherapy, and a balanced diet in combination with pharmaceutical regimens—which may include medical cannabis.
With so many symptoms that can vary by the day, it’s common for FMS patients to require more than one kind of medical cannabis product. Here are some common FMS symptoms and the different formats of medical cannabis that may help patients: For best results, medical cannabis should be used with a trained healthcare provider’s oversight to avoid overmedication or drug-drug interactions.
Compromised sleep: Oils or edibles for longer-lasting sleep management
Localized pain: Topicals
Fibro “flares”: Vape pens or dried flower in a vaporizer for immediate relief
Irritability and mood disorders: Oils, edibles, or slow-release patch for longer-lasting management
Headaches: Vape pens or dried flower for immediate relief; oils or edibles for longer pain management
Genital pain: Suppositories
These medical cannabis formats could be high-CBD, high-THC, a 1:1 ratio, or a mixture, depending on desired outcome and how well the patient tolerates cannabinoids. In one small study of 20 fibromyalgia patients, participants with close to a 1:1 ratio of THC to CBD showed a 30 per cent decrease in pain scores compared to placebo.
Pain management is the number-one reason patients turn to medical cannabis, and there are FMS patients finding improved quality of life by incorporating medical cannabis into their healthcare regimen. Our cannabis-trained pharmacists and Shoppers Cannabis Care Advisor team will help every step of the way.
Because this disorder is largely invisible, hard to articulate, and still doesn’t have conclusive origins, getting help can be challenging. When speaking to a healthcare professional about possible FMS make sure to tell them:
The intensity of the pain on a scale of 1-10
Where on your body you experience pain
How the pain feels
What brings it on
How long it lasts
What, if anything, makes it feel better
Any other abnormal symptoms: fatigue, headaches, etc.
Any family history of FMS