Since scientist first classified fibromyalgia as a disease in the 1970s, a number of treatments have been proposed, but in the last few years, scientists and physicians have looked towards CBD as one of the best ways to manage the condition.
Fibromyalgia affects nearly 25 million people in the United States and 550 million worldwide. Women are twice as likely as men to suffer from the disease. There’s no cure and the scientist still debate if it is even a standalone disease as other diseases share the same symptoms.
There’s no understanding of the root causes of fibromyalgia and like any unexplained medical syndrome, there’s no universally agreed upon treatment or cure for the disease. As a result, physicians are limited to managing the symptoms of the disease, usually involving prescription medication, patient education, cognitive behavioral therapy, and aerobic exercise.
If left alone, fibromyalgia symptoms do not improve over time. The disease is neither degenerative nor fatal, but the chronic pain of fibromyalgia is pervasive and persistent. Studies have shown that there’s a moderate risk of suicide among fibromyalgia patients as the pain can become unbearable in some cases.
About Fibromyalgia
Fibromyalgia is a disease that is characterized by widespread musculoskeletal pain and heightened pain response to pressure. Research has shown that persons with fibromyalgia experience amplified painful episodes due to the way the brain processes pain signals.
Fibromyalgia sometimes is caused by physical trauma, surgery, infection, or even psychological stress. In these cases, the symptoms usually appear rapidly. In other cases, the symptoms start gradually and increase over time with no known single event that triggers the disease.
Among the symptoms that fibromyalgia sufferers experience include:
- Abnormal menstrual cramping
- Anxiety
- Cognitive difficulties (known as “fibro fog”)
- Depression
- Fatigue
- Headaches
- Irritable bowel syndrome
- Light sensitivity
- Morning stiffness
- Noise sensitivity
- Numbness and tingling (paresthesia) in hands, arms, feet, and legs
- Pain and tender points
- Restless Legs Syndrome
- Sleep problems
- Swelling in hands and feet
- Temperature sensitivity
- Temporomandibular (jaw) joint (TMJ)
- Urinary pain and incontinence
- Widespread pain
The medical field is divided on the diagnosis of fibromyalgia. Some view it as a pathology due to the way it affects muscles, connective tissues, and the central nervous system. Others view it as heighten brain response to normal stimuli. Still, others view it as either a mood disorder or a somatic disorder (a mental disorder that manifests with physical symptoms). There are even some members of the medical community that don’t consider it a disease because of a lack of evidence when a patient is physically examined and the lack of objective diagnostic tests.
The wide variety of opinions, for those who consider it a disease, have led researchers in many directions to find treatments or cures.
In addition, some scientists argue that fibromyalgia is essentially the same as chronic fatigue syndrome, irritable bowel syndrome, or chronic muscular headaches as “no discrete boundary separates [the] syndromes”. (https://jamanetwork.com/journals/jama/fullarticle/199786)
What Is CBD?
CBD or cannabidiol is a chemical compound called a cannabinoid that is naturally produced in both cannabis plants and in many animals, including humans.
CBD is a non-intoxicating psychoactive compound. That means it does affect the brain, but it doesn’t create the “high” that people generally associate with consuming marijuana. That “high” is the result of the presence of another cannabinoid called THC. Overall there are 113 known cannabinoids in existence.
CBD has been shown to be effective in the treatment of many conditions as it has many protective and healing properties including:
- Analgesic
- Anti-anxiety
- Antibacterial
- Antidepressant
- Antifungal
- Anti-inflammatory
- Anti-psychotic
- Neuroprotective
The properties have been proven in the last few decades with the discovery of the endocannabinoid system (ECS) in the body. The ECS is comprised of neuroreceptors and neurotransmitters throughout the brain, central nervous system, and the peripheral nervous system in the body.
The focus of the ECS is primarily on 2 neuroreceptors in the ECS called CB1 (Cannabinoid receptor type 1) and CB2 (Cannabinoid receptor type 2).
CB1 receptors far outnumber the C2 receptors in the ECS. Among other parts of the body, they can be found in:
- Adrenal glands
- Brain
- Decidua
- Digestive tract
- Endothelial cells
- Fat cells
- Kidneys
- Kupffer cells
- Leydig cells
- Liver cells
- Lungs
- Muscle cells
- Ovaries
- Oviducts myometrium
- Pituitary gland
- Placenta
- Retinas
- Spine
- Stellate cells
- Thyroid gland
The CB1 receptors are known to affect:
- Anxiety
- Cardiovascular activity
- Drug and behavioral addictions
- Gastrointestinal activity
- Motor control
- Olfaction (sense of smell)
- Plasticity (adaptation to change)
While there are less CB2 receptors in the ECS (more are being found as new studies are conducted), the regions that these receptors affect are just as important. These include:
- Brain
- Gastrointestinal system
- Immune system
- Peripheral nervous system
The CB2 receptors affect some of the following biological processes and responses within the body:
- Autoimmunity
- Bone health
- Cancer inhibition
- Cardiovascular processes
- Gastrointestinal processes
- Inflammation
- Kidney function
- Liver function
- Lung function
- Neuroprotection
- Pain responses
- Skin reactions
The CB1 and CB2 receive signals from neurotransmitters throughout the body. Neurotransmitters are chemical messengers which transmits signals across chemical synapses, such as a neuromuscular junction, from one nerve cell to another nerve cell, muscle cell, or gland cell.
The CB1 and CB2 bind to neurotransmitters in the body. Examples of major neurotransmitters include:
- 3-iodothyronamine
- Acetylcholine
- Adenosine
- Adenosine triphosphate
- Adrenaline
- Anandamide
- Aspartate
- Carbon monoxide
- CART (cocaine and amphetamine regulated transcript)
- Dopamine
- D-serine
- Epinephrine
- Glutamate
- Glycine
- Histamine
- Hydrogen sulfide
- Nitric oxide
- N-methylphenethylamine
- Noradrenaline
- Norepinephrine
- Octopamine
- Opioid peptides
- Oxytocin
- Phenethylamine
- Serotonin
- Somatostatin
- Substance P
- Tryptamine
- Tyramine
- Y-aminobutyric acid (GABA)
CBD acts differently with the CB1 and CB2 receptors. In the case of a CB1 receptor, CBD acts as an antagonist by activating, but not binding to the receptor. This allows the CBD to inhibit (but not prevent) the absorption of neurotransmitters such as oxytocin.
This is helpful when CB1 absorbs the neurotransmitter too rapidly causing fast depletion which eventually results in throwing the ECS out of balance.
In the case of CB2, it acts as an agonist, allowing CBD to bind with the neuroreceptor and allowing neurotransmitters to pass through. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219532/)
How Does CBD Help Treat Fibromyalgia?
CBD has natural neuroprotective, anti-inflammatory and analgesic properties. These 3 properties are the key to reducing or eliminating pain.
At this time, there is a lack of studies specifically regarding fibromyalgia and CBD. However, many promising studies involve the use of CBD and pain. These include arthritis (which fibromyalgia is, in some medical circles, considered a type of), nerve damage, and neuropathic pain in general.
Other studies have been done on broad-spectrum cannabinoids that include both CBD and THC or on the use of cannabis as a whole.
A study in 2017 on CBD and osteoarthritis (OA) provided solid evidence of pain relief. Osteoarthritis is a type of joint disease that results from the breakdown of joint cartilage and underlying bone. The most common symptoms are joint pain and stiffness. Other symptoms may include joint swelling, decreased range of motion, and weakness or numbness of the arms and legs. These symptoms are all symptoms of fibromyalgia.
The study, which was done with laboratory rats, concluded that “this study showed for the first time that local CBD administration inhibited pain and peripheral sensitization in established OA. Topical treatment with CBD reduced leukocyte trafficking and joint hyperemia during the early stages of MIA. By attenuating this initial inflammatory response with CBD, end-stage OA pain and peripheral neuropathy were abrogated. Thus, CBD may be a safe therapeutic to treat OA pain locally as well as block the acute inflammatory flares that drive disease progression and joint neuropathy.” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690292/)
A 2012 study on CBD and inflammatory and neuropathic pain in laboratory rats concluded that “We report that systemic and intrathecal administration of cannabidiol (CBD), a major nonpsychoactive component of marijuana, and its modified derivatives significantly suppress chronic inflammatory and neuropathic pain without causing apparent analgesic tolerance in rodents. The cannabinoids significantly potentiate glycine currents in dorsal horn neurons in rat spinal cord slices.” It further goes on to say “Our findings suggest that the α3 glycine receptors (GlyRs) mediate glycinergic cannabinoid-induced suppression of chronic pain. These cannabinoids may represent a novel class of therapeutic agents for the treatment of chronic pain and other diseases involving GlyR dysfunction. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3371734/)
A 2011 study on the effects of cannabis on fibromyalgia found that “After 2 hours of cannabis use, visual analogue scales (VAS) scores showed a statistically significant reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well-being. The mental health component summary score of the SF-36 was significantly higher in cannabis users than in non-users. The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted.” (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080871/)
A 2016 study reviewed cannabinoids and autoimmune diseases. This study found “Current research in the role of cannabinoids in the immune system shows that they possess immunosuppressive properties. They can inhibit proliferation of leucocytes, induce apoptosis of T cells and macrophages, and reduce the secretion of pro-inflammatory cytokines. In mice models, they are effective in reducing inflammation in arthritis, multiple sclerosis, have a positive effect on neuropathic pain and in type 1 diabetes mellitus. They are effective as a treatment for fibromyalgia and have shown to have anti-fibrotic effect in scleroderma. Cannabinoids can be therefore promising immunosuppressive and anti-fibrotic agents in the therapy of autoimmune disorders.” (https://www.ncbi.nlm.nih.gov/pubmed/26876387)
CBD Products for Fibromyalgia
CBD comes in a wide variety of products. People who suffer from fibromyalgia generally like to use more than one product to treat the disease as a way to combat it on more than one front.
Among the products available are:
- Tinctures – These are CBD based liquids that have high concentrations of CBD taken under the tongue via a dropper. The dropper can also be used to add CBD to food or drink, although it will affect the taste of the food in a dramatic fashion as most tinctures are flavored to mask the bitter taste of the CBD.
- Vapes – These vaporizers or e-cigarettes are among the more popular ways to consume CBD. The vape has a chamber that the CBD oil is in. When activated, the CBD oil is heated and turned into an inhalable vapor. These devices come in both a disposable (single use) form and as a device that vape oil can be reloaded into for each use.
- Pills – CBD comes in a variety of standard pill forms. These include tablets, gelcaps, capsules, and gummies.
- Gels – CBD is available as a topical in the form of a gel, ointment, or cream. This allows for the direct application of the CBD on a localized area for faster relief.
- Transdermal patches – As with the gels, transdermal patches are another topical option for localized pain relief. The patches have a mild adhesive. In many cases, these patches are only good for areas that aren’t subject to moving or bending as the adhesive wears off quickly. It also can be affected by moisture, so if it is in an area that perspires on the body, it may fall off.
- Food additives – CBD can be consumed as a food additive. As mentioned above, some users prefer to add their tincture to food or drink, but there are other options to consume CBD as part of food and drink. First, manufacturers produce a number of drinks such as CBD enhanced water, sparkling water, tea, coffee, juices, sodas, Kombucha, and sports drinks. Other manufacturers produce pre-packaged foods such as baked goods and candies. In addition, users can purchase spices and oils that are specifically made for cooking with CBD.
- Skincare – Many soaps, shampoos, conditioners, body lotions, hand lotions, and bath bombs are made with CBD to allow a person to get full body skin absorption of CBD.
- Aromatics – Candles and diffusers that contain CBD allow a user to fill their home with CBD to inhale over time.
Conclusion
Without a doubt, more research needs to be done specifically on how CBD can affect fibromyalgia. At this point, all we have is anecdotal evidence. But that evidence is strong anecdotal evidence. The issues of people with fibromyalgia are similar to other diseases like arthritis. Also, it is an autoimmune disease. CBD has been found effective in treating both of these issues.
A look at the health properties of CBD with include neuroprotection, anti-inflammation, and analgesic are all types of properties in a treatment that people suffering from the pain of fibromyalgia would look for.
For patients suffering from fibromyalgia, seeking out a doctor’s care is important. If the patient wants to use CBD as part of their treatment, they should discuss it with their doctor to help integrate it into their overall health plan.
