By Elements of Green
Fibromyalgia is a chronic pain disease which affects between 3 and 6 percent of the world’s population. It is much more common in women, who make up between 75 and 90 percent of cases, and its prevalence increases with age. Fibromyalgia causes pain throughout the body and frequently has other symptoms, some of them severe. Can CBD, or cannabidiol, help with fibromyalgia? To understand what role CBD might have in a fibromyalgia treatment program, it is important to understand what fibromyalgia is, what CBD does, and how the two might fit together. The key ideas of this article is that CBD might be helpful to alleviate some of the symptoms of fibromyalgia and that patients should consult with their health care professionals before beginning to use CBD.
Fibromyalgia is not a well-understood disease. Researchers do not know the cause and there is no known cure. There is not even a clinical test which specifically identifies fibromyalgia. It used to be that a person was considered a possible fibromyalgia patient after a “tender point exam.” That means the doctor would firmly press on 18 specific points on the body to see if the patient experienced pain. The standard was that if 11 of those points caused pain when pressed firmly and other causes had been excluded the patient was considered to have fibromyalgia. Today, fibromyalgia is diagnosed when a person has widespread pain through the body for at least three months and when other potential causes of the pain have been excluded by tests.
People appear always to have had fibromyalgia, but it was only identified as a separate disease in the 1980’s. Previously it was though to be a severe form of rheumatoid arthritis or something else.
The disease often presents with other symptoms. In fact, a symptom other than pain is often used as part of the diagnosis for fibromyalgia. The main symptoms of fibromyalgia include:
- Pain: The primary symptom of fibromyalgia is pain over much of the body. A localized pain is not diagnosed as fibromyalgia. The Mayo Clinic describes the pain associated with fibromyalgia as one which causes a constant dull ache which has lasted for at least three months.
- Fatigue: Fibromyalgia patients often complain of being tired even when they have got enough sleep. The pain of fibromyalgia can interfere with sleep patterns, complicating the fatigue.
- Cognitive Difficulties: Fibromyalgia patients sometimes complain that they lose the ability to mentally focus. This symptom is common and severe enough that it is described as fibrofog.
Fibromyalgia is also frequently associated with other painful conditions like irritable bowel syndrome, migraines or tension headaches, painful bladder, and temporomandibular joint disorder (TMD). TMD is a persistent pain, weakness, or other difficulty with the jaw. Because these conditions have their own pain associated with them, it complicates the diagnosis of fibromyalgia.
The causes and mechanism by which fibromyalgia strikes are also poorly understood. Researchers and doctors think that genetics, infections, and even trauma may cause fibromyalgia or cause it to emerge.
Because there is no cure for fibromyalgia, treatment options focus on its symptoms and use both medications lifestyle changes. Lifestyle changes which can help with fibromyalgia symptoms include physical therapy, changes to how a fibromyalgia patient works and lives, and counseling aimed a developing coping strategies.
Medications for fibromyalgia come from both the prescription pharmaceutical realm and from over-the-counter medications. For pain, doctors often recommend a non-prescription pain reliever such as paracetamol (also known as acetaminophen), ibuprofen, and aspirin. For more severe cases of pain, doctors will sometimes recommend a prescription pain relief drug. However, because fibromyalgia is a lifelong condition, doctors generally recommend against opioids, which are the most potent prescription pain fighters. The chances of becoming dependent over such a long use period make the risks of an opioid too high to recommend. There is also some evidence that over the long term opioids may actually increase the pain associated with fibromyalgia. Similarly, corticosteroids are usually not recommended to fibromyalgia patients. Corticosteroids are not addictive, but long-term use can have harmful effects on people.
Other prescription options doctors may recommend include some anti-depressants and anti-seizure medications. These medications can sometimes help with chronic pain in addition to their primary use.
Research is ongoing. The European Union and the UK currently show 31 studies for various medications to treat the symptoms of fibromyalgia. A few prescription drugs are specifically approved for fibromyalgia symptoms, but most medications are prescribed “off label.” That is, the medication is officially approved for a different purpose, but doctors who know it can help with fibromyalgia prescribe it to their patients.
CBD, or cannabidiol, is one of the components of the cannabis plant. It is one of dozens of cannabinoids in the plant. These cannabinoids interact with humans’ endocannabinoid system. Unlike the more well-known cannabinoid Tetrahydrocannabinol (THC), CBD does not cause a psychoactive effect. That is, CBD will not make you high.
CBD works by binding to a cell receptor called CB1 or CB2 and regulating inflammation. Inflammation is a normal body function which aids in the fight against disease but it can also go too far and cause pain and other symptoms. People take CBD for several reasons.
- Anxiety and Stress: The majority of CBD users report that they take cannabidiol to help them with anxiety and stress. They report that CBD has a calming effect. Anxiety and stress are not formal symptoms of fibromyalgia, but some patients experience such stress as a result of living with the disease.
- Pain: Pain is the primary reason a fibromyalgia patient might take CBD after consultation with a physician. CBD has a demonstrated anti-inflammatory effect and many CBD users report that it helps reduce their pains. There are several clinical trials underway to confirm the hypothesis that CBD helps with a variety of painful conditions.
- Sleep Regulation and Energy: It seems contradictory, but some people take CBD to help improve energy levels and others take it to help them sleep. Both groups may be right – there is some research that CBD helps regulate the sleep cycle, which in turn would help people sleep when it is time to sleep and have higher energy levels with less fatigue when it is time to be awake.
- Athletic Recovery: Because of the anti-inflammatory effects of CBD and its ability to help some people maintain energy levels, more and more athletes are taking CBD as part of their training and recovery programs.
- Skin Treatment: CBD not only reduces inflammation, some studies indicate it may help with skin conditions by reducing the production of sebum, a waxy substance associated with many skin conditions such as acne.
- Clinical Uses: CBD first came to the world’s attention as a treatment for epilepsy. There is currently one approved CBD-based drug to treat a few forms of childhood epilepsy and other clinical trials are ongoing.
Since fibromyalgia is a disease primarily characterized by chronic pain over wide areas of the body and CBD is known to be an anti-inflammatory which can reduce pain, it only makes sense that people wonder if CBD can be part of the non-lifestyle treatment for fibromyalgia.
It’s important to understand that CBD does not cure fibromyalgia. The disease has no known cure. CBD may be an appropriate part of a fibromyalgia patient’s treatment, depending on what your medical professional recommends.
A study released last year finds that medical cannabis appears to be a safe and effective treatment for the treatment of fibromyalgia symptoms. However, medical cannabis includes the psychoactive ingredient THC. Whether CBD alone or in conjunction with other non-psychoactive cannabinoids can help with fibromyalgia pain is a separate question.
No studies have been done specifically about fibromyalgia and CBD. CBD is currently being or has been tested for its use with other sources of pain, including general pain among healthy individuals.
Additionally, people take CBD to help regulate their sleep patterns and sleep difficulties are often associated with fibromyalgia.
With those positive effects from CBD on healthy, adult individuals, it may make sense for fibromyalgia patients to have a discussion with their doctors about whether CBD might be part of their treatment. It’s very important to see a doctor before beginning a course of CBD if you have fibromyalgia. CBD is well-tolerated in healthy individuals but its interactions with some of the other medications commonly given to fibromyalgia sufferers have not been examined. This is particularly true for the prescription medications you may be taking as part of a fibromyalgia treatment program. Similarly, if you have fibromyalgia and have already begun using CBD, make sure your doctor knows that.
If you and your doctor agree that CBD is worth trying as part of a fibromyalgia treatment program, you should make sure that the CBD you buy is a high-quality product. Unfortunately, there are many companies selling CBD products which have less CBD than they claim or even have no CBD at all. Other companies do not do sufficient testing to ensure that you do not get impurities with the CBD you use. Much of that may improve after the UK novel foods regulations come into effect on March 31 of next year. For now, buying from a trusted supplier is key. It is not enough to avoid dodgy sources, since many legitimate stores do not yet understand CBD and the companies which make it.
Elements of Green carefully selects each of the companies which sell through us and we insist that every product undergo lab testing. This testing not only allows you to be confident that you are getting the amount of CBD you are seeking, it also ensures that you do not get heavy metals, insecticides, or other impurities with your product.
Another consideration is how to consume the CBD. Since fibromyalgia is a whole-body pain disease, it is not likely that a lotion is appropriate, though it may be useful in combination with other ways to take CBD if pain in a particular area is a problem and your physician agrees. Most people who take CBD for whole-body pain use a tincture or oil. The liquid is taken orally, but instead of swallowing it the user holds the liquid under the tongue and allows it to be absorbed directly by the membranes in the mouth. Other people choose an edible product such as a pill, capsule, or gummy. In that case the CBD is swallowed and is digested. For the fastest effect, some CBD users choose a vaping product.
Dosage is another factor to consider before beginning to take CBD. If a fibromyalgia patient and her doctor agree that CBD is something to try to help with the symptoms, they must decide how much to take just as they must agree on the proper amount of an analgesic or other medication. Some CBD studies use very high amounts of CBD, 300 milligrams per day or more. However, the UK Food Standards Agency recommends that healthy adults consume a maximum of 70 mg per day of CBD. It also reiterates the advice in this article to seek a doctor’s advice on whether to take CBD if you are taking another medication or if you are pregnant.
All the products available through Elements of Green are formulated to deliver less than 70 mg per day when taken according to the package directions. If you take two or more CBD products, such as an oil and a lotion, it is important to be mindful of the total CBD you will consume.
Finally, a CBD user must decide whether to use CBD only, CBD in conjunction with other cannabinoids but not including THC, or CBD with other cannabinoids including small amounts of THC. These are known as “purefied” CBD, “broad-spectrum CBD,” and “full spectrum CBD.” Some people prefer broad-spectrum or full-spectrum CBD because of the belief that the other cannabinoids work with the CBD to increase its effect. Others prefer purified CBD and it is those products which tend to be the subject of clinical trials for various possible uses of CBD. People who have to take a drug test, like some athletes at the top levels of their sport, prefer purified CBD because it cannot cause a false positive in the test.
If you and your doctor conclude that CBD is appropriate for you, what kind of CBD to use is another subject to discuss.