Fighting Fibromyalgia: finding comfort with medical cannabis

What is fibromyalgia?

According to the NHS, fibromyalgia, also sometimes known as fibromyalgia syndrome (FMS), is a long-term condition that causes widespread pain all over the body, alongside a number of other symptoms. 

The condition affects everyone differently, but in some cases it can significantly impact quality of life, making everyday activities challenging.

What causes fibromyalgia?

The exact cause of fibromyalgia is not still fully understood, but it is believed to involve a combination of genetic, environmental, and psychological factors.

Anyone can develop fibromyalgia, but it is more common in women than men. And while it can occur at any age, including in children and older people, symptoms typically develop between the ages of 25 and 55.

How common is fibromyalgia?

It's not clear exactly how many people in the UK are affected by fibromyalgia.

The NHS says that some estimates suggest nearly 1 in 20 people may be affected by fibromyalgia to some degree, but it is not clear exactly how many, as the condition is very difficult to diagnose.

Some people live with symptoms for many years without a diagnosis, or may be misdiagnosed with another condition which presents in similar ways. 

Symptoms of fibromyalgia 

As well as widespread pain, other symptoms of fibromyalgia include:

• Increased sensitivity to pain
• Muscle stiffness
• Problems with sleeping and fatigue 
• Problems with mental processes (known as ‘fibro-fog’), such as difficulty concentrating or remembering things
• Headaches
• Irritable bowel syndrome (IBS), a digestive condition that causes stomach pain and bloating
• Feelings of frustration, worry or low mood

The symptoms of fibromyalgia can be unpredictable and can suddenly flare up or improve seemingly out of the blue. 

How do you diagnose fibromyalgia?

Fibromyalgia can be very difficult to diagnose as there is no specific test to identify it, with diagnosis taking an average of two years or more. The symptoms also vary from person to person and often overlap with other conditions.

Instead, diagnosis is usually based on the patient’s history and ruling out other conditions that could cause similar symptoms. A doctor may recommend you undergo some tests such as blood and urine tests, X-Rays and other scans. 

It is possible that a patient could be diagnosed with fibromyalgia but also have other conditions alongside it. 

Fibromyalgia treatment

There is no cure for fibromyalgia, so treatment is focused on easing symptoms and improving quality of life, such as pain management, sleep quality, and stress reduction. This usually involves a combination of medications, lifestyle changes, physical therapy, and psychological support. 

In some cases, antidepressant medications may be prescribed to help relieve pain and support sleep and emotional health. According to the NHS, there is ‘little or no evidence’ to show that other types of medicine help reduce long-term pain.

Some people find acupuncture can help with long-term pain, but the effects are thought to be relatively short-term. 

Fibromyalgia and medical cannabis 

Fibromyalgia is one of the many conditions for which medical cannabis is prescribed in the UK. Patients who have found these conventional treatments haven’t effectively managed their symptoms may be eligible for a prescription. 

As well as helping to reduce the pain which many experience, it can also be helpful for comorbidities such as anxiety and depression, and for improving sleep quality which in turn can help reduce fatigue and brain fog during the day. 

Some studies have shown that patients are also able to reduce their use of other prescription medications after beginning treatment with medical cannabis. 

Does cannabis oil help fibromyalgia?

A 2022 review of preclinical and clinical research on the effect of cannabinoids on fibromyalgia found that cannabis-based medicines “show promise” therapeutically. 

However, the authors stressed that oral administration of cannabinoids has limitations, due to the low bioavailability of CBD and THC oils when ingested. Inhaled cannabis is shown to be the most beneficial for pain, sleep and overall quality of life, but there is a need for more clinical trials in animals to better understand its safety and efficacy.

What does the research say?

There is a growing evidence base to support the use of medical cannabis to treat fibromyalgia and improve overall quality of life for patients. Some early research by cannabis scientist, Dr Ethan Russo, even posed the idea that fibromyalgia could be caused by a deficiency in the endocannabinoid system (ECS).

Between January 2017- July 2021, researchers conducted a retrospective review of patients seeking medicinal cannabis treatment for fibromyalgia. According to their findings, a clinically significant reduction in severity was observed in three quarters of patients, as well as reductions in symptoms of depression and anxiety.

Another study from 2023 examined the impact of cannabis on the quality of life in 30 women aged 18-70-years-old with treatment-resistant fibromyalgia. After 30 days of treatment the women reported a marked improvement in general quality of life, general health, physical health and psychological domain.

The authors concluded: “Results suggest a potentially significant role of cannabis in treatment-resistant fibromyalgia women. Early cannabis treatment may result in a beneficial short-term effect on the quality of life through its influence on pain, sleep, physical and psychological domains. Further studies are still indicated to understand this potential and its long-term beneficial impact.”

Elsewhere, researchers in Germany examined the efficacy of THC as a treatment in fibromyalgia patients who were receiving interdisciplinary multimodal pain therapy (IMPT). Significant improvements in pain intensity, depression, and quality of life were seen in all patients, but these were ‘significantly greater’ in those given THC. The dose of other drugs was also reduced, or discontinued entirely, more often in patients treated with THC. 

Real-world evidence from the UK 

Here in the UK, researchers recently examined data taken from over 300 fibromyalgia patients enrolled in the UK Medical Cannabis Registry. After starting treatment with medicinal cannabis, patients reported improvements in fibromyalgia-specific symptoms, as well as overall health and quality of life. A statistically significant reduction in opioid use was also identified.

What do the experts say?

We also spoke to our own expert, Dr Hanna Gul, who is one of Releaf’s medical cannabis prescribers and an incredible Rheumatologist with 14 years of experience working within the NHS. 

Dr Gul said: 

“From a clinical perspective, I have found that the benefits of medical cannabis for patients living with fibromyalgia is multifaceted.

Breaking the cycle of poor sleep and daytime fatigue is a key first step in treating fibromyalgia, as this can not only reduce symptoms but also help with self-management and coping strategies. Medical cannabis, notably oils administered sublingually, can help with sleep initiation and improve sleep duration and quality. 

As highlighted above, medical cannabis can also reduce widespread pain symptoms, promote muscle relaxation, help reduce anxiety, elevate mood and improve overall quality of life, when appropriately prescribed. Different strains have different benefits and the method of administration can determine whether the effects are short or long-acting, therefore treatment can be tailored depending on the individual needs of the patient. 

Ultimately, for patients who have not responded to conventional treatments or are struggling with the burden of, or the side effects associated with, pain medications, I would encourage patients to try medical cannabis as long as they meet eligibility criteria and have no contraindications to treatment. Medical cannabis can be a safer alternative and have a lower risk of dependency compared to standard analgesia e.g opioids and neuropathic painkillers.”

How can I access medical cannabis for fibromyalgia in the UK?

If you feel medical cannabis could be beneficial for managing fibromyalgia symptoms, you can use the Releaf eligibility checker to determine if it's right for you. A team of expert clinicians will review your application and if appropriate you will be invited to schedule an appointment with a specialist consultant.

You can find out more about medical cannabis via the FAQs page or by contacting a member of the team. As always, never make any changes to your treatment plan without consulting a doctor first.