Is Cannabis Good for Treating Fibromyalgia? Best CBD Ratio & Edibles
May 10, 21
Fibromyalgia is a rheumatic disorder with similar features to rheumatoid arthritis and other rheumatic disorders. It is typically characterized by chronic pain throughout the entire body, heightened and painful response to pressure, (allodynia) insomnia, morning stiffness, and debilitating fatigue. Several factors are involved in fibromyalgia, including endocrine and nervous system abnormalities, genetic factors, and social and environmental stressors. 
The exact cause of fibromyalgia is yet to be clearly defined, however its prevalence reaches three percent of the population and is seven times more common in women than men. However, in a recent study, 75 percent of people in the United States who have received a clinical diagnosis of fibromyalgia do not actually meet the criteria for the disease, because their doctors did not strictly observe that criteria in making a fibromyalgia diagnosis. Although there are pharmaceutical treatments that target fibromyalgia symptom relief, the response to these conventional approaches from those with the disease is often mixed, which is why cannabis has become an attractive, and often successful, alternative treatment.  This study doesn’t provide any relief to the millions of sufferers, because conventional pharmaceutical treatments target fibromyalgia symptom relief, but patient response is mixed and side effects are common. Because of this, cannabis and CBD have fast become a common, and often successful alternative treatment. For more information, see our article on CBD for Pain.
A Cochrane review on cannabinoids and fibromyalgia was unfoundedly blunt in its conclusions that there was that there was found no convincing, unbiased, high-quality evidence suggesting that cannabinoids are of value in treating people with fibromyalgia. Notably, because the only studies that actually met the Cochrane review inclusion criteria were for the poor quality synthetic cannabinoid, nabilone, which was lousily tolerated by the patients in the studies, even though nabilone improved insomnia and pain in many of the patients.  The relative success of cannabis in fibromyalgia varies, but the plant can provide at the least, a small reduction in symptomatic intensity, especially for pain and sleep issues. For more information, see our article on CBD for Sleep.
A small, but promising study from 2011 of herbal cannabis plant on fibromyalgia researched the effectiveness of cannabis on scored symptoms of users and nonusers. The scores from the research paper showed a large reduction of stiffness and pain, enhancement of relaxation, improvement in insomnia, and an improved feeling of wellbeing. The mental-health score was significantly higher in cannabis users than nonusers.  See our articles on Cannabis CBD for Anxiety, and Depression.
Could it be possible that fibromyalgia is a symptom in and of itself? Neurologist and researcher Dr Ethan Russo studied and suggested that a “clinical endocannabinoid deficiency” could be the cause behind fibromyalgia. Later research discovered this was the case, and proved his theory. 
The Endocannabinoid System
What are endocannabinoids? Endo-cannabinoids are natural compounds made by the body, found in mothers’ breast milk and integral to human health. These are similar to the phyto-cannabinoids found inside cannabis and hemp. They are used to fuel the endocannabinoid system (ECS); the system that brings balance (homeostasis) to all other areas of the body from the reproductive and immune system to the nervous system. When the ECS is placed under too much stress, physiological and/or emotional, it can become dysfunctional. This state dysfunction is what leads to autoimmunity (meaning the immune system becomes overactive and attacks the organism it is designed to protect), or under-immunity (meaning the immune system gets sleepy and can’t identify cancerous or rogue cells from healthy cells). Fibromyalgia is an autoimmune condition by which the ECS has fallen into such a state of dysfunction that it can no longer bring order and balance to the immune system; chaos ensues, and in many women (and some men), that looks and feels like fibromyalgia. This is why when people utilize cannabinoids from cannabis, hemp, and/or CBD products, they can begin to experience great relief, as the ECS is slowly nourished by the cannabinoids back to normal healthy functioning. For more information, read our article The Endocannabinoid System Explained.
This is also why the Cannabis Health Index (CHI) rates cannabis' effectiveness for auto-immune conditions like fibromyalgia at probable-to-demonstrable range of efficacy (4 points out of 5), which is excellent.
In a 2011 study, patients with fibromyalgia reported reduced pain and stiffness 2-hours after cannabis usage. 
What CBD product is best for fibromyalgia?
In a 2019 study conducted in Denmark, researchers looked for pain-blocking effects of inhaled pharmaceutical-grade cannabis in 20 chronic pain patients with fibromyalgia. They discovered that the varieties containing THC showed an analgesic (pain relieving) effect. 
In another study from the same year, published in the Journal of Clinical Medicine, involving 367 fibromyalgia patients, researchers concluded that, “medical cannabis appears to be a safe and effective alternative for the treatment of fibromyalgia symptoms.”
The results of this study were impressive:
- Overall treatment success was achieved in 81% of patients (the proportion of patients reporting at least moderate overall improvement in their condition).
- Overall pain intensity reduced from a median of 9/10 to 5/10.
- Around 20% of patients taking opioids or benzodiazepine were able to stop or reduce thanks to medical cannabis.
Are Cannabinoids effective for fibromyalgia?
Another 2019 study published in Clinical and Experimental Rheumatology demonstrated that cannabis was effective for the treatment of fibromyalgia, with roughly 20 percent of patients taking opioids or benzodiazepine were able to stop or reduce thanks to medical cannabis. Half of the patients in the study got enough relief from cannabis to reduce or cease their painkiller usage. The authors concluded that, “Adjunctive [Medical Cannabis Treatment] may therefore be considered, especially in the [fibromyalgia] sub-population suffering from significant sleep disturbances and mild anxio-depressive symptoms.”
They also added that, “MCT [Medical Cannabis Treatment] has proved to be a much safer adjunct than opioid treatment, which is associated with a high risk/benefit ratio and is not effective in treating FM [fibromyalgia] (24); furthermore, MCT does not have any substantial addictive properties in terms of dose escalation or withdrawal syndrome (25-26). The most significant concern is tolerance because, although symptom relief is obtained after only three months, a longer treatment period could lead to declining effectiveness, although this can be avoided by extremely slow dose titration.” 
Medical disclaimer: the information contained in this article is for informational purposes only and is not intended to replace medical advice. Prior to making changes to your lifestyle or treatment plan, always consult with a licenced medical professional. Medical marijuana has been shown to help treat fibromyalgia and improve symptoms of fibromyalgia including pain relief, nausea, quality of life improvements and treat related disorders such as irritable bowel syndrome.
Cannabinoids for fibromyalgia
Fibromyalgia still remains poorly understood by the majority of the medical profession. Some theorize it could be the result of overall central sensitization to pain signaling, a defect in neurotransmitter release, or the obstruction of pathways that the body uses to inhibit pain signaling. It has also been suggested that it could be the result of a dysfunction in the body’s response to stress.  And as we mentioned earlier, it had been proposed by Dr Ethan Russo, that the condition may be due to a deficiency of endocannabinoids, which was proven 12 years later.   A small amount of people could be genetically predisposed to a defective endocannabinoid system, wherein too much anandamide circulates through the body; this might be a key underlying factor.  Ethan Russo, the physician that first theorized the endocannabinoid deficiency hypothesis, when he finally proved his theory, he concluded that after surveying the effectiveness of approved pharmaceutical treatments versus cannabis, “the results strongly favored cannabis over the poorly effective prescription medicines. These results certainly support an urgent need for more definitive randomized controlled trials (RCTs) of a well-formulated and standardized cannabis-based medicine in fibromyalgia, as existing current medicines with regulatory approval seem to fall quite short of the mark.”  For more information on regulating anandamide, see our article on Hemp and Maca.
Can CBD help fibromyalgia?
People have reported success with starting doses of 2 to 4 mg of THC. The dosage protocols can be raised to 7.5 mg of THC over time. By using THC and CBD cannabis medicines in combination, some of the side effects of THC can be mitigated. Cannabidiol (CBD) in doses from 4 to 15 mg of CBD have been reported by some patients to be effective.
Edibles for fibromyalgia
Due to the fact that oral cannabinoids provide long-lasting relief, they are more popular with fibromyalgia sufferers. These can include tinctures, sprays, and edibles. Avoid overmedication, especially for pain, since excessive doses have been shown to increase pain in a University of California study of how cannabis can be utilized to treat pain.  If CBD and THC are utilized in combination, a ratio of 2:1 is a smart starting point, and the initial oral dose should be at the lower range (5 mg/ 2.5mg CBD:THC).
How fast does CBD oil work for fibromyalgia?
CBD oil products can bring immediate relief if vaporized. Vaporized cannabis is a helpful approach for controlling exposure to combustion byproducts that could potentially be pro-inflammatory in a sensitized individual, such as those with fibromyalgia. Other forms of more immediate relief include using herbal CO2 cartridge-based CBD products, smoking (though, remain cautious of the pro-inflammatory nature mentioned above), and sublingually (under the tongue) can provide relief in as little as 15-minutes when administered on an empty stomach.
Best strains for fibromyalgia
Both CBD and THC strains are recommended, and CBD:THC hybrids can be quite effective. The strain Harlequin is typically recommended for its CBD and THC content. Purple wide-leafleted strains such as Purple Kush, and Purps can be of value for their relaxing myrcene content. Myrcene is one of the many terpenes found in the cannabis plant, for more information, see our Ultimate Guide to Terpenes.
For more information, see our other article on CBD for Fibromyalgia
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